Breast lump

Last updated
Breast lump
Synonyms Breast mass, breast tumor
Breast cancer.jpg
A breast lump associated with an inverted nipple and skin dimpling. Underlying cause was breast cancer.
Specialty Gynecology
Symptoms An area of the breast that feel different than the surrounding tissue [1]
Causes Fibrocystic change, fibroadenomas, breast infection, galactoceles, breast cancer [1]
Diagnostic method Examination, medical imaging, tissue biopsy [2]
Treatment Depends on the underlying cause [1]
Frequency Common [2]

Breast lumps are localized swellings that feel different from the surrounding tissue. [1] Breast pain, nipple discharge, or skin changes may be present. [1] Concerning findings include masses that are hard, do not move easily, are of an irregular shape, or are firmly attached to surrounding tissue. [2]

Swelling (medical) transient abnormal enlargement of a body part or area not caused by proliferation of cells

Swelling is a transient abnormal enlargement of a body part or area caused not by neoplasm but by accumulation of interstitial fluid. It can occur throughout the body (generalized), or it can affect a specific part or organ (localized). Swelling is usually not dangerous and is a common reaction to an inflammation or a bruise.

Tissue may refer to:

Breast pain is the symptom of discomfort in the breast. Pain that involves both breasts and which occurs repeatedly before the menstrual period is generally not serious. Pain that involves only one part of a breast is more concerning. It is particular concerning if a hard mass or nipple discharge is also present.

Contents

Causes include fibrocystic change, fibroadenomas, breast infection, galactoceles, and breast cancer. [1] Breast cancer makes up about 10% of breast masses. [1] Diagnosis is typically by examination, medical imaging, and tissue biopsy. [2] Tissue biopsy is often by fine needle aspiration biopsy. [3] Repeated examination may be required. [2]

A galactocele is a retention cyst containing milk or a milky substance that is usually located in the mammary glands. They can occur in women during or shortly after lactation.

Breast cancer cancer that originates in the mammary gland

Breast cancer is cancer that develops from breast tissue. Signs of breast cancer may include a lump in the breast, a change in breast shape, dimpling of the skin, fluid coming from the nipple, a newly inverted nipple, or a red or scaly patch of skin. In those with distant spread of the disease, there may be bone pain, swollen lymph nodes, shortness of breath, or yellow skin.

Medical imaging technique and process of creating visual representations of the interior of a body

Medical imaging is the technique and process of creating visual representations of 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 reveal internal structures hidden by the skin and bones, as well as to diagnose and treat disease. Medical imaging also establishes a database of normal anatomy and physiology to make it possible to identify abnormalities. Although imaging of removed organs and tissues can be performed for medical reasons, such procedures are usually considered part of pathology instead of medical imaging.

Treatment depends on the underlying cause. [1] It may vary from simple pain medication to surgical removal. [1] Some causes may resolve without treatment. [4] Breast masses are relatively common. [2] They are the most common breast complaint with the women's concern generally being that of cancer. [5] [6]

Types

Women seeking evaluation of a breast lump [7]
FindingPercentage
Fibrocystic breast changes 40%
No disease30%
Fibroadenoma 7%
Other benign mammary dysplasias and neoplasms13%
Breast cancer 10%

Cysts and abscesses

A breast cyst 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. [8]

Breast cyst Human disease

A breast cyst is a fluid-filled sac within the breast. One breast can have one or more breast 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 balloon, but sometimes a breast cyst feels firm.

A sebaceous cyst 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. [8]

Sebaceous cyst types of cyst

A sebaceous cyst is a term commonly used to refer to either:

Breast abscesses 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. [8]

Growths

Adenomas are non-cancerous abnormal growths of the glandular tissue in the breast. The most common form of these growths, fibroadenomas, 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. [8]

Intraductal papillomas 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. [8]

Breast cancer 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. [8]

Fatty lumps

Fat necrosis 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. [8]

A lipoma is a non-cancerous lump of fatty tissue that is soft to the touch, usually movable, and is generally painless. [8]

Other

Breast hematomas and seromas may be visible as a local swelling of the breast. Seromas are a common complication of breast surgery. Hematomas can also occur after breast surgery or breast injury or, more rarely, they can occur spontaneously in patients with coagulopathy.

Diagnosis

A fine needle biopsy Needle biopsy.jpg
A fine needle biopsy

Breast lumps are often discovered during a breast self-examination 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.

