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Breast lump
Breast lump Content Supplied by NHS Choices
Introduction

Breast lumps are a common condition and have a number of different causes. While most lumps are not breast cancer, any unusual changes to the breasts should be checked by a GP as soon as possible.

There are several types of benign breast lump. They can vary in appearance or texture depending on the type. Most breast lumps are caused by hormonal changes that occur at different times in a woman's life, such as during the menstrual cycle when a woman gets her monthly period.

Some of the most common benign breast lumps include:

  • a breast cyst - a fluid filled lump most common in pre-menopausal women and those who take hormone replacement therapy
  • a fibroadenoma - a benign firm lump in the breast more common in young women, such as those in their twenties

Read more information about the causes of a breast lump.

When to see your GP

It is important you see your GP as soon as possible if you notice changes to your breasts. Finding a lump in your breast can be a worry but most breast lumps are non- cancerous (benign) and will not require treatment. 

Read about the signs and symptoms of a breast lump for more information.

It is also important to be 'breast aware' to help you notice any changes and get them checked as soon as possible.

Read about preventing breast lumps for information on being breast aware and breast screening.

Who is affected?

Breast lumps are quite common. Every year in the UK, about 3 in every 100 women visit their GP regarding a problem with their breasts. Most breast lumps, about 9 out of 10, are non-cancerous (benign).

Treating a breast lump

If your breasts are painful, medication can help ease the pain. If there is fluid in some types of lump, such as a cyst or abscess, it may need draining.

In some cases, surgery may be required to remove a large lump. However, this is not usually necessary unless the lump is large, growing or causing other symptoms.

Read more information about treating a breast lump.

Symptoms of a breast lump

Depending on the underlying cause, the way breast lumps look or feel can vary. Some breast lumps may also cause other symptoms.

When to see your GP

You should see your GP if you notice any changes to your breasts such as:

  • a lump or area of thickened tissue in either breast
  • discharge from either of your nipples (which may be streaked with blood)
  • a lump or swelling in either of your armpits
  • a change in the size or shape of one or both of your breasts
  • dimpling on the skin of your breasts
  • a rash on or around your nipple
  • a change in your nipple's appearance, for example, if it becomes sunken into your breast
  • pain in either of your breasts or armpits that is not related to your period

Is a breast lump serious?

While you should always see your GP about any changes to your breasts, benign (non-cancerous) breast lumps:

  • do not increase your risk of developing breast cancer in the future
  • will not turn into breast cancer

Some breast lumps, such as breast abscesses (infected collection of fluid or pus), can be painful and others, such as fibroadenomas, may feel quite large. However, most breast lumps do not require any treatment.

Types of breast lumps

Common types of breast lumps include:

  • fibroadenosis
  • fibroadenoma
  • breast cysts
  • breast abscesses
  • fat necrosis (caused by damage to fatty tissue in the breast)

These types of breast lumps and their symptoms are explained below.

Fibroadenosis

Fibrocystic breast disease, also known as fibroadenosis, is a term used to describe a group of benign (non-cancerous) conditions that affect the breast. The symptoms of fibroadenosis include:

  • breast pain (mastalgia)
  • breast enlargement
  • lumpiness of the breast (nodularity), particularly just before or during a period

Fibroadenosis can develop in one or both breasts, or can affect just part of one breast. The symptoms can also vary significantly between women, with some women finding them slightly annoying and others finding them very painful. The pain and lumpiness will usually disappear after your period.

The cause of fibroadenosis is not well understood. However, it may be the result of the breast tissue responding abnormally to hormonal changes that occur with the menstrual cycle. 

Fibroadenoma

A fibroadenoma is a smooth, well-rounded solid lump that sometimes develops outside the milk ducts. Milk ducts are the tiny tubes in the breast that carry milk.

Fibroadenomas are made up of fibrous and glandular tissue, which has a rubber-like texture and moves easily when touched.

A fibroadenoma will sometimes disappear, but it can remain and grow larger, particularly during pregnancy.

Breast cyst

A breast cyst is a fluid-filled sac that develops within the breast tissue and may feel like a soft grape. Breast cysts are common and normal. Cysts form as a natural part of the ageing of breast tissue and are most commonly found in women aged 35-50 years.

Cysts vary in size. Some can be tiny, while others can grow to several centimetres in diameter. Single or multiple cysts can occur in one or both breasts.

Cysts often do not cause any symptoms, although some women may experience pain, particularly if the cyst increases in size during the menstrual cycle. They do not significantly increase the risk of breast cancer developing.

Breast abscesses

A breast abscess is a painful collection of pus that forms under the skin of the breast. It can also cause:

  • a high temperature (fever) of 38°C (100.4°F) or above
  • inflammation (redness and swelling)

Read more information about a breast abscess.

Causes of breast lumps

A benign (non-cancerous) breast lump and breast pain can be caused by several different conditions.

