Discover the possible causes and treatment options for painful lumps in the breast. Learn about the signs and symptoms that warrant a visit to the doctor

Breast Lump

Overview

A breast lump is an abnormal mass or swelling that can be felt or seen within the breast tissue. 
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A breast lump is a term used to describe a growth or swelling in the breast tissue that feels different from the surrounding breast tissue. Breast lumps can vary in size, texture, and location, and they are a common occurrence in women of all ages. While most breast lumps are benign, meaning they are not cancerous, some require further evaluation and treatment. 
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A breast lump is the commonest presentation of breast cancer in Pakistan. According to a small-scale study, almost 24.06% of the patients present with a malignant (cancerous) breast lump, while 75.94% were benign (non-cancerous)<a href="#accordion">[1]</a>.

In men, too, gynecomastia may result in the formation of a lump beneath the nipple, usually affecting both breasts. 
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There are different types of breast lumps, which can be broadly categorized into two groups<a href="#accordion">[2]</a>: 
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<h5>Cancerous Breast Lumps:</h5>

Breast cancer is a malignant condition that can begin in different parts of the breast tissue, such as the ducts, lobules, or other tissues. The most common types of breast cancer are invasive ductal carcinoma and invasive lobular carcinoma. Other less common types of breast cancer include inflammatory breast cancer, Paget&#39;s disease of the breast, and others. 
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<h5>Non-Cancerous Breast Lumps:</h5>

Non-cancerous breast lumps can be caused by different conditions, including breast cysts, fibroadenoma, intraductal papilloma, fat necrosis, and others. Although these lumps are not cancerous, they can still cause discomfort and need to be evaluated by a medical professional. 
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<ul>
	<li>Cyst: A breast cyst is a fluid-filled sac that can develop in the breast tissue. They can be round or oval in shape and may be soft or firm to the touch. This condition mostly affects women aged 30-50 years. The lump changes in size with the menstrual cycle and is uncommon after menopause. Also, it can be painful or tender.</li>
	<li>Abscess: This is a collection of pus that can develop in the breast tissue, usually as a result of a bacterial infection. Symptoms include a painful lump in the breast along with fever, redness, and warmth in the affected area.</li>
	<li>Fibroadenoma: This is a non-cancerous tumor that can develop in the breast tissue. They are usually round or oval in shape and may be firm or rubbery to the touch. It is most prevalent in females aged 14-35, though it can occur at any age. Symptoms include a painless lump in the breast that changes in size or tenderness with the menstrual cycle.</li>
	<li>Intraductal Papilloma: These are small, wart-like growths that can develop in the milk ducts of the breast. They are usually benign, but in rare cases, they can be cancerous. Symptoms include a painless lump in the breast and nipple discharge that may be clear or bloody.</li>
	<li>Fat Necrosis: This is a benign condition that occurs when there is damage to the fatty tissue in the breast. Symptoms include a lump that is firm or hard to the touch, and changes in the skin over the lump, such as dimpling or puckering.</li>
	<li>Lipoma: This is a benign tumor that develops from fat cells in the breast tissue. They are usually painless and may feel soft or rubbery to the touch. 
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</ul>
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Signs and Symptoms

The signs and symptoms of breast lumps vary depending on the underlying cause. They include: 
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<ul>
	<li>A firm, round, and smooth breast lump</li>
	<li>A hard, irregular-shaped breast lump</li>
	<li>A large, solid lump that moves under the skin</li>
	<li>Lump changes or grows bigger</li>
	<li>Breast pain or tenderness</li>
	<li>Swelling, redness, or warmth in the breast</li>
	<li>Nipple discharge (not breast milk)</li>
	<li>Skin changes, such as dimpling and redness</li>
	<li>Lump does not go away after menstruation 
	&nbsp;</li>
</ul>

Note: If you discover a new lump in the breast or even in the armpit, get it evaluated by a healthcare professional immediately. 
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Causes

There are several possible causes of a breast lump, including: 
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Fibrocystic Breast Changes: Fibrocystic breast changes refer to benign changes in breast tissue that can cause breast pain or discomfort.

Breast Cysts: Breast cysts are fluid-filled sacs that can develop within the breast and may cause breast lumps or tenderness.

Breast Cancer: In some cases, fibrocystic breast changes may be associated with an increased risk of developing breast cancer.

Infections Or Inflammation: Infections or inflammation of the breast, such as mastitis, can cause breast pain, redness, and swelling.

Trauma Or Injury: Trauma or injury to the breast can result in breast pain, bruising, or changes in breast shape.

Lipoma: A lipoma is a benign fatty tumor that can develop in breast tissue and may cause a palpable lump.

Galactocele (usually during lactation): Galactocele is a milk-filled cyst that can occur during lactation and may cause a breast lump or discomfort.

Mastitis: Mastitis is an infection of the breast tissue that typically occurs during breastfeeding and causes breast pain, swelling, and redness.

