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Breast Lump
Fine needle aspiration of Breast lumpThe breast
The female breast is a complex gland that is made up of several different types of tissue. Each breast contains milk glands and milk ducts for transporting milk. These structures can increase or decrease in both size and number as and when they are needed. For example, during pregnancy, the milk ducts in the breasts will grow and the breasts will get larger. During breastfeeding, the breasts may change size several times throughout the day as milk is produced and the baby feeds.
The breast is made up of fibrous connective tissue, fatty tissue, nerves, blood vessels and lymph nodes (small oval-shaped glands that remove unwanted bacteria and particles from the body)


How common are breast lumps?
Breast lumps are quite common. About 3 in every 100 women visit their doctor regarding a problem with their breasts.
Most breast lumps, about 9 out of 10, are benign (non-cancerous).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.


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 doctor if you notice a lump in your breast or any change in its appearance, feel or shape.

For further information please see breast screening.


Types of breast lumps
Common types of benign breast lumps include:
    • Fibroadenosis

    • Fibroadenoma

    • Breast Cysts

    • Breast Abscesses

    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 (tumour) 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. It is also known as a “breast mouse”. 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 very 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. Cysts vary in size. Some can be very tiny, while others can grow up 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). An abscess can also develop in a female even if she is not lactating.

 Is a breast lump serious?
While you should always see your doctor about any changes to your breasts, benign (non-cancerous) breast lumps:
  • should not increase your risk of developing breast cancer in the future

  • will not turn into breast cancer


Hormones
Hormonal changes are the most common cause of benign breast lumps. Hormones are chemicals that are 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 Hormone Replacement Therapy (HRT; treatment that is used to replace the female hormones that a woman's body is no longer producing because of the menopause)

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 doctor will advise you about any treatment that is necessary. If treatment is not necessary, you may be asked to return if you notice any further changes to your breasts.

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


Surgical treatment
Most of the time, if the lump is more than 2 cms in size, the doctor will advise the excision of the lump. It is a short procedure lasting about 30 minutes which is performed under general anesthesia. Usually the incision is taken in a cosmetic fashion in the around the areola and the lump is removed. This lump is then sent for histopathological check up which is mandatory for all cases.

If the patient has a cyst, usually the symptomatically painful cyst is aspirated in the outpatient and the fluid which is collected is sent for cytological examination. If there is rapid reaccumulation of fluid in the cyst on follow up or the patient had severe discomfort then the cyst is removed surgically and evaluated further.
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