About Breast Lumps
U.S. Department of Health and Human Services Public Health Service
National Institutes of Health
natural to be concerned if you've found a lump in your breast. But...80
percent of all breast lumps are BENIGN,
which means NO cancer is present. After reading this, you will know
more about the normal changes that can occur in a woman's breasts.
And you'll learn what to do if you find a lump or other change in
lumps are found by women themselves, either through regular BREAST
SELF-EXAM or just by accident. Others are discovered during
routine breast exams by a health professional and through MAMMOGRAMS,
special x-rays of the breast.
20 percent of breast lumps are MALIGNANT
(cancerous). However, if cancer is found at an early stage and treated
promptly, the outlook is good. In fact, 85 to 95 percent of women
with early breast cancer will be alive 5 years after diagnosis.
Most of them will be free of breast cancer for the rest of their
is normal to be afraid when you find a lump in your breast. But
don't let fear stop you from seeing a doctor right away if you think
something is wrong. You will feel more confident about finding a
breast lump early by:
Doing a monthly breast self-exam (BSE).
Having a regular breast exam by a health professional.
Having regular mammograms
- What is the difference between having a lump in the breast and
simply having "lumpy" breasts?
- The breasts are made up of ducts,
lobes, and fat. Under the breasts are muscles and ribs. These normal
features may make the breasts feel "lumpy" or uneven.
In addition, many women have changes in their breasts that are related
to their monthly menstrual cycle. Swelling, tenderness, and pain
in the breasts may occur before and sometimes during the menstrual
period. At the same time, one or more lumps or a feeling of increased
"lumpiness" may appear in the breasts. These symptoms are caused
by extra fluid collecting in the breast tissue, which is normal.
If the "lumpiness" or lumps do not go away after the end of your
period, it is important to see a doctor.
If you are past menopause and you find any new lump or thickening
in your breast, you should see your doctor.
- What am I looking for when I do BSE?
- You are looking for a lump that stands out as different from the
rest of your breast tissue. Many women are confused about BSE because
their breasts generally feel "lumpy." Becoming more familiar with
your breasts by doing BSE each month will help you tell the difference
between your normal "lumpiness" and what may be a change.
your doctor or other health professional to do a breast exam with
you and to explain what you are feeling in your breasts. They can
make sure you are doing BSE correctly and thoroughly, which will
make you feel more confident.
- What should I do if I find a lump in my breast?
- If you notice a lump in one breast, examine the other one.
If both breasts feel the same, then what you feel is probably a
normal part of your breast. You should, however, mention it to your
doctor at your next visit.
a lump of any size appears in either breast and does not go away
after your menstrual period, see your doctor. The doctor may refer
you to a specialist to discuss the need for further tests.
you do not have a doctor of your own, your local medical society
or the Cancer Information Service (CIS) may be able to help you
find a doctor or breast clinic in your area. The toll-free telephone
number of the CIS is 1-800-4-CANCER.
- How is a breast lump evaluated?
- Your doctor can evaluate a lump in a number of ways.
PALPATION is a physical exam of the breast.
The doctor examines each breast and underarm by feeling the tissue.
Although a doctor can tell a lot by the way the lump feels, no one
can be certain what a lump is just by palpation.
ASPIRATION, also called fine needle aspiration,
can help the doctor discover whether the lump is a cyst (fluid filled)
or a solid mass of CYST tissue. Aspiration
is usually done in the doctor's office. First, the doctor uses a
LOCAL ANESTHETIC to numb the area. Then,
the doctor inserts a needle into the lump and tries to withdraw
fluid. If it is a cyst, removing the fluid will collapse it. The
fluid may be sent to a laboratory for testing to be sure no cancer
cells are present. When the lump is solid, the doctor sometimes
removes a sample of cells with the needle. These cells are then
sent to a laboratory for analysis.
A MAMMOGRAM is a type of x-ray that creates
an image of the breast on film or paper. It can help determine whether
a lump is benign or cancerous. In fact, it can sometimes detect
cancer in the breast before a lump can be felt. The National Cancer
Institute (NCI) suggests that beginning at age 40, all women should
have a mammogram every 1 to 2 years. When a woman reaches 50, she
should have a mammogram each year. A doctor may also recommend a
mammogram if any sign or symptom of breast cancer is found, regardless
other methods also are being studied. None is now reliable enough
to be used alone, but they may be helpful when combined with other
Ultrasound uses high-frequency sound waves to get an image of
the breast and can help determine if a lump is a cyst or a solid
mass. It is usually used along with palpation and mammography.
Diaphanography, or transillumination, shines a light through the
breast to show its inner features.
