Normal breast lumpiness
It is normal for the breast to become a bit lumpy. This can often be transient and can sometimes feel like a discrete lump. Discriminating between lumpy but normal breast tissue and a potentially suspicious lump requires expert examination often combined with ultrasound. Sometimes a needle biopsy will be performed to confirm that the lumpy area is just normal breast tissue.
These are entirely benign lumps that consist of fibrous tissue. They often feel smooth and round. Expert examination, combined with ultrasound and a needle biopsy confirms the diagnosis. Once diagnosed, these lumps can be safely left alone. Most will either stay the same or get smaller over time. Very occasionally they will enlarge. Large, enlarging or tender Fibroadenomas are usually removed. Sometimes this can be with a needle if the lump is small. Otherwise a small operation is required (see Surgery for Benign Breast Lumps).
Breast cysts are normal but can be a nuisance. They only occur in pre-menopausal women or in post-menopausal women taking HRT. They usually present as a lump that appears quickly ("wasn't there yesterday"). The diagnosis is easily made and the cyst can be aspirated (usually painlessly) with a fine needle.
Unfortunately cysts often recur and although if you have had cysts before, another lump is highly likely to be another cyst, this cannot be assumed and expert examination is always required. There is no association between cysts and risk of breast cancer but very rarely breast cancer can be partially cystic.
There are a host of other entirely benign causes of a breast lump. They are usually diagnosed by a combination of expert examination combined with ultrasound with/without a mammogram and a needle biopsy (performed under local anaesthetic). Obviously the most important cause of a breast lump is breast cancer. The possibility of this (though often a small possibility) for all breast lumps means that all breast lumps require expert investigation.
Breast cancer can present in many ways but most commonly as a breast lump.
There are many features that will determine whether a lump is suspicious or not. Cancerous lumps are often irregular and hard but can feel exactly like cysts or Fibroadenomas. The diagnosis is usually made by a combination of expert examination combined with ultrasound and a mammogram and a needle biopsy (performed under local anaesthetic).