1. I’ve a lump in my breast? Is it a sign of breast cancer?
First of all, you shouldn’t panic. It is common to have breast lumps. Most of them are benign (non-cancerous). Unfortunately, the most common sign of breast cancer is a painless lump.
What you need to do is to have it checked by a doctor and have some tests done to make sure that the lump is okay.
While breast cancer can’t be ruled out, you certainly shouldn’t panic. Most of the time, breast lumps are benign (non-cancerous) and are symptoms of a less serious problem. Be sure to arrange an appointment with your doctor to diagnose the issue.
2. Besides cancer, what are some common causes of breast lumps and related treatment options?
There’re actually many causes of breast lumps. Some common ones come from the skin (sebaceous cysts) and fatty tissue surrounding the breast (lipomas), which can be left alone or removed depending on your preference. The common lumps that come from the breast itself include:
These are usually found in ladies between the ages of 20 – 30. They are usually small 1 – 2cm, smooth in their contour and very mobile. They arise from the milk glands where there is a benign overgrowth of tissue. For older ladies or larger lumps, we need to make sure that it is not a phyllodes tumour, which is a “cousin condition”.
Treatment options: Fibroadenomas can be safely left alone but occasionally your doctor may recommend it to be removed. Phyllodes tumour needs to be removed.
Breast cysts and fibrocystic changes
Breast cysts (fluid-filled lumps) are very common in ladies in their 30 – 50’s. During this time, the breast tissue undergoes a process of involution (breast tissue starting to shrink). The milk glands can turn into cysts and the surrounding breast tissue becomes more fibrous, and hence the term fibrocystic changes. It is not a disease as it does not cause ill-health and does not increase your risk of breast cancer significantly. It can however, make your breast lumpy and tender, and is a cause of nipple discharge (straw to greenish discharge with no blood). Occasionally, cysts can get infected.
Treatment options: Cysts are usually left alone. If they are large or painful, it can be drained using a small needle and syringe with local anaesthetics.
Ladies’ breasts are sensitive to the hormonal changes that drive the menstrual cycle. One of the hormones called progesterone causes the breast to be lumpy and tender. Sometimes the lumpiness can be so prominent that a lump can be felt when all there is are normal breast tissue. This lumpiness occurs usually 7 days before and after the menses. It can persist occasionally.
Treatment options: This lumpiness will settle over time, but it is important that a lady is checked to make sure that she does not have any lumps.
3. I’m a guy. Can I get breast lumps?
Yes, men have small amounts of breast tissue behind the nipples. These can develop over time (a condition called gynaecomastia) usually due to a combination of causes.
4. Are there ways to tell if a breast lump is cancerous?
Any breast lump should be managed by a doctor experienced in looking after breast conditions. This is because a lump can look benign but turn out to be cancerous. To minimise this risk of missing a breast cancer, the doctor will perform “triple assessment”, which consists of clinical assessment (history taking and physical examination), radiological assessment (mammograms and ultrasound as appropriate) and if necessary, pathological assessment (a biopsy). To date, there are no blood tests clinically proven to have high levels of accuracy to detect breast cancer.
5. What can I expect during a breast doctor appointment?
Your doctor will enquire into your symptoms and risk factors. During breast examination, you will be requested to remove your top and bra. There should be a chaperone. You will lie down with your hands behind your neck. Your doctor will examine your breasts and armpit, and may also do a bedside ultrasound scan. Depending on the findings, your doctor may arrange for mammograms and ultrasounds, followed by a biopsy if necessary.
6. How often should I get a breast examination?
All ladies should self-examine their breasts monthly. For those with menses, the examination should be done 7 days after the start of the menses. For those without menses, any day of the month is good.
Ladies between the ages of 40 – 50 should consider going for a breast screening annually. Ladies after the age of 50 should go for a breast screening every 2 years.
7. What surgery options are available?
For benign lumps, some can be safely left alone in the breast, and removal is optional. There are some benign lumps, such as phyllodes tumour, that will require removal. As for breast cancer, there is a wide range of options available, which aim to get rid of the cancer and also to restore cosmesis. The key is to catch any lumps early when they are small by monthly self-breast examination and by attending routine breast screening.
If you have signs and symptoms that you are unsure about, speak to your doctor. You may also find out more about breast cancer screening by speaking with one of our specialists today.
If you’re worried about the cost of surgery, Gleneagles Hospital offers price guarantee for your breast lumps removal surgery so you can budget for the procedure without any bill shock afterwards. This will give you the peace of mind you need to go ahead without any unwanted surprise fees. Learn more about Price Guarantee Procedures.
The improvement on your quality of life can be dramatic, so it’s important to prioritise treatment if you need it.
Article reviewed by Dr Andrew Clayton, general surgeon at Gleneagles Hospital
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