Breast lumps: Symptoms, treatment and prevention
Though most breast lumps turn out to be non-cancerous, it's imperative that you have every lump and any other changes in breast tissue checked out by your doctor. Whether you detect a lump during your monthly breast self exam (BSE) or your healthcare provider finds one during a clinical breast exam or mammogram, here is what you need to know about breast lumps.
Breast lumps require attention
Changes in the breast can be caused by benign factors or cancer, and some benign changes actually can increase your risk of breast cancer. Even though most breast lumps turn out to be non-malignant, some don't -- and all breast lumps require medical follow-up.
"When I found the small lump in my right breast, I was told not to worry because it was common for women to have lumpy breasts," recalls Audrey Graves, a Nebraska wife and mom who was diagnosed with cancer at age 29. "Even my doctor told me not to worry because he felt there was a 99 percent chance the lump was nothing." A biopsy confirmed that the lump was indeed breast cancer.
Types of breast lumps
According to the American Cancer Society, the most common causes of breast lumps are benign and may be due to infection, monthly or age-related hormone changes, birth control pills, cysts and fibrocystic changes.
Types of benign breast lumps include:
- fibroadenoma -- a benign solid tumor
- atypical hyperplasia -- fast-growing abnormal cells
- adenosis -- due to enlarged breast lobules
- cysts -- benign, fluid-filled sacs
- duct ectasia – occurs when a breast duct becomes blocked and fluid builds up
- mastitis – breast infection mostly in breastfeeding women that leads to an abcess
- phyllodes tumors – rare tumors with an overgrowth of connective tissue
- intraductal papillomas – wart-like growths of gland tissue, blood vessels and fibrous tissues in the breast duct
- fat necrosis – cysts due to scarring
- lipomas – fatty tumors that can appear anywhere on the body
Other breast lumps may be due to changes in the breast leading to breast cancer.
Treatment of benign breast lumps
When a breast lump is detected, follow-up screening is required to determine the cause. A mammogram, biopsy, ultrasound or other testing will be done to rule out breast cancer and plan an appropriate treatment of benign or cancer-related lumps. Treatment depends on the type of lump.
Typically, fibrocystic breast changes do not require clinical treatment. Fine-needle aspiration removes the fluid and is often done as part of a cyst biopsy. Fibroadenomas and intraductal papillomas can be removed surgically. Breast lumps due to mastitis usually go away after treatment with hot compresses, warm showers and antibiotics.
Treatment of breast lumps related to breast cancer
When a breast lump is determined to be breast cancer, a number of treatment options are available, depending on the type of cancer, location, stage of severity, general health and age. Breast cancer is usually treated surgically and then followed up by radiation, chemotherapy or hormone therapy.
Treatment typically includes one or several protocols:
- Surgery can include mastectomy (removal of the entire breast and lymph nodes under the arm) or lumpectomy (removal of the lump and lymph nodes under the arm).
- Chemotherapy is often given after surgery to reduce the chance of recurrence or before surgery if a breast tumor is large or the cancer has spread to other parts of the body.
- Radiation is usually given after a lumpectomy to help reduce the risk of recurrence.
- Hormone therapy is used to prevent the recurrence or growth and spread of a breast cancer tumor that relies on the body's hormones to grow (estrogen-receptor-positive or progesterone-receptor-positive breast cancer). Hormone therapy often includes tamoxifen, an estrogen-blocking drug, or newer types of drugs called aromatase inhibitors.
Regardless of your initial diagnosis and treatment plan, keep in mind that your healthcare team may need to change your plan once treatment starts. "Before my bilateral masectomies, I had no thought of needing chemotherapy," says Dana Hooper, a 31-year-old breast cancer survivor from Arizona. "But that changed once I was diagnosed with an invasive form of breast cancer. In order for the doctors to feel more confident about zapping any cancer cells that could get loose, chemotherapy was recommended. Despite the horrifying prospect, I recognized that a few months of my life getting chemotherapy and dealing with the side effects would be worth what it was giving me."
Prevention of breast lumps related to cancer
Many benign breast lumps are due to changes in the body and may form without any other symptoms. If you have a history of benign breast lumps or are concerned that you may develop them, ask your doctor for tips on prevention.
To date, there are no proven ways to prevent malignant breast lumps, but experts say you can reduce your risk of developing breast cancer:
- Know your risk factors.
- Do monthly BSEs.
- Get regular clinical breast exams (and mammograms if you are age 40 or older).
- Talk to your doctor about genetic counseling if you have a family history.
- Maintain a healthy weight.
- Eat a healthful diet.
- Limit your alcohol consumption.
- Avoid smoking or secondhand smoke.