Thermography measures the heat patterns in the breast to produce
A BIOPSY is the only certain way to learn
whether a breast lump or suspicious area seen on a mammogram is
cancer. In a biopsy, the doctor surgically removes all or part of
the lump and sends it to the laboratory for analysis. There are
several biopsy methods that a doctor may use: needle biopsy, incisional
biopsy, excisional biopsy, and mammographic localization with biopsy.
the doctor will do a Needle Biopsy to remove a small amount of tissue
from the lump. A needle biopsy can be performed in the doctor's
office. This is most often done when cancer is suspected and the
doctor hopes to confirm the diagnosis immediately. If cancer is
not found, a more thorough biopsy will follow.
it was thought that inserting a needle or cutting into a breast
lump might cause cancer to spread. This is not true.
Incisional Biopsy is the surgical removal of a portion of a lump.
This procedure is often used when the growth is very large. Again,
if no cancer is found, a more thorough biopsy may follow to make
sure the entire lump is free of cancer.
an Excisional Biopsy the doctor removes the entire lump. This is
currently the "standard" biopsy procedure and the most thorough
method of diagnosis. Incisional and excisional biopsies are usually
done in the outpatient department of a hospital. Either a local
or general anesthetic may be used.
Localization with Biopsy (also known as needle localization is used
for suspicious areas such as microcalcifications (tiny specks of
calcium) that cannot be felt but can be seen on a mammogram. During
this procedure, the breast is x-rayed and small needles are placed
to outline the suspicious area for the surgeon, who then removes
the tissue for biopsy. This can be done using a local anesthetic
in the outpatient department of a hospital.
doctor may suggest one or more of these procedures to evaluate a
lump or other change in your breast. The doctor may also suggest
watching the suspicious area for a month or two. Because many lumps
are caused by normal hormonal changes, this waiting period may provide
if you feel uncomfortable about waiting, speak with your doctor
about your concerns. You also may want to get a second opinion,
perhaps from a breast specialist or surgeon. Many cities have breast
clinics where you can get a second opinion. The Cancer Information
Service also may be able to help you locate doctors to consult.
- What will the doctor be able to learn from a biopsy?
- The biopsy can tell the doctor whether your lump is benign or
malignant. If it is cancer, your doctor will talk with you about
choices of treatments, and you may be advised to get a second opinion.
(You can call the Cancer Information Service for other NCI publications
that deal with breast cancer treatment.)
no cancer is found, you may be told that the lump or suspicious
area is the result of a FIBROCYSTIC CONDITION,
FIBROCYSTIC DISEASE, BENIGN
BREAST DISEASE, or one of many other conditions. Remember, 80
percent of all breast lumps are NOT cancer.
- What is a fibrocystic condition, fibrocystic disease, or benign
- Unfortunately, doctors do not agree on standard terms for benign
breast changes. We prefer to use the term BENIGN
BREAST CONDITION for those changes in a woman's breasts that
are not cancerous. These include normal changes that occur during
the menstrual cycle as well as benign lumps that can appear in the
breast. If your doctor uses a different term, or one you do not
understand, ask for an explanation.
- How many women have a benign breast condition?
- It is estimated that at least 50 percent of all women have irregular
or "lumpy" breasts. In addition, many doctors believe that nearly
all women have some benign breast changes beginning at age 30. A
woman is more likely to have these breast changes if she has never
had children, has had irregular menstrual cycles, has a family history
of breast cancer, or is thin. Women who have had more than one child
and women who are taking birth control pills have a reduced risk.
- What are the symptoms of a benign breast condition?
- Women may have increased "lumpiness" with tenderness, pain, and
swelling just before their period begins. These symptoms lessen
after the menstrual period, only to reappear the next month. Many
women find that these symptoms disappear after MENOPAUSE.
breast lumps may appear at any time. Some cause pain, others don't.
They may be large or small, soft or rubbery, fluid-filled or solid,
and movable. In addition, some benign breast conditions may produce
a DISCHARGE from the nipple.
- What kinds of benign breast conditions are there?
may cause a feeling of fullness in the breast, which goes away
after the menstrual period. This condition is most common in women
35 to 50 years of age.
are fluid-filled sacs that often enlarge and become tender and
painful just before the menstrual period. Cysts are found most
often in women 35 to 50 years of age. They usually are found in
both breasts. There may be many cysts of different sizes. Some
cysts are so small that they can't be felt; others may be several
are solid, round, rubbery, and freely movable breast lumps. Usually
they are painless. They appear most often in young women between
15 and 30 years of age. Fibroadenomas occur twice as often in
black women as in others. They are benign but Should Be Removed
to be certain of the diagnosis. Fibroadenomas do not go away by
themselves and may enlarge during pregnancy and breast-feeding.
are single, painless lumps that are sometimes found in older women.
They are made up of fatty tissue and are slow-growing, soft, and
movable. They can vary in size from a dime to a quarter. Lipomas
should be removed or biopsied to make sure that they are not cancerous.
are small wartlike growths in the lining of a duct near the nipple.
