A breast mass, also known as a breast lump, is a localized
swelling that feels different from the surrounding
tissue.
[ ]Breast pain
Breast pain is the symptom of discomfort in either one or both breasts. Pain in both breasts is often described as ''breast tenderness'', is usually associated with the menstrual period and is not serious. Pain that involves only one part of a b ...
, nipple discharge
Nipple discharge is fluid from the nipple, with or without squeezing the breast. The discharge can be milky, clear, green, purulent, bloody, or faintly yellow. The consistency can be thick, thin, sticky, or watery.
Nipple discharge may be nor ...
, or skin changes may be present.[ Concerning findings include masses that are hard, do not move easily, are of an irregular shape, or are firmly attached to surrounding tissue.][
Causes include fibrocystic change, ]fibroadenomas
Fibroadenomas are benign breast tumours characterized by an admixture of stromal and epithelial tissue. Breasts are made of lobules (milk producing glands) and ducts (tubes that carry the milk to the nipple). These are surrounded by glandular, ...
, breast infection
Mastitis is inflammation of the breast or udder, usually associated with breastfeeding. Symptoms typically include local pain and redness. There is often an associated fever and general soreness. Onset is typically fairly rapid and usually occ ...
, galactoceles, and breast cancer
Breast cancer is a cancer that develops from breast tissue. Signs of breast cancer may include a Breast lump, lump in the breast, a change in breast shape, dimpling of the skin, Milk-rejection sign, milk rejection, fluid coming from the nipp ...
. Breast
The breasts are two prominences located on the upper ventral region of the torso among humans and other primates. Both sexes develop breasts from the same embryology, embryological tissues. The relative size and development of the breasts is ...
cancer makes up about 10% of breast masses.[ Diagnosis is typically by examination, ]medical imaging
Medical imaging is the technique and process of imaging the interior of a body for clinical analysis and medical intervention, as well as visual representation of the function of some organs or tissues (physiology). Medical imaging seeks to revea ...
, and tissue biopsy
A biopsy is a medical test commonly performed by a surgeon, an interventional radiologist, or an interventional cardiologist. The process involves the extraction of sample cells or tissues for examination to determine the presence or extent o ...
.[ Tissue biopsy is often by ]fine needle aspiration biopsy
Fine-needle aspiration (FNA) is a diagnostic procedure used to investigate lumps or masses. In this technique, a thin (23–25 gauge (0.52 to 0.64 mm outer diameter)), hollow needle is inserted into the mass for sampling of cells that, a ...
. Repeated examination may be required.[
Treatment depends on the underlying cause.][ It may vary from ]simple pain medication
An analgesic drug, also called simply an analgesic, antalgic, pain reliever, or painkiller, is any member of the group of drugs used for pain management. Analgesics are conceptually distinct from anesthetics, which temporarily reduce, and in so ...
to surgical removal.[ Some causes may resolve without treatment.] Breast masses are relatively common. It is the most common breast complaint with the women's concern generally being that of cancer.
Types
Cysts and abscesses
A breast cyst
A breast cyst is a cyst, a fluid-filled sac, within the breast. One breast can have one or more cysts. They are often described as round or oval lumps with distinct edges. In texture, a breast cyst usually feels like a soft grape or a water-filled ...
is a non-cancerous, fluid-filled sac in the breast. They generally feel smooth or rubbery under the skin and can be quite painful or cause no pain at all. Cysts are caused by the hormones that control the menstrual cycle and are rare in women older than 50.[WebMD: Breast Lump Overview](_blank)
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A sebaceous cyst
A sebaceous cyst is a term commonly used to refer to either:
* Epidermoid cysts (also termed epidermal cysts, infundibular cyst)
* Pilar cysts (also termed trichelemmal cysts, isthmus-catagen cysts)
Both of the above types of cysts contain ...
is a non-cancerous, closed sac or cyst below the skin that is caused by plugged ducts at the site of a hair follicle. Hormone stimulation or injury may cause them to enlarge but if no symptoms are present, medical treatment is not required.
Breast abscess
Mastitis is inflammation of the breast or udder, usually associated with breastfeeding. Symptoms typically include local pain and redness. There is often an associated fever and general soreness. Onset is typically fairly rapid and usually occ ...
es are non-cancerous pockets of infection within the breast. They can be quite painful and cause the skin over the breast to turn red or feel hot or solid. Abscesses of the breast are most common in women who are breast-feeding.
Growths
Adenoma
An adenoma is a benign tumor of epithelium, epithelial tissue with glandular origin, glandular characteristics, or both. Adenomas can grow from many glandular organ (anatomy), organs, including the adrenal glands, pituitary gland, thyroid, prosta ...
s are non-cancerous abnormal growths of the glandular tissue in the breast. The most common form of these growths, fibroadenoma
Fibroadenomas are benign breast tumours characterized by an admixture of stromal and epithelial tissue. Breasts are made of lobules (milk producing glands) and ducts (tubes that carry the milk to the nipple). These are surrounded by glandular, ...
s, occur most frequently in women between the ages of 15 and 30 and in women of African descent. They usually feel round and firm and have smooth borders. Adenomas are not related to breast cancer.
Intraductal papilloma
Intraductal papillomas of the breast are benign lesions with an incidence of approximately 2-3% in humans. They result from abnormal proliferation of the epithelial cells lining the breast ducts.
Two types of intraductal papillomas are generally ...
s are wart-like growths in the ducts of the breast. These lumps are usually felt just under the nipple and can cause a bloody discharge from the nipple. Women close to menopause may have only one growth, while younger women are more likely to have multiple growths in one or both breasts.
