A breast mass, also known as a breast lump, is a localized swelling that feel different from the surrounding tissue. Breast pain,

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 norma ...

, 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, breast infection,

galactocele A galactocele (also called lacteal cyst or milk cyst) 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. They present as a firm mass, ...

s, and

breast cancer 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, milk rejection, fluid coming from the nipple, a newly inverted nipple, or a r ...

Breast The breast is one of two prominences located on the upper ventral region of a primate's torso. Both females and males develop breasts from the same embryological tissues. In females, it serves as the mammary gland, which produces and sec ...

cancer makes up about 10% of breast masses. Diagnosis is typically by examination, medical imaging, and

tissue biopsy A biopsy is a medical test commonly performed by a surgeon, interventional radiologist, or an interventional cardiologist. The process involves extraction of sample cells or tissues for examination to determine the presence or extent of a disea ...

. Tissue biopsy is often by fine needle aspiration biopsy. Repeated examination may be required. Treatment depends on the underlying cause. It may vary from simple pain medication 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

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
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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 ker ...

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 occurs ...

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

Adenomas 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 glandula ...

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 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, milk rejection, fluid coming from the nipple, a newly inverted nipple, or a r ...

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 a form of necrosis characterized by the action upon fat by digestive enzymes. In fat necrosis the enzyme lipase releases fatty acids from triglycerides. The fatty acids then complex with calcium to form soaps. These soaps appea ...

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 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 include upper back, ...

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 signs, ...

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 reduction surgery *Augmentation mammoplasty * Mastectomy *Lumpectomy *Breast-conserving surgery, a less radical cancer surgery than mastectomy *Mastopexy, ...

. Hematomas can also occur after

or breast injury or, more rarely, they can occur spontaneously in patients with coagulopathy.

Diagnosis

Breast lumps are often discovered during a

breast self-examination Breast self-examination (BSE) is a 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. BSE was once promoted hea ...

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, as this facilitates diagnosis in case of recurrence or follow-up.

Treatment

Treatments for breast lumps vary depending on the type of lump. Standard

s and abscesses require drainage for treatment, while

s and fatty lumps are best treated by surgical removal.

Fibroadenoma treatment

Several treatment options currently exist for

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 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 waves with frequencies higher than the upper audible limit of human hearing. Ultrasound is not different from "normal" (audible) sound in its physical properties, except that humans cannot hear it. This limit varies ...

-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.

References

External links

WebMD - Breast Lump Overview
{{DEFAULTSORT:Breast Lump Medical signs Breast diseases Wikipedia medicine articles ready to translate