A breast lump is another tissue that grows inside the breast. Depending on the type of lump, the texture of the lump can be solid or filled with fluid.
Most breast lumps are benign (noncancerous). However, a lump in the breast can also be a sign of breast cancer . Therefore, it is important to get checked immediately if you notice a lump growing in the breast.
Apart from women, breast lumps can also be found in men. This condition needs to be distinguished from gynecomastia , namely breast enlargement in men which is generally associated with hormonal imbalances, excess body weight, or side effects of drugs.
Causes of Breast Lumps
The causes of breast lumps are very diverse, depending on the type of lump itself. The following is an explanation of the types of breast lumps and their respective causes:
A cyst is a fluid-filled lump that forms due to a buildup of fluid in the mammary gland. Women can have one or more cysts in one or both breasts.
It is not known why breast cysts form, but this condition is thought to be related to changes in female hormones during the menstrual cycle.
Fibroadenoma is a benign tumor of the breast that most often affects women aged 20-30 years. Fibroadenomas form from breast tissue and connective tissue, and can occur in one or both breasts.
Fibroadenomas are divided into simple fibroadenomas which are not cancerous, and complex fibroadenomas which can increase the risk of breast cancer.
Until now, it is not known what causes fibroadenomas. However, this condition is thought to be related to the hormone estrogen, or the use of birth control pills.
3. Fibrocystic breasts
Fibrocystic breasts are growths of fibrous tissue and cysts within the glands of the breast. Compared to breast cysts, fibrocystic breast lumps contain more fibrous tissue, which is connective tissue that is shaped like fibers.
This condition can happen to anyone, but is usually experienced by women during their fertile period, namely in the age range of 30–50 years.
The exact cause of fibrocystic breasts is not known, but is thought to be related to changes in the hormone estrogen during the menstrual cycle.
4. Intraductal papilloma
Intraductal papillomas are benign tumors that form in the ducts, which are the tubes that carry milk from the mammary glands (lobules) to the nipple. These tumors are formed from fibrous tissue, glands, and blood vessels.
Intraductal papilloma can be a single tumor ( solitary intraductal papilloma ) which is not cancerous, or consists of many tumors ( multiple papillomas ) which have a risk of becoming cancerous. This condition is known to most often occur in women aged 35–55 years.
Until now, it is not known what causes intraductal papilloma. However, there has been suspicion that this condition is related to contraceptive use, hormone replacement therapy , and family history.
Mastitis is inflammation of the breast tissue which is sometimes accompanied by infection. These conditions can lead to the formation of abscesses (collections of pus) in the breast tissue.
Generally, people with mastitis are breastfeeding mothers, but mastitis can also occur in women in general, and can even be experienced by men.
The main cause of mastitis is a blockage in the duct. Clogged breast milk can settle in the breast, then cause inflammation which leads to infection.
Mastitis can also be caused by bacteria that enter the breast. Bacteria can come from the surface of the patient's skin or the baby's mouth, then enter through a wound in the skin of the nipple or through the nipple hole. The bacteria that enter then grow and infect breast tissue.
Lipomas are lumps of fat that grow slowly under the skin. These lumps can grow anywhere on the body, such as the neck, shoulders, back, stomach or breast. Lipomas are benign and harmless tumors, but they can be annoying if they are large enough.
It's not known exactly what causes lipomas. However, this condition tends to occur in someone from a family who has a history of lipomas.
Although it can be experienced by anyone, lipomas are more common in people aged 40-60 years.
7. Fat necrosis
Fat necrosis occurs when the fat glands in the breast are damaged. Although generally caused by injury, this condition can also occur due to side effects of radiotherapy or surgical procedures on the breast, such as:
- Breast reconstruction
- Breast reduction
- Breast biopsy
8. Breast cancer
Breast cancer is cancer that forms in breast tissue. Although more common in women, breast cancer can also be experienced by men.
