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Breast Lumps

breast lump

Finding a lump in your breast can cause a lot of anxiety. Most breast lumps, particularly in younger women, are not caused by cancer. They may be benign, non-cancerous lumps, infection or cysts. You should make an appointment with your doctor as soon as possible if you find a breast lump.

The breast is connected to muscles on the wall of your chest. It is made up of fatty tissue. Within the fatty tissue are lobules or milk-forming glands. Milk drains from these glands into breast ducts during breast-feeding. Milk then leaves the ducts through your nipple. The glands and ducts can decrease or increase in number and size. Breast lumps can involve any of these different tissues, or components, that make up your breast.

Common causes of breast lumps

Physiological (normal) swelling and tenderness

This is also known as fibrocystic change or fibroadenosis. Your breasts change throughout your menstrual cycle each month because of your hormones. At least half of all women who have periods will have some pain, tenderness and lumpiness in their breasts at some time in the month. It is more common in women aged 30-50.

Fibroadenoma

This is a benign (non-cancerous) breast lump that usually occurs in women under the age of 40. They occur as a result of excess growth of the glands and connective tissue in the breasts. They usually feel like round, firm, and rubbery lumps. They tend to go after the menopause.

Breast cysts

A cyst is a fluid-filled lump. Cysts are more common in women approaching menopause, although they can occur at any age. They are usually oval or round lumps that are smooth and firm. They tend to move slightly when pressed. It is common for them to appear within two weeks prior to your period and then resolve soon after the period.

Infection

A lump caused by infection is fairly common in women who are breast-feeding. The ducts that carry the breast milk can become blocked. Bacteria, or germs, can enter through cracks in the nipple. This can lead to the development of an abscess in the breast.

Fat necrosis

Injury or trauma to the fatty tissue in your breast can cause a lump. If they persist then they can be removed.

Lipoma

A lipoma is a fatty growth that develops within the fatty tissue of your breast. It is non-cancerous and usually does not need any treatment.

Breast cancer

The vast majority of breast lumps are not caused by breast cancer. However, breast cancers are a cause of lumps in the breasts.
When you see your doctor, they may start by asking you some questions.

Questions may include:

  • When did you notice the lump?
  • Do you have any breast pain?
  • Do you have any nipple discharge?
  • When was your last period (if you still have them)?
  • Are you taking an hormonal medication such as the contraceptive pill or hormone replacement therapy?
  • Have you had breast lumps before?
  • Do you have any history of breast problems in your family?

Breast examination

Your doctor may then suggest that they examine your breasts. You may be asked to remove your top and bra by the doctor. They may want to examine your breasts, with your arms in the air and then by your sides. They may also want to examine your breasts when you are sitting and then lying down. They may also want to examine underneath your arms to feel for any enlarged lymph glands. Your doctor may ask you to point out the lump to them. If you have had any nipple discharge, your doctor may ask you to demonstrate this yourself by asking you to squeeze your nipple.

What happens next?

If you are in your twenties or thirties, are still having periods and have only just noticed the lump, your doctor may suggest that you return for another examination after your next period.

However in cases that seem more serious you will most probably be referred to a surgeon specializing in breast problems. Even if you are referred urgently, you should remember that your lump may still turn out to be benign. The majority of people referred to a breast clinic do not have breast cancer.

What to expect

The breast specialist doctor will examine your breasts in a similar way to what happened when you saw your GP. They may then suggest that you have some further tests. These can include a mammogram and/or an ultrasound scan of your breast.

The breast specialist may also suggest that they take a sample (biopsy) of the lump. There are two common ways of doing this, either by fine needle aspiration or a core biopsy. Sometimes ultrasound scanning is done to guide the procedure.

What is a mammogram?

A mammogram is essentially an X-ray of your breasts. A radiographer will ask you to remove your top and bra. The mammogram is generally done with you standing up. Each breast is compressed between two X-ray plates. This may feel a little uncomfortable but the discomfort should only last for a few minutes. Two images of each breast are taken in different positions.

What is an ultrasound scan of the breast?

An ultrasound scan of the breast uses the same technique as an ultrasound scan that women have when they are pregnant. Again, you will be asked to remove your top and bra. Some gel will be spread on to your breast. The ultrasonographer will then move the scanning probe over the surface of your breast. High-frequency sound waves allow them to produce an image of your breast that they can look at. They should be able to see any lumps in your breast.

What is fine needle aspiration?

Fine needle aspiration cytology (FNAC) is when a small, fine needle with a syringe connected to it is used to take a sample of breast cells from the lump. This sample is then sent to the laboratory and is examined under a microscope. It is usually a quick procedure and may be a little uncomfortable.

It may take three days for the results, or sometimes longer depending on the clinic. The results can show if the lump is cancerous or non-cancerous. Sometimes not enough cells are present in the sample to give a definite answer. In this case you will need further tests.

What is a core biopsy?

For a core biopsy, a larger needle is used to take a sample of tissue from your breast lump. You will usually be given a local anaesthetic to numb the area before the biopsy is taken. More than one biopsy may be taken. The tissue that is taken is sent to the laboratory and is examined under a microscope.

You should also remember that even if your tests do come back as benign (non-cancerous), you should still continue to be vigilant and be breast aware. You should regularly check your breasts for anything that is not normal for you.

Breast cancer screening

If you are between 50 and 70 years old, you will be called for regular breast cancer screening using mammography. You should continue to attend this. You will automatically be sent an appointment for a mammogram every three years.


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