Breast Lump & Benign Breast Disease
Evaluation and treatment of non-cancerous breast lumps and related breast conditions
What is breast lump & benign breast disease?
Breast tissue is made of glandular lobules and ducts held in fat, and it changes throughout life as hormones change. Discrete lumps can arise from any of those tissues, and the great majority of them are benign.
The common benign ones are fibroadenomas, firm rubbery growths of gland and fibrous tissue that slip about under the fingers, and cysts, fluid-filled sacs that come and go with the cycle. Both are ordinary findings in women under forty.
A lump that is hard, fixed to the tissue around it, or growing steadily is the one that needs a definite answer. Age matters here, since the chance that a new lump is a cancer rises with each decade, and that is the reason the same lump is investigated differently at thirty and at sixty.
What you might notice
- A lump felt in the breast
- A change in the shape or skin of the breast
- Milky discharge from the nipple when not breastfeeding
How it is diagnosed
Assessment follows three steps taken together. A doctor examines both breasts and both armpits, imaging is done, and a sample of cells is taken where there is anything to sample. All three have to agree before a lump is called benign.
Imaging is chosen by age. Ultrasound is used in younger women, whose breast tissue is dense, and a mammogram is added from about forty, where it picks up patterns no hand can feel.
The cell sample is taken in the clinic under scan guidance, so it comes from the right part of the lump. The report takes a few days and everything that follows is built on it.
Recovery
Most work on a breast lump is done as a day case and you go home the same day with a small dressing.
The area is bruised and firm for two to three weeks while the space left behind fills in and settles, and that firmness can be more alarming to feel than the original lump was. It softens over a couple of months.
The laboratory report comes back within about a week, and the follow-up visit exists to go through it. Where the report is benign, nothing further is needed beyond ordinary breast awareness.
If it is left untreated
A lump that all three parts of the assessment agree is benign can safely be left and reviewed in a few months to confirm it is not changing. Many fibroadenomas shrink on their own.
What cannot be left is a lump that has never been assessed. Breast cancer is treatable, and the treatment is less drastic the smaller the tumour is when it is found, so the cost of waiting is measured in how much bigger the operation has to be later.
A lump in a man, a lump tethered to the skin, and any new lump after the menopause are all reasons to be seen without waiting.
Questions about breast lump & benign breast disease
Does a lump mean cancer?
Most do not. The majority of lumps in women under forty are fibroadenomas or cysts, and both are benign. The probability rises with age, and that is the reason the same lump is investigated more thoroughly at sixty than at twenty-five. No lump can be called benign on the odds alone though: the examination, the imaging and the cell sample all have to agree before anyone says so.
Will a needle test spread it?
No. It is a common worry and there is no evidence behind it. Sampling with a needle is the standard first step everywhere, and taking a few cells does not seed a tumour along the needle track. Without it the alternative would be surgically removing every lump, and most of them are harmless.
Will the breast look different afterwards?
For a small benign lump, very little. The incision is placed at the edge of the areola or in the fold under the breast where the scar hides, and the space left fills in over a couple of months. Where more tissue has to come out, the surgeon plans how the remaining tissue is moved to hold the shape, and that is discussed with you beforehand.
Other general surgery treatments
Treatment of abdominal wall hernias that cause pain, swelling or functional discomfort
Day CareManagement of gallstones and related gallbladder problems, including surgery when indicated
Day CareTalk to a care coordinator about breast lump & benign breast disease
Leave a number and a care coordinator calls you back with what the treatment involves and which hospital it would be at. They book a consult only if you want one