The type of breast cancer depends on the type of breast cells affected, including ductal carcinoma in situ , lobular carcinoma in situ , inflammatory breast cancer and angiosarcoma.
The cause of breast cancer is not known with certainty. However, there are several factors that increase the risk of developing breast cancer, namely:
- BRCA gene mutations that run in families
- Hormonal factors
- Unhealthy lifestyle, such as smoking
- Chemical exposure
- Environmental pollution
Symptoms of Breast Lump
Breast lumps can vary in size and texture, depending on the type of lump. Some of the characteristics of lumps that can appear include:
- The lump may appear singly or multiplely in one or both breasts
- The size of the lump can be less or more than 5 cm, but it can enlarge
- Lumps can feel soft, rubbery, solid, or like a fluid-filled sac
- The shape of the lump can be round or oval, and can or cannot be moved
- The lump enlarges before menstruation and returns to its original size after menstruation is over
In addition, other symptoms that can also appear are:
- Changes in the size and shape of both breasts
- Nipples secrete clear, cloudy, or even bloody discharge
- Swollen breasts (feel hard and warm to the touch)
- Nipples feel itchy or sensitive
- Fever with a temperature ≥38.3°C
- The body feels tired
When to see a doctor
All types of lumps in the breast should be examined by a doctor , especially if the lump has the following characteristics:
- The lump does not go away after menstruation, or more than 4–6 weeks
- A new lump appears
- Enlarged lump
- Breast size looks asymmetrical
- The lump feels solid and does not shift when moved
- Nipples bleeding
- Breast skin is red, hardened, or shriveled like an orange peel
- Bruised breasts for no apparent reason
- The nipple is inverted or in an abnormal position
- A lump appears in the armpit
Diagnosis of Breast Lumps
The doctor will ask about the symptoms experienced, when the lumps started to appear, as well as the medical history of the patient and his family. After that, the doctor will carry out a physical examination by feeling the patient's breasts.
A physical exam can help your doctor determine the location, density, and movement of the lump. Next, the doctor will suggest supporting tests to confirm the diagnosis, including:
Mammography is an X-ray photo of the breast. In this examination, the patient's breast will be placed on a tool that emits X-rays, so that images of breast tissue can be seen more clearly.
Through mammography, doctors can see if there are abnormalities in the breast, such as tumors, calcium buildup, or dense tissue in the breast.
2. Breast ultrasound
Ultrasound (USG) is an examination that uses sound waves, to produce images. Breast ultrasound is very useful in examining breast lumps, especially in distinguishing lumps that are solid and filled with fluid.
3. Magnetic resonance imaging (MRI)
An MRI uses a magnetic field and sound waves to display images of the inside of the body. An MRI is used to more closely examine lumps that are not clearly visible on mammography or ultrasound.
Ductography or galactography is the taking of pictures of the mammary glands with an X-ray machine. This examination will help the doctor determine the cause of the discharge from the nipple, either blood or clear fluid.
Ductography is preceded by injection of contrast fluid through the nipple.
A biopsy is a procedure for taking a sample of a lump or whole lump, to be examined in the laboratory. Some of the breast biopsy methods are:
- Fine-needle aspiration biopsy ( fine-needle aspiration )
- Core needle biopsy
- Stereotactic biopsy ( stereotactic biopsy )
- Vacuum - assisted biopsy
- Surgical biopsy ( surgical biopsy )
Breast Lump Treatment
In most cases, benign breast lumps do not require treatment, because they are harmless. Even in some cases, the lump can disappear by itself.
Medical action will be taken if the lump is large, getting bigger, painful, accompanied by sores, changes in the shape of the nipple, or discharge from the nipple.
The procedure for treating a breast lump depends on the type of lump, including:
Lumpectomy begins by giving the patient local anesthesia. After the anesthetic works, the doctor will make an incision around the tumor area, then remove the tumor and some of the surrounding tissue. This procedure is usually performed on women with a single lump that is less than 5 centimeters in diameter.
