Nine out of 10 breast lumps aren’t cancerous, but they do need to be checked out. Dr Melanie Wynne-Jones explains why…
Our breasts contain milk-producing glands, connected by a network of ducts to the nipples, as well as fat, connective/fibrous tissue and attachments to muscles and ligaments. And any of these tissues can develop lumps or pain.
Current advice is to be ‘breast aware’, which means knowing what looks and feels normal for you. A good way to check your breasts is in the shower using your soapy hand, and report any worries to your GP straight away.
Even if she doesn’t think it’s cancer, she’ll probably refer you to be seen at the breast clinic within a couple of weeks for an ultrasound scan or mammogram and/or biopsy (sample taken using a tiny needle and local anaesthetic).
If it does turn out to be cancer, the sooner it’s diagnosed, the better the outlook. Men should report any changes, too, as around 350 men get breast cancer each year in the UK.
Your breasts may become fuller, lumpier or more tender before your period and settle again afterwards.
This has been called fibroadenosis, fibrocystic change or ‘mastitis/mastopathy’, and is probably due to monthly hormonal fluctuations.
See your GP to be sure, or if it’s persistent or troublesome. She may refer you, for safety’s sake.
Things that can help include wearing a well-fitting or sports bra, lifestyle changes (not smoking, reducing coffee and saturated fat), painkillers, rub-in non-steroidal, anti-inflammatory creams, such as ibuprofen, or taking evening primrose oil capsules (unless you’re planning pregnancy or have epilepsy).
Breast cysts often appear suddenly as a tender, smooth marble-like lump, but may have no symptoms. They usually affect women between the ages of 30 and 60 years, and are sometimes triggered by hormone replacement therapy.
Cysts can grow, be multiple or recurrent. They contain a pale fluid, which can be removed and tested using a fine needle and local anaesthetic.
Fibroadenomas are often called ‘breast mice’, as they’re soft and small and seem to move under your fingers.
They’re probably hormone related and often disappear, but may be removed if there’s any doubt on the scan or mammogram.
Breast abscesses are benign but unpleasant. They usually develop after mastitis, especially during breastfeeding.
You’ll feel unwell with aching and a fever, and notice a sore, red, hot, hard patch that may become a lump. Antibiotics usually help in the early stages, but you may need to have the pus drained, under a general anaesthetic.
Gynaecomastia means abnormal swelling of one or both breasts. It’s caused by hormone changes and often occurs briefly in newborn babies, teenage boys and older men (only 1% are cancerous).
In later life, it’s often a side effect of drugs used to treat heart disease, indigestion, mental health and other problems, but it can also be due to hormone and liver disorders, so tests are needed, although treatment is rarely required.
Common skin conditions can affect the breasts and armpits, such as eczema, psoriasis, sebaceous cysts and skin cancers, including Paget’s disease of the nipple.
Chest-wall problems can cause pain and swelling. Costochondritis, which affects the gristly joints between the ribs and breastbone, can produce one or more tender lumps.
But never diagnose yourself – only your GP can tell you whether anything needs to be done.
4 Reasons To See Your GP
1. All lumps, thickening, or persistent/recurrent pain in your breast or armpit.
2. Change in the size or shape of one or both breasts or nipples. Your skin may get pulled inwards.
3. Changes in the skin of your breasts or nipples – dimpling, redness or a dry, weeping or scaly rash.
4. A watery, coloured or blood-stained discharge from your nipple.