Discovering a breast lump during self-examination can be a cause of great concern for most women. With the awareness about breast cancer, most women are now cautious about any breast lump in the event that it is a malignant tumor (cancer). However, cancer is not the only cause of an abnormal breast mass and understanding the different types of breast lumps and the character of these masses may help to ease unnecessary concern. However, any and every breast lump should be investigated by a medical doctor, preferably a gynecologist.
Refer to Breast Anatomy for a further explanation of the female breast structure.
Types of Breast Lumps
When assessing a breast lump, a number of points have to be considered in order to gauge the likelihood of a malignant tumor. Your findings should be verified by a medical doctor and followed up with necessary diagnostic investigation like a mammogram.
- Is the breast lump :
- on one side (unilateral) or on both sides (bilateral)
- soft, firm or hard
- well- defined (edges can be clearly detected and borders are smooth) or poorly-defined (craggy, uneven borders that are difficult to follow)
- movable or fixed to the underlying tissues
- Are there other signs and symptoms like :
For a list of possible causes, refer to Causes of a Breast Lump.
Solid Breast Lumps
Both cancerous (malignant) and non-cancerous (benign) conditions can produce solid lumps in the breast. The consistency of these lumps can vary from soft to firm or hard. Malignant breast lumps are usually painless.
Benign Breast Lumps
- Fibrocystic changes in the breast, caused normally due to hormonal fluctuation, can produce breast lumps that may be painful and have a hard or rubbery feel. A lumpy, irregular feeling of the breast may occur due to thickening of the breast tissue.
- A solid, rubbery, round, well-defined, mobile, painless breast lump is most likely to be a fibroadenoma. Because of its mobility, a fibroadenoma is sometimes referred to as a breast mouse.
- A single, firm, round, painless lump may be due to fat necrosis as a result of trauma.
- A lipoma may be felt as a soft, round, non-tender lump.
Malignant Breast Lumps
Whenever assessing and describing a breast lump, it is important to highlight they key factors of the characteristics of the lump.
A solid, painless, firm to hard lump in the breast with irregular margins may indicate malignancy. It may have restricted mobility and may be fixed to the underlying tissue. The skin over the breast may show puckering or dimpling. In the early stages, however, these changes may not be present. Nipple discharge or nipple retraction may be additional features that are not always present.
Malignant breast lumps are more likely to be found in the upper and outer quadrant of the breast and in the region behind the nipples and areola.
Cysts are small fluid-filled sacs or pouches, often feeling like small grapes. It often fluctuates in shape when pressure is applied (think of a water balloon).
- Soft, fluid-filled swellings of various sizes may be felt in the breast as simple breast cysts. They may be bilateral and often increase in size and become more painful just before the onset of periods.
- A galactocele is a milk cyst often formed during lactation (breast milk production).
- A cystic lump may be produced by a breast abscess.
- Enlarged lymph nodes in the axillary region (armpit) near the breast may be felt as breast lumps. It may occur due to infection or malignancy. Hard, fixed, matted (stuck together) lymph nodes may be a sign of spread of breast cancer. This is discussed further under Swollen Armpit Lymph Nodes.
- Lymphatic obstruction can cause breast swelling due to blockage in lymph flow. It may be caused by a tumor, infection, injury or surgery.