These include the following:

  • a cyst (fluid-filled lump) - most common in pre-menopausal women and those who take hormone replacement therapy
  • a fibroadenoma - a small lump in the breast more common in young women, such as those in their twenties
  • mastitis (inflammation of the breast) - this can be either breastfeeding mastitis or non-breastfeeding mastitis
  • nipple discharge (galactorrhoea)
  • dilated milk ducts - milk ducts are the tiny tubes in your breast that carry milk
  • trauma to the breast due to injury
  • scarring of the breast from past surgical procedures
  • fibrocystic breast disease (fibroadenosis) - a benign growth in the breast that causes lumpiness and tenderness, most common in pre-menopausal women (women who are still having periods)
  • fat necrosis - a hard, irregular lump often caused by trauma or bruising to the breast, for example, following breast-reduction surgery
  • lipoma - a benign fatty growth that causes a lump
  • breast abscess - a painful collection of pus under the skin
  • an intraductal papilloma - a benign growth in a milk duct, which may also cause nipple discharge
  • a haematoma (blood clot)

Breast pain can also sometimes be caused by your menstrual cycle. This is known as cyclical breast pain. Breast pain not associated with your menstrual cycle is sometimes referred to as non-cyclical breast pain.

Read more information about how a breast lump is diagnosed.

Hormones

Hormonal changes are the most common cause of benign breast lumps. Hormones are chemicals produced by the body and have a wide range of effects. Sometimes changes in the levels of hormones in your body can cause your breasts to feel lumpy or swollen.

Hormonal changes can occur:

  • in teenagers
  • during the monthly menstrual cycle
  • during the menopause, which is when a woman's periods stop
  • if you take the oral contraceptive pill, which contains artificial versions of female hormones
  • if you take HRT, which is treatment to replace female hormones a woman's body is no longer producing because of the menopause
Diagnosing a breast lump

It is important to be aware of how your breasts usually look and feel so you can quickly pick up on any changes that may occur.

See your GP if you notice a lump in your breast or any change in its appearance, feel or shape. Your GP may ask a number of questions, including:

  • when you first noticed the lump
  • whether you have other symptoms, such as pain or a discharge from your nipple
  • whether your symptoms change with your menstrual cycle
  • whether you have ever injured your breast
  • whether you have any risk factors for breast cancer, such as a close family member who has previously had breast cancer  
  • what medications you are currently taking
  • whether you are currently breastfeeding or whether you have done so in the past

Your GP will carry out a physical examination of both your breasts, including the lump, and may refer you for further tests. Some tests you may have are explained below.

Mammogram

A mammogram is a simple procedure that uses X-rays to create an image of the inside of your breasts.

A mammogram can help identify early changes in your breast tissue. Younger women usually have denser breasts than older women, which makes changes more difficult to identify. Therefore, mammograms are not as effective in women under 35 years of age. If you are under 35, your GP may suggest you have a breast ultrasound instead (see below).

If you need to have a mammogram, a radiographer (an X-ray specialist) will position one of your breasts on a flat X-ray plate. A second X-ray plate will press down on your breast from above, so that it is temporarily flattened between the two plates. An X-ray will then be taken, which will produce a clear image of the inside of your breast.

After the first X-ray has been taken, the same procedure will be carried out on your other breast.

A mammogram only takes a few minutes to carry out. You may find it a bit uncomfortable or even slightly painful. After the procedure is complete, the mammogram (the image of your breast) will be examined for anything unusual.

Ultrasound

If you are under 35 years of age, a breast ultrasound may be recommended because your breast tissue may be too dense for a mammogram. However, women over 35 will often have a mammogram and breast ultrasound to investigate a breast lump.

Your doctor may also suggest you have a breast ultrasound if they need to know whether a lump in your breast is solid or contains liquid.

Ultrasound uses high-frequency sound waves to produce an image of the inside of your breasts. An ultrasound probe or sensor will be placed over your breasts to create an image on a television screen. The image will highlight any lumps or abnormalities that may be present in your breasts.

Read about ultrasound scans for more information about this procedure. 

Biopsy

You may need a breast biopsy if the cause of your breast lump cannot be diagnosed using a mammogram or ultrasound. A biopsy is a procedure that involves removing a tissue sample from the lump for further testing. 

A core needle biopsy (CNB) is often used to get the tissue sample. Sometimes a fine-needle aspiration (FNA) biopsy may be used to get the tissue sample, or to drain a cyst.

To obtain the sample, a special, hollow needle is inserted through your skin and into the area being examined. Ultrasound or X-rays will be used to help the doctor or surgeon guide the needle to exactly the right place.

When the needle is in position, it will 'suck out' a sample of tissue. If you have a needle biopsy, a local anaesthetic will usually be used to numb the area so that you won't feel pain or discomfort.

Read more information about a biopsy.

Treating a breast lump

In most cases, a benign (non-cancerous) breast lump does not need any treatment unless the lump is particularly large or painful.

After diagnosing the cause, your GP will advise you about treatment that is necessary. If treatment is not necessary, you may be asked to return if you notice  further changes to your breasts.  

Breast pain

You should visit your GP as soon as possible if you experience breast pain. They will be able to carry out a physical examination and, if necessary, refer you for further tests.

Read about cyclical breast pain for more information about treating breast pain related to your menstrual cycle.

If your breast pain is not related to your menstrual cycle, you can ease the pain by:

When using painkillers always check the instructions on the packet or the patient information leaflet to make sure the medication is suitable for you and to find the correct dose.

