26.NOV.2019 4 MIN READ | 4 MIN READ

While having a lump in your breast is certainly concerning, it doesn’t necessarily mean that you have breast cancer. Here are some common causes of breast lumps, and measures you can take to keep yourself in the pink of health.

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 ok.

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:

Fibroadenomas

Breast lump causes
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 make your breast lumpy and tender, and is a cause of nipple discharge (straw to greenish discharge, 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.

Cyclical lumpiness

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 persists 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 amount 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?

Detecting breast cancer
Any breast lump should be managed by a doctor experienced in looking after breast conditions. This is because a lump can look benign but turns 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 is no blood tests clinically proven to have a high level 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 you mammograms and ultrasound followed by a biopsy if necessary.

6. How often should I get a breast examination?

Breast screening
All ladies should self-examine their breasts monthly. For those with menses, the examination should be done seven 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 breast screening annually. Ladies after the age of 50 should have 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

References

Brazier, Yvette (2018, July 12). What are breast lumps. Retrieved on 30 October 2019 from https://www.medicalnewstoday.com/articles/186084.php

John Hopkins Medicine(n.d.). Common benign lumps. Retrieved on 30 October 2019 from https://www.hopkinsmedicine.org/health/conditions-and-diseases/common-benign-lumps

Mayo Clinic (n.d.). Breast lump: Early evaluation is essential. Retrieved on 30 October 2019 from https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/breast-lump/art-20044839

Breast Cancer.org (n.d.). Breast Self-Exam. Retrieved on 30 October 2019 from https://www.breastcancer.org/symptoms/testing/types/self_exam

Gupta, Samier (n.d.). Breast self-exam. Retrieved on 30 October 2019 from https://www.singaporecancersociety.org.sg/get-screened/breast-cancer/breast-self-examination.html

Medical News Today (n.d.). What to know about fibroadenomas of the breast. Retrieved on 30 October 2019. https://www.medicalnewstoday.com/articles/323951.php#about

Healthline (n.d). Fibrocystic breast disease.https://www.healthline.com/health/fibrocystic-breast-disease#when-to-call-your-doctor

Maurer Foundation (n.d).How to do a breast self-exam. Retrieved on 31 October 2019. https://www.maurerfoundation.org/about-breast-cancer-breast-health/how-to-do-a-bse-breast-self-exam/

Web md (n.d) Breast Lumps: Causes and When to Call a Doctor. Retrieved on 31 October 2019. https://www.webmd.com/breast-cancer/benign-breast-lumps#2

Medline Plus (n.d.) Breast lump removal. Retrieved on 1 November 2019. https://medlineplus.gov/ency/article/002918.htm

26.NOV.2019
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Lee Andrew Clayton
General Surgeon
Gleneagles Hospital

Dr Andrew Clayton Lee is a general surgeon and oncoplastic breast surgeon at Gleneagles Hospital, Singapore.