People should make sure that the medical records of any breast-related illnesses are retained, [9] as this facilitates diagnosis in case of recurrence or follow-up.

Treatment

Treatments for breast lumps vary depending on the type of lump. Standard breast cysts and abscesses require drainage for treatment, while sebaceous cysts and fatty lumps are best treated by surgical removal. [8]

Fibroadenoma treatment

Several treatment options currently exist for fibroadenomas: "wait and watch," open surgery and minimally-invasive surgical alternatives.

Related Research Articles

Breast reconstruction

Breast reconstruction is the rebuilding of a breast, usually in women. It involves using autologous tissue or prosthetic material to construct a natural-looking breast. Often this includes the reformation of a natural-looking areola and nipple. This procedure involves the use of implants or tissue taken from other parts of the woman's body.

Bartholins cyst cyst in a blocked Bartholins gland

A Bartholin's cyst occurs when Bartholin's gland, within the labia, becomes blocked. Small cysts may result in few symptoms. Large cysts may result in swelling of one side of the vagina, and pain with sex or walking. If the cyst becomes infected an abscess occurs. These are typically red and very painful.

Pagets disease of the breast type of cancer that outwardly may have the appearance of eczema, with skin changes involving the nipple of the breast.

Paget's disease of the breast is a type of cancer that outwardly may have the appearance of eczema, with skin changes involving the nipple of the breast. The condition is an uncommon disease accounting for 1 to 4.3% of all breast cancers and was first described by Sir James Paget in 1874. The condition in itself often appears innocuous, limited to a surface appearance and it is sometimes dismissed, although actually indicative of underlying breast cancer.

Nipple discharge

Nipple discharge is the release of fluid from the nipples of the breasts. Abnormal nipple discharge may be described as any discharge not associated with lactation. The nature of the discharge may range in color, consistency and composition, and occur in one or both breasts. Although it is considered normal in a wide variety of circumstances it is the third major reason involving the breasts for which women seek medical attention, after breast lumps and breast pain. It is also known to occur in adolescent boys and girls going through puberty.

Lumpectomy is a surgical removal of a discrete portion or "lump" of breast tissue, usually in the treatment of a malignant tumor or breast cancer. It is considered a viable breast conservation therapy, as the amount of tissue removed is limited compared to a full-breast mastectomy, and thus may have physical and emotional advantages over more disfiguring treatment. Sometimes a lumpectomy may be used to either confirm or rule out that cancer has actually been detected. A lumpectomy is usually recommended to patients whose cancer has been detected early and who do not have enlarged tumors. Although a lumpectomy is used to allow for most of the breast to remain intact, the procedure may result in adverse affects that can include sensitivity and result in scar tissue, pain, and possible disfiguration of the breast if the lump taken out is significant. According to National Comprehensive Cancer Network guidelines, lumpectomy may be performed for ductal carcinoma in situ (DCIS), invasive ductal carcinoma, or other conditions.

Fibroadenoma breast benign neoplasm comprised of fibrous and glandoular tissues located in breast

Fibroadenomas, are benign breast tumours characterized by an admixture of stromal and epithelial tissue. Breasts are made of lobules and ducts. These are surrounded by glandular, fibrous and fatty tissues. Fibroadenomas develop from the lobules. The glandular tissue and ducts grow over the lobule to form a solid lump.

Fine-needle aspiration diagnostic procedure to investigate lumps using a thin needle. can be either for histopathology or cytopathology

Fine-needle aspiration (FNA) is a diagnostic procedure used to investigate lumps or masses. In this technique, a thin, hollow needle is inserted into the mass for sampling of cells that, after being stained, will be examined under a microscope (biopsy). The sampling and biopsy considered together are called fine-needle aspiration biopsy (FNAB) or fine-needle aspiration cytology (FNAC). Fine-needle aspiration biopsies are very safe minor surgical procedures. Often, a major surgical biopsy can be avoided by performing a needle aspiration biopsy instead, eliminating the need for hospitalization. In 1981, the first fine-needle aspiration biopsy in the United States was done at Maimonides Medical Center. Today, this procedure is widely used in the diagnosis of cancer and inflammatory conditions.

A seroma is a pocket of clear serous fluid that sometimes develops in the body after surgery. This fluid is composed of blood plasma that has seeped out of ruptured small blood vessels and inflammatory fluid produced by the injured and dying cells.

