Breast lumps: cancerous or benign

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During your breast self-exam, you may notice lumps or changes in the texture of your breast. While this may cause you concern, it is important to understand that most breast lumps are not cancerous. A lump can be malignant (cancerous) or precancerous , but there are several types of benign (benign) lumps in the breast. To further complicate matters, many benign breast changes can mimic breast cancer .

Breast lumps can vary in size, growth rate, and symptoms. It is almost impossible to determine the cause of the tumor based on an examination of the breast, so be sure to consult your doctor when you first notice it.

Often tests – mammography , ultrasound , magnetic resonance imaging (MRI), or biopsy (where a sample of the lump is removed and examined under a microscope) is the only way to determine what a breast lump really is.

The following gives you an idea of ​​the most common causes of breast lumps.

Waiting for the answers you need during the trial period can be tricky. Keep in mind that even if you have breast cancer, the disease is treatable , especially if caught early.

Illustration by Brianna Gilmartin, Get Drug Information

Benign breast changes

Many breast lumps are benign and do not turn into cancer or spread. However, they can be painful or uncomfortable and cause health complications (such as infections), even if they are not cancer.

Breast cysts

A breast cyst is a benign fluid-filled sac in the breast tissue. They are very common and generally affect women in their 40s who are in perimenopause (the time before menopause when a woman stops menstruating), but they can occur at any age .

A breast cyst often appears smooth and tender. If you press on the cyst, it will rest like a balloon. The breast cyst can move and change in size during the menstrual cycle . Breast cysts can also be painful or painful, especially before the start of your menstrual cycle.

Breast cysts can be located anywhere in the breast, on the surface or inside. Although an ultrasound or fine needle may be required for an accurate diagnosis, simple cysts are rarely associated with breast cancer .

Fibroadenomas of the breast

Fibroadenomas of the breast are benign tumors of the glandular and connective tissue. They usually occur in women in their 20s and 30s, but they can occur at any age.

Fibroadenomas are usually round and firm. It can usually be moved under the skin during a breast self-exam. Fibroadenomas are often located near the surface of the breast. Some of them may be too small to feel and can be found accidentally on a mammogram.

A biopsy is needed to diagnose fibroadenoma, and your healthcare provider may recommend removal. Lumpectomy , radiofrequency ablation, and other fibroadenoma treatments can be used to remove a benign tumor.

Adenosis

Adenosis is a benign disease characterized by enlargement of the breast lobes (a breast lobe is a gland that produces milk). With adenosis, a lump may form that resembles a cyst or tumor. This can be accompanied by the appearance of calcifications on the mammogram.

Mastitis

Mastitis, an infection of the breast, is often accompanied by redness, swelling, and pain. Sometimes it can be difficult to distinguish mastitis from inflammatory breast cancer (a rare type that accounts for only 1 to 5% of all breast cancers), which usually begins with redness, tenderness, and a rash rather than a lump.

Ductal ectasia

Duct ectasia is a benign condition in which the milk ducts become blocked and swollen, often causing a grayish discharge. This can cause slight swelling just below the nipple or the nipple pulling inward . This occurs most often during menopause.

Fat necrosis

When the breast is damaged by surgery or injury, scar tissue can develop. Fat necrosis may occur that looks like a hard lump. Fat necrosis can cause discharge from the breast and adhesion of the nipple and skin. Fat necrosis can mimic cancer on imaging tests and a biopsy is required to determine the difference.

Oil cysts

Breast oil cysts are fluid-filled sacs that can appear smooth and soft. They are usually found on breast self-exams and can be found on mammograms, ultrasounds, or MRIs of the breasts.

Caused by the breakdown of adipose tissue, they often occur after breast surgery. They are called oil cysts because they contain a liquid form of body fat.

Although breast oil cysts do not become cancerous or increase the risk of breast cancer, they can occur along with the underlying cancer. They can be left alone or aspirated to remove the cyst.

Other benign formations

Other benign lesions include breast hematomas , hemangiomas, adenomyopheliomas, and neurofibromas.

Keep in mind that if you have a benign tumor, your risk of breast cancer, a condition that affects one in eight women, is not lowered . While you may breathe a sigh of relief after a benign breast tumor is diagnosed, you should still continue with regular mammograms, doctor visits, and breast self-exams.

Benign breast lumps and future risk of cancer

  • Women with a history of benign breast disease are more likely to develop breast cancer than women who have never had breast cancer. Benign breast disease (BBD) increases the risk of developing breast cancer in the future, in addition to the risk that a woman may already have due to a family history, personal history of breast cancer, or a mutation genetics, according to a 2019 study published in the International Journal of Cancer .

Precancerous lesions in the breast

Some breast lumps are not cancerous, but they are strongly associated with an increased risk of cancer. Others are precancerous growths, and cells can transform to become cancer cells in the future. While most benign breast tumors are left alone or removed for convenience, precancerous lesions must be removed.

Intraductal papillomas

Intraductal papillomas are tumors that begin in the milk ducts of the nipples and are often characterized by nipple discharge . Although these tumors are usually benign, they can be associated with an increased risk of cancer, especially if there are areas of atypical hyperplasia (usually found on biopsy) .

