Your health care provider recommended breast self-exams. So once a month you diligently do your exam. You stick to your three-step plan for preventative breast health. But what happens when you find a lump? Your first call should be to your health care provider. Because nothing is more powerful in the fight against breast cancer than early detection and treatment.
Here’s the good news: the majority of unusual lumps and bumps in the breast turn out to be noncancerous or benign—by some accounts nearly 80%. So while you are waiting for your appointment with your health care provider, let’s take a moment to get to know some of the more common benign conditions, what they feel like, and how they’re treated.
Cysts. A cyst is a fluid-filled sac that develops in the breast tissue. They typically occur in women between the ages of 35 and 50 and are most common in those approaching menopause. They often get larger and become tender and painful just before a menstrual period, and may even seem to appear overnight. Cysts are rarely malignant.
When you are doing a breast self-exam, a cyst can feel either soft or hard. When close to the surface of the breast, cysts can feel like a large blister, smooth on the outside, but fluid-filled on the inside. However, when they are deeply imbedded in breast tissue, cysts will feel like hard lumps because they are covered with breast tissue.
Your health care provider may identify a lump as a cyst by physical examination, mammography or ultrasound examination. A fine-needle aspiration will help them confirm the diagnosis. This procedure involves guiding a very fine needle into the cyst and withdrawing fluid from it. This same procedure also acts as the treatment for this condition, because once the cyst is collapsed (aspirated), it disappears. Cysts may reappear at a later date, in which case they may be drained again.
Fibroadenomas. Fibroadenomas are solid, smooth, firm, benign lumps that vary in size and can grow anywhere in the breast tissue. They are most commonly found in women in their 20s and 30s. They are the most common benign lumps that occur in women, and can occur in women of any age. Increasingly, they are being seen in postmenopausal women who are taking hormone therapy. The painless lump feels rubbery, moves around freely and very often is found by the woman herself.
While most health care providers can recognize this type of lump simply by feeling it, generally, the diagnosis is confirmed by mammography, ultrasound or needle biopsy. Sometimes, in very young women, the fibroadenoma is just left alone. However, since sometimes they can enlarge with pregnancy and breastfeeding, doctors may recommend surgically removing the fibroadenoma.
Fibrocystic Breasts. What if your breasts normally feel lumpy? Women who feel ropiness or a granular texture under the skin of their breasts sometimes feel like there’s no point in doing self-exams, since the tissue feels lumpy anyway. But the key point of self-exams is to detect changes; if you do enough of them, you’ll get to know what’s normal for you, and you’ll be more likely to notice any differences. If you do notice a difference, your health care provider can follow up with you and either perform tests or refer you to a breast care specialist for diagnostic testing.
Any lump or change in the breast is a good enough reason to call your health provider for an exam. Health care providers much prefer having to deal with a false alarm than having to deal with a serious condition that a patient has been quiet about for too long. While finding a lump can be scary, you are doing the right thing by doing regular breast exams. Because the best defense to preventing breast cancer is early detection.
Online Medical Reviewer: Freeborn, Donna, PhD, CNM, FNP
Online Medical Reviewer: Bowers, Nancy, RN, BSN, MPH
Last Annual Review Date: 6/18/2011
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