Breast cancer
Breast cancer is a cancer that develops from breast tissue. Signs of breast cancer may include a Breast lump, lump in the breast, a change in breast shape, dimpling of the skin, Milk-rejection sign, milk rejection, fluid coming from the nipp ...
usually feels like a hard or firm lump that is generally irregular in shape and may feel like it is attached to skin or tissue deep inside the breast. Breast cancer is rarely painful and can occur anywhere in the breast or nipple.
Fatty lumps
Fat necrosis
Fat necrosis is necrosis affecting fat tissue (adipose tissue). The term is well-established in medical terminology despite not denoting a specific pattern of necrosis. Fat necrosis may result from various injuries to adipose tissue, including: p ...
is a condition in which the normal fat cells of the breast become round lumps. Symptoms can include pain, firmness, redness, and/or bruising. Fat necrosis usually goes away without treatment but can form permanent scar tissue that may show up as an abnormality on a mammogram.
A lipoma
A lipoma is a benign tumor made of adipose tissue, fat tissue. They are generally soft to the touch, movable, and painless. They usually occur just under the skin, but occasionally may be deeper. Most are less than in size. Common locations inc ...
is a non-cancerous lump of fatty tissue that is soft to the touch, usually movable, and is generally painless.
Other
Breast hematoma
Breast hematoma is a collection of blood within the breast. It arises from internal bleeding (hemorrhage) and may arise due to trauma (breast injury or surgery) or due to a non-traumatic cause.
Symptoms
Symptoms may include visible discoloring ...
s and seroma
A seroma is a pocket of clear serous fluid (filtered blood plasma). They may sometimes develop in the body after surgery, particularly after breast surgery, abdominal surgery, and reconstructive surgery. They can be diagnosed by physical sign ...
s may be visible as a local swelling of the breast. Seromas are a common complication of breast surgery
Breast surgery is a form of surgery performed on the breast.
Types
Types include:
* Breast augmentation
* Breast reduction
* Breast-conserving surgery, a less radical cancer surgery than mastectomy
* Lumpectomy
* Mastectomy
* Mastopexy, or brea ...
. Hematomas can also occur after breast surgery
Breast surgery is a form of surgery performed on the breast.
Types
Types include:
* Breast augmentation
* Breast reduction
* Breast-conserving surgery, a less radical cancer surgery than mastectomy
* Lumpectomy
* Mastectomy
* Mastopexy, or brea ...
or breast injury or, more rarely, they can occur spontaneously in patients with coagulopathy
Coagulopathy (also called a bleeding disorder) is a condition in which the blood's ability to coagulate (form clots) is impaired. This condition can cause a tendency toward prolonged or excessive bleeding ( bleeding diathesis), which may occur s ...
.
Diagnosis
Breast lumps are often discovered during a breast self-examination
Breast self-examination (BSE) is a breast cancer screening, screening method used in an attempt to detect early breast cancer. The method involves the woman herself looking at and feeling each breast for possible lumps, distortions or swelling.
B ...
or during a routine check-up. Upon noticing an unusual lump in the breast the best course of action is to schedule an examination with a physician who can best diagnose the type of breast lump and strategy for treatment.
Treatment
Treatments for breast lumps vary depending on the type of lump. Standard breast cyst
A breast cyst is a cyst, a fluid-filled sac, within the breast. One breast can have one or more cysts. They are often described as round or oval lumps with distinct edges. In texture, a breast cyst usually feels like a soft grape or a water-filled ...
s and abscess
An abscess is a collection of pus that has built up within the tissue of the body, usually caused by bacterial infection. Signs and symptoms of abscesses include redness, pain, warmth, and swelling. The swelling may feel fluid-filled when pre ...
es require drainage for treatment, while sebaceous cyst
A sebaceous cyst is a term commonly used to refer to either:
* Epidermoid cysts (also termed epidermal cysts, infundibular cyst)
* Pilar cysts (also termed trichelemmal cysts, isthmus-catagen cysts)
Both of the above types of cysts contain ...
s and fatty lumps are best treated by surgical removal.
Fibroadenoma treatment
Several treatment options currently exist for fibroadenoma
Fibroadenomas are benign breast tumours characterized by an admixture of stromal and epithelial tissue. Breasts are made of lobules (milk producing glands) and ducts (tubes that carry the milk to the nipple). These are surrounded by glandular, ...
s: "wait and watch," open surgery and minimally-invasive surgical alternatives.
*"Waiting and watching" is common for very small fibroadenomas and involves routine check-ups with a physician every 6–12 months.
*Open surgery has historically been the most common method for removing large fibroadenomas, but has several disadvantages. Surgery often requires general anesthesia
Anesthesia (American English) or anaesthesia (British English) is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia (relief from or prev ...
and a day in the hospital, and can leave significant scarring at the site of the incision.
*Minimally-invasive surgical alternatives include biopsy-removal techniques and cryoablation
Cryoablation is a process that uses extreme cold to destroy tissue. Cryoablation is performed using hollow needles (cryoprobes) through which cooled, thermally conductive fluids are circulated. Cryoprobes are positioned adjacent to the target in ...
. Biopsy-removal involves using a vacuum-assisted biopsy device to remove the fibroadenoma bit by bit. This procedure can be effective but often does not remove all of the fibroadenoma, resulting in a possible re-growth. In cryoablation, an ultrasound
Ultrasound is sound with frequency, frequencies greater than 20 Hertz, kilohertz. This frequency is the approximate upper audible hearing range, limit of human hearing in healthy young adults. The physical principles of acoustic waves apply ...
-guided probe is inserted into the fibroadenoma through a small incision in the breast. Extremely cold temperatures are then used to freeze the lesion, which eventually dies and is reabsorbed into the body.
See also
* Cancer Diagnosis Probe
References
External links
WebMD - Breast Lump Overview
{{DEFAULTSORT:Breast Lump
Medical signs
Breast diseases
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