Breast Lumps, Bumps and Pain: What's Normal and What's Not

Learning to distinguish your breasts' normal lumps is key to your long-term health. Here's how.
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Knowing a lump from a bump

More than half of all women occasionally have lumpy, painful and swollen breasts. The good news is that nine out of ten breast lumps are not cancer but just benign conditions, says Alison Estabrook, M.D., chief of breast surgery at Columbia-Presbyterian Medical Center in New York City.

There are a variety of benign conditions that cause lumps and bumps. Here are several types of lumps, and what to do if you find one.

Overall lumpiness and a ropy or grainy texture

What it is: Lumpiness in generalized areas of both breasts, usually in the area around the nipples and the upper, outer parts of the breast is often an indication of fibrocystic breasts. According to the National Cancer Institute, this condition is characterized by overall lumpiness and a ropy or grainy texture, rather than one single lump.

What to do: Don't risk it -- ask your doctor or gynecologist for a clinical breast exam and consider a diagnostic mammogram and ultrasound screening. All lumps should be carefully monitored for changes, as fibrocystic breasts put you at increased risk for breast cancer. Be diligent about regular self-exams and yearly clinical exams. Report any changes immediately to your doctor.

Tender, lumpy breasts

What it is: Painful, lumpy breasts about 14 days before the onset of your period that fade each month. The condition can also be triggered by stress or excess salt or caffeine.

What to do: Don't risk it -- ask your doctor or gynecologist for a clinical breast exam and consider a diagnostic mammogram and ultrasound. All lumps should be carefully monitored for changes, as fibrocystic breasts put you at increased risk for breast cancer. Be diligent about regular self-exams and yearly clinical exams. Report any changes immediately to your doctor.

A single lump that's hard on the outside, squishy on the inside

What it is: Often it's a cyst. They typically occur as a distinct, solitary lump that feels like a solid, oval-shaped mass. Cysts occur most often in women 35 to 50 years of age. It's important to have a cyst diagnosed to make sure that it is not a breast cancer lump. Painful, benign cysts can be drained by a needle in the doctor's office. Cysts can recur.

What to do: Don't risk it -- ask your doctor or gynecologist for a clinical breast exam and consider a diagnostic mammogram and ultrasound. All lumps should be carefully monitored for changes since they put you at increased risk for breast cancer. Be diligent about regular self-exams and yearly clinical exams. Report any changes immediately to your doctor.

A small, solid round lump that can be moved

What it is: This is usually a fibroadenoma, a benign and usually painless condition. Most often they are found by a woman herself. A fibroadenoma usually appears as a single lump that feels like a small rubber ball inside the breast tissue and can easily be moved around. These are the most common type of lumps in women in their late teens and early twenties, according to the National Cancer Institute.

What to do: Don't risk it -- ask your doctor or gynecologist for a clinical breast exam and consider a diagnostic mammogram and ultrasound. All lumps should be carefully monitored for changes since they put you at increased risk for breast cancer. Be diligent about regular self-exams and yearly clinical exams. Report any changes immediately to your doctor.

Exaggerated general lumpiness

What it is: This is often pseudolumps or several areas of breast tissue that feel more prominent or persistent than usual, basically just exaggerated lumpiness. Although a pseudolump is innocent, it's usually distinct and persistent enough that it can confuse many surgeons into thinking it is a cyst, a fibroadenoma or a breast cancer lump.

What to do: Don't risk it -- ask your doctor or gynecologist for a clinical breast exam and consider a diagnostic mammogram and ultrasound. All lumps should be carefully monitored for changes since they put you at increased risk for breast cancer. Be diligent about regular self-exams and yearly clinical exams. Report any changes immediately to your doctor.

A firm, unmovable lump

What it is: This is usually a symptom of breast cancer. While benign breast lumps -- sacks of fluid or lumps of fat, move with the breast, cancers defy gravity. Thickened or dimpled skin is a sign of a lump that's unmoveable -- and a cause for concern.

What to do: First, remember that 90 percent of women who catch breast cancer early survive. But to be one of them, you must get a proper diagnosis and treatment. See your doctor. She will examine you thoroughly, then follow up with a mammogram. If there's a possibility that it's cancer, she may perform a needle biopsy, inserting a small needle into the lump to retrieve a cell sample to be reviewed by a pathologist for a diagnosis.

Continued on page 2:  Other breast conditions

 

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