A breast lump is another tissue that grows inside the breast. The texture of the lump depends on the type. For example, there is a lump that feels solid, or filled with fluid.
Although most breast lumps are benign (non-cancerous), a lump can also be a sign of breast cancer. Therefore, it is very important to get checked immediately, if you notice a lump growing in the breast.
This article will focus more on discussing breast lumps, which are benign or noncancerous tumors.
Causes of Breast Lumps
The causes of breast lumps vary, depending on the type of lump itself. The following will explain the types of breast lumps, along with each cause.
Cyst
A cyst is a fluid-filled lump. Women can have one or more cysts in one or both breasts. Breast cysts are generally round or oval in shape. Although generally soft, cysts can also sometimes feel solid.
Cysts are formed due to the accumulation of fluid in the breast glands. It is not known why this happens, but it is thought to be related to changes in female hormones in the menstrual cycle.
Fibroadenoma
Fibroadenoma is a benign tumor of the breast that most often occurs in women in the age range of 20-30 years. Fibroadenomas form from breast tissue and connective tissue, and can occur in one or both breasts.
Fibroadenoma is divided into two types. The first type is simple fibroadenoma, which is not cancerous. While the second type is complex fibroadenoma, which can increase the risk of developing breast cancer. If it is considered dangerous, surgery will usually be recommended.
Until now, it is not known what causes fibroadenoma. However, this condition is thought to be related to the hormone estrogen, or the use of birth control pills before the age of 20.
Breast fibrocysts
Fibrocystic breast is an abnormal growth of fibrous tissue, so that it is more prominent than fatty tissue. Fibrous tissue is a tissue that makes up ligaments, which are tissues that connect bones. Fibrous tissue also forms scar tissue and connective tissue. This condition can occur in anyone, but usually affects women in the age range of 30-50 years.
The exact cause of fibrocystic breasts is not known, but it is thought to have something to do with changes in the hormone estrogen in the menstrual cycle.
Intraductal papilloma
Intraductal papillomas are benign tumors that form in the ducts, which are tubes that carry milk from the mammary glands (lobule) to the nipple. These tumors are formed from fibrous tissue, glands, and blood vessels. Intraductal papilloma is known to most often afflict women aged 35-55 years.
Intraductal papillomas may be single tumors (solitary intraductal papilloma). This type generally grows near the nipple, and is not cancerous. While papilloma which consists of many tumors (multiple papilloma) are more at risk of developing cancer.
Intraductal papilloma generally occurs in women in the age range 35-55 years. However, it is not known what causes and risk factors for this condition.
mastitis
Mastitis is inflammation of the breast tissue, which is sometimes accompanied by infection. This condition can lead to the formation of an abscess (collection of pus) in the breast tissue. In severe cases, mastitis will be fatal if not treated immediately. Although it generally afflicts breastfeeding mothers, mastitis can also be experienced by women in general, even men.
Mastitis is caused by bacteria that enter the skin layer, then infect breast tissue. Apart from a bacterial infection, mastitis can also be caused by a blockage in the ducts, the tubes that carry milk from the breast glands to the nipple. The blockage will make the milk settle in the breast, then trigger inflammation that leads to infection.
Lipoma
Lipomas are fatty lumps that grow slowly under the skin. These lumps can grow in any part of the body such as the neck, shoulders, back, abdomen, including breasts. Lipomas are benign and harmless tumors, but they can be removed if they are large enough and bothersome.
It is not known exactly what causes lipomas. However, this condition tends to occur in someone from a family who has a history of lipoma. Although it can be experienced by people of all ages, lipomas are more common in people aged 40-60 years.
Fat necrosis
Fat necrosis is damage to the fat glands in the breast, which generally occurs as a result of injury. This condition can also occur after undergoing surgery or radiation therapy on the breast.
Necrosis can be caused by many factors, including side effects of radiotherapy or surgical procedures. Some of the methods of breast surgery in question are lumpectomy, mastectomy, breast reconstruction, breast reduction, and breast biopsy.
Breast Lump Symptoms
Breast lumps can vary in size and texture, depending on the type of lump. Some of the characteristics of lumps that can appear include:
- The lumps may appear singly or multiplely, in one or both breasts.
- The size of the lump can be less or more than 5 cm, but it can grow bigger.
- The lump may feel soft, spongy, or solid.
- The shape of the lump can be round or oval, and can be moved.
- The lump enlarges before menstruation, and returns to its original size after menstruation is complete.
In addition, other symptoms that can appear are:
- Breasts feel hard.
- Changes in the shape of both breasts.
- Swollen breasts.
- Nipples are itchy or sensitive.
- Breasts feel hard and warm to the touch.
- Fever.
- Weak.
- Nipples have discharge that may appear clear or cloudy.
Immediately consult a doctor if the following symptoms appear:
- The lump does not go away after menstruation, or more than 4 or 6 weeks.
- A new lump appears.
- The lump grows.
- The lump is palpable solid and does not shift when moved.
- Nipples bleed.