Phyllodes Tumor: Phyllodes tumors are rare tumors that develop in the connective tissue of the breast and may present as a breast lump or mass. 
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Breast cancer screening involves a range of tests and exams to detect any signs of breast cancer, including breast lumps. Early detection of breast cancer through screening can improve treatment outcomes and survival rates. 
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<h5>Clinical Breast Exam </h5>

A physical exam is an important tool in the screening of breast lumps. Here are some key steps that a healthcare provider may follow during a physical exam:

<ol>
	<li>Visual Inspection: The healthcare provider visually inspects the breast and surrounding areas for any visible changes, such as skin dimpling, redness, or changes in the size or shape of the breast.</li>
	<li>Palpation: The healthcare provider feels the breast tissue to detect any lumps or abnormalities. They may use different levels of pressure and different hand positions to thoroughly examine the breast tissue.</li>
	<li>Lymph Node Examination: The healthcare provider examines the lymph nodes under the arms and around the collarbone to check for any swelling or tenderness.</li>
	<li>Documentation: The healthcare provider documents any findings, including the size, shape, texture, and location of any lumps or abnormalities. 
	&nbsp;</li>
</ol>

<h5>Mammogram</h5>

A mammogram is an X-ray of the breast that can detect any abnormalities, including lumps or masses that cannot be felt during a breast exam. 
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Diagnosis

The healthcare provider order additional tests based on the results of the initial examination: 
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Breast MRI: An imaging scan that utilizes magnetic fields to generate detailed images of the breast.

Needle Aspiration: A procedure in which a needle is used to extract a cell sample for examination.

Ultrasound: An ultrasound uses high-frequency sound waves to create images of breast tissue. It can help determine if a lump is a fluid-filled cyst or a solid mass.

Biopsy: A method of collecting a larger tissue sample for laboratory analysis. It can be done in various ways. For instance, during a core biopsy, radiologists use a larger needle to extract a tissue sample, whereas, during an excisional biopsy, the entire breast lump is removed by surgeons. A biopsy helps determine if a lump is cancerous or noncancerous. 
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Treatment

The treatment of breast lumps depends on the underlying cause. If the lump is a non-cancerous cyst, it may not require any treatment. However, if the lump is cancerous, treatment options may include: 
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Surgery: The most common treatment for breast cancer is surgery. The type of surgery mainly depends on the size and location of the tumor among other factors. For instance, a patient can be treated by lumpectomy or removal of the tumor and some surrounding tissue, while another may require mastectomy or removal of the entire breast.

Radiation Therapy: Radiation therapy may be used after surgery to kill any remaining cancer cells. It may also be used as the primary treatment for smaller tumors.

Chemotherapy: Chemotherapy is a treatment that uses drugs to kill cancer cells. It is often used after surgery to kill any remaining cancer cells or to shrink the tumor before surgery.

Hormone Therapy: Hormone therapy is used to block the effects of estrogen or progesterone, which can stimulate the growth of certain types of breast cancer. 
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The complications of a breast lump depend on the underlying cause of the lump.

Some benign breast lumps can grow larger or become tender or infected.

If the lump is malignant, the complications can be much more severe. Breast cancer can spread to other parts of the body if not treated early, leading to a decreased quality of life and potentially fatal outcomes.

In some cases, the treatment of breast lumps can also result in complications. For example, surgery may lead to scarring, infection, or nerve damage. Radiation therapy may cause skin irritation or fatigue. Chemotherapy can cause a range of side effects, including hair loss, nausea, and an increased risk of infection. 
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There are several risk factors associated with the development of breast lumps, including: 
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Family History: Women who have a first-degree relative (mother, sister, or daughter) with a history of breast cancer have a higher risk of developing breast lumps themselves.

Genetic Mutations: Certain genetic mutations, such as those in the BRCA1 and BRCA2 genes, increase the risk of breast lumps.

Hormonal Factors: Changes in hormonal levels, such as those that occur during menstrual cycles, pregnancy, and <a href="https://merisehat.pk/disease/menopause">menopause</a>, can contribute to the development of breast lumps.

Previous Breast Cancer: Women who have previously had breast cancer are at an increased risk of developing new breast lumps.

Radiation Exposure: Women who have received radiation therapy to the chest area for other medical conditions are at an increased risk of developing breast lumps. 
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There are several steps women can take to reduce their risk of developing breast lumps or to catch them early when they occur: 
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Breast Self-exams: Women should perform breast self-exams regularly to check for any lumps or changes in the breast tissue.

Clinical Breast Exams: Women should receive a clinical breast exam from a healthcare provider at least once a year.

Healthy Lifestyle: Maintain a healthy lifestyle by eating a nutritious diet, exercising regularly, and limiting alcohol intake.

Regular Medical Check-ups: Women should attend regular medical check-ups and report any changes in their breasts to their healthcare provider immediately.

Genetic Counseling And Testing: Women with a family history of breast cancer or genetic mutations can consider genetic counseling and testing to determine their risk of developing breast lumps or cancer. 
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Key Points

<ul>
	<li>A breast lump is a term used to describe a growth or swelling in the breast tissue that feels different from the surrounding breast tissue.</li>
	<li>Most breast lumps are not cancerous, but it&#39;s important to get them checked by a doctor to rule out any serious conditions.</li>
	<li>Breast lumps can occur in both women and men, although they are more common in women.</li>
	<li>Breast lumps can occur due to various causes, including hormonal changes, cysts, fibroadenomas, and breast cancer.</li>
	<li>The most common type of breast lump is a benign fibroadenoma, which is a non-cancerous tumor made up of glandular and connective tissue.</li>
	<li>Treatment for a breast lump depends on the underlying cause. Benign lumps may not require any treatment, while cancerous lumps may require surgery, chemotherapy, radiation, or a combination of treatments.</li>
	<li>Regular breast self-examination and clinical breast examinations can help with the early detection of breast lumps. 
	&nbsp;</li>
</ul>