Danazol

Danazol is a medication that can be used to treat  pain associated with benign fibrocystic breast disease (fibroadenosis).

Danazol is only available on prescription and usually comes as a capsule to be swallowed. It is not suitable for pregnant or breastfeeding women and can cause some side effects such as:

  • feeling sick
  • weight gain

For a full list of side effects or more information about this medicine, see the patient information leaflet that comes with it or our Danazol medicines information.

Other treatments

Some experts have suggested that breast pain may be improved by reducing your intake of:

  • caffeine, found in tea, coffee and cola
  • saturated fat, found in butter, crisps and fried food

However, the benefits of making these dietary changes have not been proven.

Surgery

If your lump is large, growing or is causing other symptoms, you may need surgery to remove it. For example, you may need surgery if you have:

  • Fat necrosis, which causes a hard irregular lump that may be removed if it continues to get bigger.
  • Intraductal papilloma, which is a benign growth in a milk duct (the tube that carries milk). The affected ducts may be removed if they continue to cause nipple discharge or inflammation.

Fibroadenomas

Some women decide to have a fibroadenoma  surgically removed, particularly if it is large. The surgical procedure to remove a lump in your breast is called a lumpectomy and may be carried out under general anaesthetic, painkilling medication that makes you unconscious.

An alternative method to remove a fibroadenoma is to destroy it with a laser (a high-energy light beam). The procedure is carried out under local anaesthetic, which means you will be awake. The laser is inside a fibre which is inserted through a needle and positioned inside the lump. Waves of light are then passed through the fibre to destroy the lump.

The safety and effectiveness of using lasers to treat breast lumps is still uncertain, and one study reported that most women found it painful. The National Institute for Health and Clinical Excellence (NICE) has stated that laser therapy for fibroadenomas should only be carried out within specialist breast services and with proper monitoring. 

Breast cysts

A small needle and syringe is sometimes used to draw out the fluid from breast cysts. This is called aspiration. After the cyst has been drained the lump usually disappears. The fluid may be sent to the laboratory for examination under the microscope if it is bloodstained or an ultrasound scan shows a solid area in the cyst.

Sometimes, breast cysts that have been drained can refill, or you may develop a new cyst somewhere else. You should always visit your GP if you notice any changes to your breasts, such as a cyst refilling. The cyst can be drained again, but if it keeps refilling you may need surgery to remove it. 

Breast abscesses

A breast abscess is a painful collection of pus that can be treated by draining out the pus. This is usually done by removing pus with a needle under ultrasound guidance in the breast X-ray department of a hospital.

In rare cases, a small incision (cut) is made into the abscess to drain the pus. This is performed under local or general anaesthetic in hospital.

Read more information about treating a breast abscess.

Preventing breast lumps

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Most breast lumps cannot be prevented because they are caused by hormonal changes that you have no control over. However, it is important you identify a breast lump as soon as it develops and get it checked by your GP to rule out breast cancer.

Be breast aware

The Department of Health recommends women should be 'breast aware' and encourages them to check their breasts regularly.

Breast aware means being familiar with your breasts and what is normal for them. This is so you can recognise any signs or symptoms, such as a lump, easily and quickly. The advice below may help you become 'breast aware'.

  • You can feel your breasts while lying down in bed or in the bath or shower using a soapy hand. Using body lotion can help. It is important to feel the whole breast, including the armpit.
  • You can look at your breasts in the mirror. Move your arms above your head, onto your hips or by your sides so you can see your breasts from every angle, including the underside.
  • As older women are at greater risk of developing breast cancer, it is very important to be aware of any unusual changes after the menopause (when your periods stop).
  • Breasts may change with age and life events, such as pregnancy, breastfeeding, during your periods and after the menopause. This is why it is important to know what is normal for you so you will recognise any changes.

See breast cancer key messages for more information about the signs and symptoms of breast cancer and how to be breast aware. If you notice a lump on your breast have it checked by your GP as soon as possible.

Screening

Regular breast screening is also important because it will help detect any small changes before you have other signs or symptoms. Screening is a way of identifying people who may have an increased risk of developing a certain condition.

For breast cancer, screening is carried out using mammograms. This is a procedure that uses X-rays to produce an image of the inside of your breasts.

Read about diagnosing breast lumps for more information about mammograms.

The NHS Breast Screening Programme provides free breast screening every three years for all women in the UK who are 50 years of age or over.

The programme is now phasing in an extension of the age range of women eligible for breast screening to those aged 47 to 73. This started in 2010 and is expected to be complete by 2016. 

NHS breast screening is not usually available for younger women (those under 35 years of age) because mammograms are not as effective for this age group. Breast cancer also tends to be uncommon in young women.

You should speak to your GP if you are below the screening age and are concerned about changes in your breasts or have a family history of breast cancer. However, most breast units also have a family history surveillance service for patients at high risk of developing breast cancer due to their family history.

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The information in the Map has been approved by the UK's leading clinical experts, is based on the best available clinical evidence, and is continually updated. To take advantage of this unique resource go to:

Map of Medicine: breast disease

 
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