They usually affect women between 45 and 50 years old and can
produce bleeding from the nipple.
is an inflammation of the ducts that causes a thick, sticky, gray-to-green
discharge from the nipple. Without treatment, the condition can
(sometimes called "postpartum mastitis") is most often seen in
women who are breast-feeding. It is an inflammatory condition
in which the breast appears red and feels warm, tender, and lumpy.
occasionally appears in older women and in women with very large
breasts. The condition can result from a bruise or blow to the
breast, although the woman might not remember the specific injury.
The trauma causes the fat in the breast to form lumps that are
painless, round, and firm. Sometimes the skin around them looks
red or bruised. Again, a doctor should examine the area.
Word Of Caution:
If you find a change in your breast, do not use these descriptions
to try to diagnose it yourself. There is no substitute for a doctor's
- What is the treatment for a benign breast condition?
- Treatment varies, depending on the type of condition a woman
has. If you have a single lump, it is usually removed in the biopsy.
Most cysts are aspirated, and if they don't disappear, they are
removed by surgery. Although there is no treatment for normal monthly
breast changes, some studies have looked at various ways of treating
the uncomfortable symptoms. The results of those studies do not
all agree. You may wish to discuss the treatments described below
with your doctor.
a long time doctors thought that eliminating beverages and foods
that contain caffeine such as coffee, tea, cola, and chocolate (all
of which also contain a substance called methylxanthine) would reduce
monthly breast pain and tenderness.
studies have been unable to prove that such a change in diet affects
symptoms. However, women continue to report to doctors that when
they stop drinking coffee or eating chocolate, the pain and swelling
in their breasts is less.
E is another treatment that has been suggested. It is generally
accepted that taking this vitamin may help reduce the symptoms of
breast pain and tenderness. You should speak with your doctor before
taking vitamin E.
doctors will suggest an antihormone treatment (Danazol) when a woman
has severe symptoms. Danazol may relieve pain and tenderness and
decrease "lumpiness"; however, serious side effects are possible,
and you should discuss all aspects of this treatment with your doctor
if it is recommended.
- Do doctors ever suggest more extensive surgery for benign breast
- In cases where a woman's breasts are extremely difficult to examine,
when there have been many biopsies or there are biopsy-proven tissue
changes that place that woman in a high-risk category AND there
is a family history of breast cancer, a doctor may suggest a PROPHYLACTIC
MASTECTOMY. In this surgery, both breasts are removed. Some
women then choose to have breast reconstruction.
your doctor suggests this treatment, you should consider getting
a second opinion, preferably from a breast specialist. Remember
that there is no reason to hurry into this decision. You should
be comfortable with your choice and learn everything about the procedure,
its possible side effects, and your risks of future problems. Prophylactic
mastectomy is a controversial treatment, and many doctors prefer
instead to schedule frequent exams to check for any breast changes.
- Will insurance pay for the diagnosis and treatment of a benign
- Talk with your doctor about your diagnosis and call your insurance
company to ask about their coverage for benign breast conditions.
Only a very small percentage of women with a benign breast condition
are at greater risk of developing cancer. Despite this fact, some
insurance companies have canceled policies or raised premiums for
women who have been diagnosed with "fibrocystic disease."
- Can benign lumps turn into cancerous ones?
- Benign lumps DO NOT turn into cancer. However, cancerous lumps
can develop near benign lumps and can be hidden in a mammogram.
This is another reason why removal of a benign lump is usually recommended.
- What are microcalcifications?
- They are tiny specks of calcium in the breast tissue that are
sometimes detected by a mammogram. They can be related to a benign
breast condition or breast cancer. In some cases, microcalcifications
are seen when there is no lump present. The pattern and location
of microcalcifications help the doctor determine if additional tests
- What causes a discharge from the nipple and should I be concerned?
- You should see your doctor whenever you notice a spontaneous discharge
from the nipple (when something comes out without the breast being
squeezed). The fluid may be clear, milky, bloody, or even green.
If you have a discharge when you do BSE, you should also check with
conditions can cause a discharge. The doctor will take a sample
of the discharge and send it to a laboratory to be analyzed. Occasionally,
the doctor may order special tests to help in diagnosing the cause
of the discharge. Your doctor can then recommend treatment.
you are pregnant, breast-feeding, or have recently had a baby, a
milky fluid that comes out of both breasts is most likely related
to your pregnancy. If you have questions or if the fluid is bloody,
talk to your doctor.
- What if I notice a lump in my breast during pregnancy?
- During pregnancy, the milk-producing glands become swollen and
the breasts might feel lumpier than usual. It can be difficult to
examine your breasts when you are pregnant, but you should continue
to do so. Although not common, breast cancer has been diagnosed
during pregnancy. So, if you have a question about the way your
breasts feel, talk to your doctor.