Radial scars

Radial scarring is a rare condition that can be benign, precancerous, or malignant. They usually don't cause palpable swelling (as you may feel), but they can show up on a mammogram as a spiny mass. A biopsy is usually required, especially since cancer cells can mix with the scar by radiation.

Ductal or lobular hyperplasia

Atypical lobular hyperplasia and atypical ductal hyperplasia are considered precancerous conditions. In other words, these growths are not cancerous, but they can become cancerous, so they must be treated before their characteristics change.

Tumors in situ (LCIS and DCIS)

Ductal carcinoma in situ (DCIS) is a malignant tumor. By definition, they are not considered invasive because they have not yet pierced the basement membrane, the encapsulating layer that separates cancer cells from surrounding tissue.

CIS is considered stage 0 cancer, while invasive tumors are defined as stage I to IV breast cancers.

Lobular carcinoma in situ (LCIS ) is not precancerous, but is associated with an increased risk of cancer .

Filodia tumors

Filodia mammary tumors are rare and can be benign or malignant. Since benign philodic tumors tend to become malignant, benign and malignant lesions are treated in the same way.

Most cases of breast cancer begin in epithelial cells and form carcinomas. In contrast, phyllodic tumors begin in mesenchymal cells ( connective tissue cells) and the tumors are defined as sarcomas.

Breast cancer

Breast cancer is a malignant growth of abnormal cells in breast tissue. Cancer can grow uncontrollably and spread to the breast, lymph nodes, or organs in distant parts of the body.

Malignant breast tumors include :

Location and composition

Breast cancer can occur in any part of the breast, but it is most often the upper outer part of the breast. It can be located near the surface or deeper than the chest, next to the chest wall. It can also occur in the armpits where there is more breast tissue (called the "tail" of the breast).

A breast cancer lump usually remains immobile during a breast self-exam, but because the tissue around it can move, it is sometimes difficult to tell what is moving during a manual exam.

A malignant tumor in the chest can be irregular ( although it can sometimes be round) with a pebbly surface that resembles a golf ball. It is often as tough as a piece of raw carrots.

Diagnosis and treatment

A clinical breast exam and mammogram can help with the diagnosis, although an ultrasound or MRI is sometimes required. Each of these types of tumors has unique characteristics that can be seen on imaging studies.

Even with all these imaging studies, it can be difficult to determine whether a tumor is benign or malignant, and a biopsy will likely be needed.

Mammograms can miss up to 15% of breast cancers, especially in women with tight breasts (a diagnosis that can only be made with imaging tests). A biopsy is the only way to differentiate cancer from a benign condition.

The distinctive features of each tumor type are most clearly visible on biopsy. There are several different breast biopsy techniques available, including rod biopsy or open biopsy, and the best option will depend on the characteristics of the tumor.

Finally, it is important to know that the breast biopsy usually takes cells from a small part of the tumor, leaving the possibility of a false negative result (normal biopsy despite having breast cancer).

Metastatic cancer

In rare cases, cancer metastases to other parts of the body , such as colon cancer or lung cancer, can lead to a new lump in the breast. A biopsy will help distinguish primary breast cancer from metastases that have occurred in other parts of the body.

Treatments for breast cancer depend on the stage of diagnosis and often target a specific tumor. In addition to surgery, treatment may include chemotherapy, hormone therapy, radiation therapy, or targeted therapy .

Frequently asked questions

How fast does a breast cancer tumor grow?

On average, the doubling time for a breast cancer tumor or the time it takes for a tumor to duplicate is approximately 50 to 200 days. The rate at which a breast tumor grows depends on the type of breast cancer, the characteristics of the tumor, the age of the patient at diagnosis, and the status of menopause. Inflammatory breast cancer tumors and triple negative breast cancer tumors tend to grow faster than estrogen receptor positive and HER2 negative tumors.

What should I do if I find a lump while breastfeeding?

Breast cancer is rare in women of childbearing age, and tumors found during lactation are more likely to be benign. Breast changes during lactation are normal and can include a blocked milk duct or mastitis. However, it is important to inform your doctor about any new tumor to make sure it is benign and to receive treatment that helps alleviate discomfort.

What does breast cancer look like on a mammogram?

Mammograms have a black background with white and gray coloring to show the breast tissue. Cancers usually present as a pronounced white patch, although dense breast tissue can make it difficult to see. However, up to 20% of breast cancers are not found on mammograms.

What does a breast lump look like?

Cancer in the breast usually becomes hard and immobile when pressed. It can also be irregular in shape. A benign breast lump may be softer and fluffier and will move when pressed.

Do breast cancer tumors hurt?

Lumps in breast cancer are generally not painful, but a small percentage of people develop painful lumps in breast cancer.

Get the word of drug information

Lumps in the chest are very common. It is important to check your breasts regularly for lumps. If you notice swelling, there is no need to panic, but it is also important not to ignore or delay care and treatment. Be sure to seek medical attention if you notice a lump in your breast; Call your doctor within a few days for a speedy imaging appointment or office visit.

Even benign growths generally need to be removed, treated, or closely monitored, so you need medical attention whether you have breast cancer or not.

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