Cryotherapy aims to destroy abnormal cells by freezing them. In this procedure, the doctor will inject liquid nitrogen directly into the tumor area using a special needle.
3. Fine needle aspiration
Fine needle aspiration is a procedure for removing fluid from a breast lump using a special needle. This procedure is done with the help of ultrasound, so that the needle is placed precisely in the lump.
Mastectomy is a surgical procedure to remove all breast tissue. This procedure can be done on one or both breasts. Mastectomy performed on breast cancer patients.
In addition to a number of procedures above, doctors can also give birth control pills to regulate the menstrual cycle and reduce estrogen levels in patients.
In patients with mastitis, doctors can prescribe antibiotics and pain relievers, such as paracetamol or ibuprofen. Breastfeeding mothers who have mastitis do not need to stop breastfeeding, because this condition is not harmful to the baby and breastfeeding can actually help healing.
If the lump is breast cancer, in addition to a mastectomy, the doctor will also run radiotherapy, chemotherapy , or hormone therapy. In some cases, doctors may combine these methods, depending on the size and stage of the cancer, as well as the age and condition of the patient.
Complications of Breast Lumps
Breast lumps are generally benign and harmless. However, in some types of breast lumps, late treatment can result in permanent damage to the breast or breast cancer.
Once a breast lump has been diagnosed, it is important to follow the doctor's advice and treatment. This will lower the risk of complications, such as:
- Breast cancer that spreads to other organs or metastases
- Changes in breast shape due to tissue damage
- Spread of breast infection due to abscess
Breast Lump Prevention
Most breast lumps are difficult to prevent, because they occur due to hormonal changes that cannot be controlled. However, it is important for women to understand their breasts so that it is easier to recognize when there are changes in these organs.
One way that can be done to recognize your own breasts is BSE (breast self-examination). By doing BSE, patients can detect lumps early on.
BSE is carried out once a month, on the 7th to 10th day, starting from the first day of menstruation, or every month on the same date for those who have menopause.
Here are the steps on how to do BSE:
- Stand in front of the mirror naked with your hands raised above your head. Observe if there are changes in the shape, size, skin color, and skin surface of the breast. Please note, the shape of the right and left breasts are generally not symmetrical so there is no need to worry.
- Press your palms together firmly so that your breasts protrude forward. Observe whether there are lumps, wrinkled skin like oranges or depressions, such as dimples and nipples that are pulled in.
- Gently massage the area around the nipple to the tip of the nipple, then observe for abnormal discharge, such as yellowish white that is sometimes mixed with blood like pus. In breastfeeding mothers, this fluid is different from breast milk.
- Perform an examination of the right breast in a lying position, by placing a pillow behind your back and your right hand under your head. After that, feel the breast using the three fingers (index, middle, ring) of the left hand that are closed.
- Gently press the breast with the three fingers. Do a circular motion starting from the outside of the breast to the inside and touching the nipple, with a clockwise rotation. Focus and feel well to know if there is a thickening or lump.
- Do the same thing on the left breast using the right hand, with the left hand placed under the head.
- Pay special attention to the breast area near the armpit. This is because breast tumors are most often found in this area.
Besides BSE , another preventive step is SADANIS (clinical breast examination). SADANIS is performed by trained medical personnel. This examination is recommended to be done periodically, so that lumps or other abnormal signs in the breast can be found as early as possible.
The Ministry of Health of the Republic of Indonesia urges regular BSE and SADANIS examinations to be carried out. The goal is to detect breast cancer early. This can increase the life expectancy of sufferers.
In addition to BSE and SADANIS, you are also advised to do some of the simple efforts below, to reduce the risk of getting breast lumps, especially breast cancer:
- Do not smoke
- Exercise regularly
- Eat a healthy and nutritionally balanced diet
- Get enough rest
- Manage stress well