Cryoablation Process using extreme cold to destroy tissue

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 such a way that the freezing process will destroy the diseased tissue. Once the probes are in place, the attached cryogenic freezing unit removes heat from ("cools") the tip of the probe and by extension from the surrounding tissues.

Ductal carcinoma in situ Human disease

Ductal carcinoma in situ (DCIS), also known as intraductal carcinoma, is a pre-cancerous or non-invasive cancerous lesion of the breast. DCIS is classified as Stage 0. It rarely produces symptoms or a breast lump one can feel, and is usually detected through screening mammography.

Fibrocystic breast changes Human disease

Fibrocystic breast changes is a condition of the breasts where there may be pain, breast cysts, and breast masses. The breasts may be described as "lumpy" or "doughy". Symptoms may worsen during certain parts of the menstrual cycle. It is not associated with cancer.

Breast diseases make up a number of conditions. The most common symptoms are a breast mass, breast pain, and nipple discharge.

An adnexal mass is a lump in tissue of the adnexa of uterus. Adnexal masses can be benign or cancerous, and they can be categorized as simple or complex. One of the most important factors used to determine the clinical suspicion of malignancy of an adnexal mass is the sonographic appearance of the mass. Indications that the mass is at a higher risk of being malignant include the presence of loculations, nodules, papillary structures, or septations or a size greater than 10 cm.

Breast surgery is a form of surgery performed on the breast.

Ovarian diseases are conditions that happen to young women and can affect their reproductive system and general health.

Breast biopsy

A breast biopsy is usually done after a suspicious lesion is discovered on either Mammography or Ultrasound in order to get tissue for pathological diagnosis. Several methods for a breast biopsy now exist. The most appropriate method of biopsy for a patient depends upon a variety of factors, including the size, location, appearance and characteristics of the abnormality. The different types of breast biopsies include fine needle aspiration (FNA), vacuum assisted biopsy, core needle biopsy, and surgical excision biopsy. Breast biopsies can be done under ultrasound, MRI or a Stereotactic biopsy technique. Vacuum assisted biopsies are typically done using stereotactic techniques when the suspicious lesion can only be seen on mammography. On average, 5-10 biopsies of a suspicious breast lesion will lead to the diagnosis of one case of breast cancer.

Breast hematoma is a collection of blood within the breast. It arises from internal bleeding (hemorrhage) and may arise due to trauma or due to a non-traumatic cause.

Pediatric gynaecology or pediatric gynecology is the medical practice dealing with the health of the vagina, vulva, uterus, and ovaries of infants, children, and adolescents. Its counterpart is pediatric andrology, which deals with medical issues specific to the penis and testes.

References

  1. 1 2 3 4 5 6 7 8 9 "Breast Masses (Breast Lumps)". Merck Manuals Professional Edition. Retrieved 29 October 2018.
  2. 1 2 3 4 5 6 Klein, S (1 May 2005). "Evaluation of palpable breast masses". American family physician. 71 (9): 1731–8. PMID   15887452.
  3. ↑ Yu, YH; Wei, W; Liu, JL (25 January 2012). "Diagnostic value of fine-needle aspiration biopsy for breast mass: a systematic review and meta-analysis". BMC cancer. 12: 41. doi:10.1186/1471-2407-12-41. PMID   22277164.
  4. ↑ "Breast lumps". NHS. Retrieved 29 October 2018.
  5. ↑ Hindle, William H. (2012). Breast Care: A Clinical Guidebook for Women’s Primary Health Care Providers. Springer Science & Business Media. p. 12. ISBN   9781461221449.
  6. ↑ Salzman, B; Fleegle, S; Tully, AS (15 August 2012). "Common breast problems". American family physician. 86 (4): 343–9. PMID   22963023.
  7. ↑ Mitchell, Richard Sheppard; Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson. Robbins Basic Pathology (8th ed.). Philadelphia: Saunders. p. 739. ISBN   1-4160-2973-7.
  8. 1 2 3 4 5 6 7 8 9 WebMD: Breast Lump Overview
  9. ↑ Amarjeet Singh; Indarjit Walia; Lakhbir Dhaliwal (2010). Demedicalizing Women's Health. Gyan Publishing House. p. 88. ISBN   978-81-212-1034-8.
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