Breast Lump

What is a Breast Lump?

Breast tissue consists of fatty, glandular, and connective tissue. A Breast Lump is an abnormal growth of breast tissue that appears as a protuberance or bulge in the breast. Breast Lumps can be felt on palpation. Some may be firm while some may be mobile when touched. Most of the Breast Lumps are benign (non-cancerous).

Is Breast Lump a Medical emergency?

A Breast Lump is not a medical emergency.

Causes

Breast tissue is present in both males and females. Hormonal changes can cause lumps to form in the breast tissue. Pre-teen girls can develop small Breast Lumps, but these usually go away during puberty. Likewise, adolescent boys can get Breast Lumps during puberty. These types of Breast Lumps are temporary and they disappear on their own within few months.

Other reasons for the formation of Breast Lumps include:

• Breast cysts, such as fluid-filled cysts, or milk cysts
• Fibrocystic breasts
• Fibroadenoma
• Hamartoma
• Intraductal papilloma
• Lipoma
• Mastitis
• Injury
• Breast cancer

Risk factors

Factors that increase the probability of developing Breast Lumps include:

• Not being physically active
• Overweight or obesity
• Advancing age
• Having dense breasts
• Taking hormone supplements
• Previous history of Breast Lumps or breast cancer
• Family history of breast cancer
• Radiation exposure to the breast
• Drinking alcohol

Symptoms & signs

Signs and symptoms of Breast Lumps vary depending on the cause. They include the following:

• Breast tenderness
• Irregular nodules or small lumps
• Dense breast tissue
• A well-rounded, smooth, solid lump. Some may be mobile when touched
• A firm cyst-like appearance, sometimes irregular in shape
• Thickening in the breast
• Puckering or dimpling in the skin of the affected breast
• Rash on the skin of the breast, kind of scaly and red
• Changes in size and shape of the breast
• Nipple turning inward on the affected breast
• The breast and/or nipple may be scaly, red, or swollen
• Nipple discharge either fluid or bloody

Investigations

The following investigation tests are performed for diagnosing Breast Lumps:

• Breast examination is done to rule out any lumps in the breasts, or any previous medical conditions related to breasts.
• A complete medical history is performed that includes past medical history, surgical history, medications, and social history of smoking and another substance abuse is reviewed.
• A mammogram, which is a kind of breast x-ray is performed to rule out breast abnormalities.
• Breast ultrasound and MRI to get detailed images of breast structures.

If Breast Lumps are diagnosed, an additional biopsy of the lump tissue is taken. The collected specimen is sent for laboratory analysis to rule out breast abnormalities. There are several types of breast biopsies, which are:

• Fine-needle aspiration biopsy
• Core needle biopsy
• Vacuum-assisted biopsy
• Stereotactic biopsy
• Surgical biopsy (excisional biopsy)
• Surgical biopsy (incisional biopsy)

Diagnosis

Diagnosis of the Breast Lump is made by reviewing the symptoms and considering the results of the above investigation tests.

Treatment options

Medical treatment

In most cases, Breast Lumps disappear naturally. However, they can be a sign of cancer. Therefore, evaluation is necessary after noticing a Breast Lump. All Breast Lumps will not need treatment. Treatment depends upon the cause of the Breast Lump:

• If there is a breast infection, antibiotics are prescribed.
• If a Breast Lump is a type of cyst, the fluid is aspirated. Most of the cysts go away after they are drained. In a few cases, cysts may disappear on their own without any treatment.
• If a Breast Lump is found to be cancerous, chemotherapy and immunotherapy are provided. Chemotherapy is a drug treatment that is prescribed to destroy cancer cells. It is given in the form of pills or IV. Immunotherapy drugs are used to strengthen the immune system to fight against cancer cells.
• If a Breast Lump is caused due to an injury, the physician may recommend rest and pain medications.
• If a Breast Lump is caused due to fibroadenoma, it can resolve on its own without any treatment.

Interventional treatment including surgery and indications for surgery/ Surgical treatment

For cancerous Breast Lumps the following surgical treatments are performed:

• Lumpectomy: A procedure that is performed to remove the Breast Lump
• Mastectomy: Mastectomy is a surgical procedure performed to remove one or both breasts, either partially or completely

Radiation

If a Breast Lump is found to be cancerous, radiation therapy is provided. Radiation uses high-energy beams of x-rays or protons to destroy cancer cells. This therapy is used in combination with chemotherapy or it can be used after a surgical procedure. Radiation beams are directly focused on the affected area to shrink the tumor.

Role of diet/ Exercise/ Lifestyle changes/ Preventive measures

Certain measures can help to prevent Breast Lumps:

• Limiting or avoiding alcohol intake
• Avoiding tobacco smoking
• Maintaining adequate weight
• Regular exercises and physical activities
• Limiting dosing and duration of hormone therapy
• Avoiding exposure to radiation and environmental pollution
• Consuming foods rich in fiber, such as whole grains, beans, and legumes; soybean-based products; foods rich in vitamin D and other vitamins, fresh fruits, and vegetables.

Non-medical treatment of Breast Lumps includes:

• Apply heat to the affected breast
• Take hot showers
• Massage the affected area
• Wear a supportive bra
• Avoid caffeinated drinks
• Over-the-counter pain medications

Complications

Though most of the Breast Lumps are painless, some may cause pain, swelling, tenderness to touch, and discomfort. Breast Lumps can increase the risk of breast cancer.

Prognosis

The prognosis of Breast Lumps depends upon the type of the lump, whether it is non-cancerous or cancerous. Breast Lumps are common, and most often they are noncancerous and resolve on their own without any specific treatment. Early diagnosis and prompt evaluation of Breast Lumps can give better outcomes.

When to contact the doctor? / How to identify the complications?

As mentioned previously Breast Lumps are noncancerous; however, if the following are noticed it is always advisable to get a medical consultation:

• A lump that is persistent and grows in size
• A lump that is hard and different from the rest of the breast tissue
• Formation of a new lump
• Change in shape of breast size, shape, and appearance
• The breast looks bruised or the skin on the breast looks red
• Any bloody discharge from the nipple or presence of an inverted nipple

Indications for hospitalization

If Breast Lumps are found to be cancerous requiring surgical removal, hospitalization is warranted. Otherwise, treatment for Breast Lumps is provided on an outpatient basis in a physician’s clinic and no hospitalization is required.

Suggested clinical specialists/ Departments to consult for this condition

• General surgery
• Oncology