- The skin of the breast is red, hardened, or shriveled like an orange peel.
- Bruised breast for no apparent reason.
- Nipples that go inward or in an abnormal position.
- A lump appears in the armpit.
Breast Lump Diagnosis
As a first step in the diagnosis, the doctor will ask about the symptoms experienced and when the lumps began to appear. After that, the doctor will perform a physical examination by palpating the patient's breasts. A physical examination can help the doctor determine the location of the lump, so that if an investigation is carried out, the doctor can focus on the area. However, to make sure the lump in the patient is not cancer, the doctor will carry out supporting examinations, such as:
Mammography
Mammography is an X-ray of the breast. In this examination, the patient's breast will be pressed, so that the image of the breast tissue can be seen more clearly. Through mammography, a number of abnormalities in the breast can be seen, for example a tumor, calcium buildup, or dense tissue in the breast.
Ultrasound
Ultrasound (USG) is an examination that uses sound waves, to produce images. Breast ultrasound is very useful in examining breast lumps, especially in distinguishing solid lumps from lumps filled with fluid.
MRI
An MRI uses a magnetic field and sound waves to display pictures of the inside of the body. An MRI is used to more closely examine a lump that is felt on physical examination, but not seen on a mammography or ultrasound.
Ductography
Ductography or galactography, is a procedure for taking pictures of the mammary glands with an X-ray machine, to help the doctor find out the cause of the discharge from the nipple. This procedure is preceded by injection of contrast into the nipple.
Biopsy
A biopsy is a procedure to take a sample of a lump or the entire lump, for examination in a laboratory. Some of the breast biopsy methods are:
- Fine needle aspiration (fine-needle aspiration biopsy)
- Surgical biopsy (surgical biopsy)
- Vacuum assisted biopsy (vacuum-assisted biopsy)
- Core needle biopsy (core needle biopsy)
Breast Lump Treatment
In many cases, benign breast lumps do not need to be treated because they are harmless and bothersome. Even in some cases, the lump can disappear by itself. New medical action will be taken when the lump gets bigger or causes severe pain.
The procedure for treating a breast lump depends on the type of lump, including:
Lumpectomy
Lumpectomy begins with giving the patient a local anesthetic. After the anesthetic has worked, the doctor will make an incision around the area of the tumor, then remove the tumor and a small amount of tissue around it. This procedure is usually performed on women with a single lump less than 5 centimeters in diameter.
Cryotherapy
Cryotherapy or freezing therapy aims to destroy abnormal cells by freezing them. In this procedure, a special needle is inserted directly into the tumor area. Then, the doctor will inject liquid nitrogen to freeze the tumor.
Fine needle aspiration
Fine needle aspiration is a procedure for removing fluid from a breast lump using a special needle. This procedure is done with the help of ultrasound, so that the needle is placed right on the lump.
In addition to the methods above, doctors can also prescribe drugs, such as birth control pills to lower estrogen levels. In the case of mastitis, the doctor may prescribe antibiotics and pain relievers, such as paracetamol or ibuprofen. If you are breastfeeding, there is no need to stop breastfeeding, because it is still safe for the baby and can actually help healing.
If the lump in the breast is breast cancer, the doctor may perform a number of procedures such as surgery, radiotherapy, chemotherapy, or hormone therapy. In some cases, doctors may combine 1-2 treatment methods above, depending on the size and stage of the cancer, as well as the age and health condition of the patient.
Breast Lump Prevention
Most breast lumps can't be prevented, because they occur due to hormonal changes that can't be controlled. However, it is very important for women to understand their breasts, so that it is easier to notice when there are changes in these organs.
One way that can be done to recognize your own breasts is to do BSE (breast self-examination). By doing BSE, patients can detect lumps early on.
BSE is done once a month, 7-10 days after the first day of menstruation, in the following way:
- Stand in front of the mirror, and observe if there are changes in the shape, size, skin color, and surface of the skin of the breast. Please note, generally the shape of the right and left breasts is not symmetrical. Therefore, there is no need to worry.
- Lift both hands up, then bend your elbows and place your hands behind your head (neck). Then, push your elbows back and forth while observing the shape and size of your breasts.
- Feel the breast using three fingers (index, middle, ring) that are closed. Then with gentle pressure, do a circular motion starting from the outside of the breast to the inside and touching the nipple. Focus and feel well to know if there is a thickening or lump.
- While showering, place your right hand behind your head. Then after soaping, check the right breast with the left hand in a circular motion, from the nipple to the outside of the breast. Do the same steps on the left breast.
- When lying down, place your left hand under your head. Then, examine the left breast with the right hand. Do the same on the right breast.
- Squeeze both nipples and observe for abnormal discharge from the nipples.
Apart from BSE, another preventive measure is SADANIS (clinical breast examination), which is carried out by trained medical personnel. Every woman is advised to undergo SADANIS periodically, in order to find lumps or other abnormal signs in the breasts as early as possible. Doctors recommend SADANIS done every 3 years in women aged 20-40 years, and once a year for women over the age of 40 years.