Found a Breast Lump: Common Causes, What the Exam Involves and When to Be Seen

What it involves

MedlinePlus defines a breast lump as a swelling, growth or mass in the breast, and notes that lumps in both men and women raise concern for breast cancer even though most are not cancerous. Breast tissue responds to hormone changes, so lumps can come and go.

Who this is for

• Women who feel a new lump or thickening during a self-exam or in the shower
• Men and women with nipple discharge, a nipple that has turned inward or skin that looks dimpled
• Women age 40 or older who have not had a mammogram in the past year and want advice about screening
• Anyone with breast bruising that has no injury behind it

What to expect

• Questions about when you noticed the lump, where it is, and whether you have pain, discharge, fever or an injury
• A thorough breast exam, and a lesson in self-exam if you would like one
• A review of risk factors, medicines, hormones and supplements
• A mammogram, ultrasound or biopsy arranged by referral when the exam calls for it

Most lumps are not cancer, but each one needs a look

MedlinePlus says breast lumps raise concern even though most are not cancerous, and it advises seeing your provider for any new lump or breast change. Only an exam and, when needed, imaging or a biopsy can tell the difference. A lump that feels different from last month, or one that stays after your period, is worth mentioning at the visit. Waiting to see what happens is not how the encyclopedia advises handling a new lump.

Common causes in women

The encyclopedia says lumps in a woman are most often fibroadenomas, cysts or normal variations in breast tissue known as fibrocystic changes. Fibroadenomas are noncancerous, rubbery lumps that move easily and are usually not tender. Cysts are fluid-filled sacs that often feel like soft grapes and can be tender before a period. Fibrocystic changes are painful, lumpy breasts, usually worse right before a period, and they do not raise the risk of breast cancer. Other causes include an injury, a collection of fatty tissue, milk cysts and a breast abscess. Another change in women's health that deserves a visit is bleeding between periods or very heavy periods, which the abnormal uterine bleeding guide covers.

Lumps at other ages

Breast lumps can appear at any age. MedlinePlus notes that newborns of both sexes may have lumps from their mother's estrogen that go away on their own, that girls develop tender breast buds before puberty, and that teenage boys may develop breast enlargement and lumps from hormone changes that almost always go away over a period of months. Lumps in adult men raise the same concern as lumps in women, and a new one deserves the same visit.

Changes that should prompt a call

Contact a provider, MedlinePlus says, if the skin on the breast looks dimpled or wrinkled like the peel of an orange, if you find a new lump, if you have bruising without an injury, if you have nipple discharge that is bloody, clear like water or pinkish, or if a nipple turns inward when it normally does not. The health topic page also lists a lump or firm feeling under the arm, and the swollen lymph nodes guide describes how a provider looks at swollen glands in the armpit.

What happens at the visit

MedlinePlus says your provider will take a complete history, including factors that may raise breast cancer risk, and then do a thorough breast exam. Questions often include when and how you first noticed the lump, where it is, whether you have pain, discharge or fever, whether it is a recent change, whether you have had a breast injury and what hormones, medicines or supplements you take. Serenity By A Dr. Sareen does not list mammography or breast ultrasound among its in-office services, so imaging is arranged by referral.

Imaging, needles and next steps

The encyclopedia lists a mammogram to look for cancer, a breast ultrasound to see whether a lump is solid or a cyst, drawing fluid from a cyst with a needle, and a needle biopsy as the steps a provider may take. Solid lumps are usually biopsied with a needle, and cysts can be drained, after which no further treatment is needed if the lump disappears. Breast infections are treated with antibiotics, and an abscess is drained. If breast cancer is found, the options are discussed carefully with your provider.

Sources

• MedlinePlus: Breast lump (medical encyclopedia)
• MedlinePlus: Breast Diseases (health topic)