- Does every new lump need to be biopsied?
- Not necessarily. If a new lump appears, you cannot be sure that
it is benign, even if you have had a benign lump removed in the
past. Your doctor should evaluate it and decide whether a biopsy
- Is a biopsy going to change the shape of my breast?
- Generally, a biopsy leaves only a minor scar, but this depends
on the location and size of the lump and how deep it is in the breast.
You should discuss the procedure with your doctor so you understand
just what is going to be done and what the result is going to look
- Does having a benign breast change mean I am at greater risk of
- Generally, no. Most benign breast changes do not increase a woman's
risk of getting breast cancer. Recent studies show that only certain,
very specific breast changes, which are detected by biopsy, put
a woman at higher risk of developing breast cancer. Most important,
70 percent of the women who have a breast biopsy for a benign condition
are not at any increased risk of cancer. About 26 percent of breast
biopsies show changes that slightly increase the risk of developing
breast cancer, and only 4 percent show breast changes that moderately
increase the woman's risk.
your biopsy shows benign changes, discuss with your doctor what
kind of changes were found and whether those changes increase your
risk of developing breast cancer.
- What other factors cause a woman to be at increased risk of getting
- Age is a factor. The older you are, the greater your chance of
getting breast cancer. One in four women diagnosed with breast cancer
has a family history of the disease. Other risk factors include
having your first child after age 30, never being pregnant, getting
your first period at an early age, or having a late menopause.
not place too much faith in being "safe" if you have none of these
risk factors - what puts you at risk for getting breast cancer is
that you are a woman. The majority of women who are diagnosed with
breast cancer do not fall into any special "high-risk" category.
TO ASK YOUR DOCTOR
hope that this booklet has answered many of your questions about
noncancerous breast lumps. However, no booklet can take the place
of talking with your doctor. Feel free to ask the doctor any questions
you have. If you do not understand the answer, ask your doctor to
is helpful to write down questions as you think of them. The questions
below are some of the most common that women have; you may have
others. Jot your questions down and take this list with you when
you see your doctor.
Will you teach me how to do breast self-examination (BSE) and check
to see that I'm doing it properly?
What should I look for when I do BSE?
How can I distinguish lumps from the other normal parts of my breast?
What kind of lumps do I have?
Do you think I need to have a biopsy? If no, why not?
Do I need to have a mammogram? If yes, how often?
How often should I make an appointment to see you?
answers to questions you may have about breast lumps or breast cancer,
call the following toll-free telephone number and you will be automatically
connected to the Cancer Information Service office serving your
In Hawaii, on Oahu call 524-1234 (call collect from neighboring
Spanish-speaking staff members are available to callers from the
following areas (daytime hours only): California, Florida, Georgia,
Illinois, New Jersey (area code 201), New York, and Texas.
Drugs or gases that cause complete or partial loss of feeling or
sensation. When Local Anesthetics are used, the patient is usually
awake. General Anesthetics put the patient to sleep.
Withdrawal of fluid from a cyst with a hypodermic needle.
Breast Condition: Noncancerous changes in the breast that can
cause pain, lumpiness, or other problems. Also called fibrocystic
The removal and microscopic examination of cells or tissues for
Self-Exam (BSE): A method for women to check their own breasts
for changes in appearance or feel.
A general name for over 100 diseases in which abnormal cells grow
out of control.
A fluid-filled sac or cavity.
Any fluid coming from the nipple. It may be clear, milky, bloody,
gray, or green.
A pathway in the breast through which milk passes from lobes to
Condition: Breast irregularities or lumpiness that are not cancerous;
sometimes referred to as "fibrocystic disease" or "benign breast
Group of glands in the breast that produce milk.
An x-ray of the breast.
Inflammation of the breast causing pain and tenderness.
The time of a woman's life when her monthly menstrual periods stop,
sometimes called "change of life."
A small deposit of calcium in the breast that can appear on a mammogram
and may sometimes indicate breast cancer.
Hormonal Changes: Tissue changes that occur in response to the
changing levels of female hormones during the menstrual cycle.
Feeling the breast for any abnormalities.
A doctor with special training in diagnosing disease from samples
Mastectomy: Removal of the breast when no disease is present
in order to prevent breast cancer from developing.
SELF-EXAMINATION (BSE) INSTRUCTIONS
familiarize yourself thoroughly with these instructions and remember
to conduct regular BSE. Women taking charge of their own health
are doing BSE regularly; they are also eating healthy foods, exercising,
and not smoking.
BSE IS NOT A SUBSTITUTE FOR REGULAR BREAST EXAMS BY A DOCTOR
OR ROUTINE MAMMOGRAMS.
see -> Benign