Everyone’s breasts are different. They vary in size and shape. But all breasts are made up of fatty tissue and glandular tissue. The glandular tissues secrete/make milk at the time when a woman is breast feeding. The milk passes through the milk ducts and nipples. The shape and size of the breasts changes depending on puberty, menstrual cycle, pregnancy and age. Most of the changes that occur in your breasts are normal and there is nothing to worry about. Very few of the changes such as the occurrence of ‘Breast Lumps’ and ‘Breast pain’ must not be ignored and needs medically checked by a good gynaecologist.
Broadly, breast lumps can be divided into cancerous and non-cancerous. Most of the time, breast lumps are benign (not cancerous) and are fibroadenomas or cysts. Less commonly, they can be Intraductal Papillomas. Breast lumps differ in size, shape and their location. If you find any lump in your breast, don’t worry, you are not alone. Nearly 50% of the women have lumps in their breasts. Lumps in breast are common during premenstrual period (just before the start of periods) and they go away on their own after the periods end. If they don’t go away and if you have been noticing it for few months, you need to get it checked by your gynaecologist.
Research is still underway to figure out the causes of breast lumps. A lot of evidence has been acquired by the experts which says that Hormone Replacement Therapy in which a combination of estrogen and progestin are given can increase the risk of breast cancer in women. HRT has shown to change the breast’s structure and increase the density of the breast. It becomes difficult to read the mammogram of a woman who has been undergoing HRT. Though the percentage of women who acquire breast cancer due to HRT is very small, it still puts women at risk of breast cancer.
Types of breast lumps:
- Fibroadenomas – The most common type of breast lumps. These are solid growth of tissues that may move inside the breast and can be felt by your fingers. They don’t hurt or cause pain when touched. These occur in women aged between 16 and 24. Your doctor may advise removal if they don’t go away on their own or if they are becoming large or if you are concerned about the lumps. Once removed, you doctor may even check for the presence of cancer cells.
- Nipple Adenomas are tumors that form in the nipple area. They sometimes return even after removal. Sometimes nipple adenomas are associated with cancer.
- Cysts – Cysts contains fluids and are typically round in shape. There can be one or more cysts inside the breasts and are typically found in women aged between 35 and 50. After menopause, cystic lumps disappear on their own. If they don’t even after menopause, you should see your doctor.
- Intraductal Papilloma – Papillomas are wart-like lumps that form inside the milk ducts right behind the nipples. They can discharge fluids or fluids mixed with blood. They can be found in women aged over 40.
Though rare, there are other types of breast lumps that may cause pain and swelling:
- Breast lumps formed due to breast infection – they are painful and swell.
- Phyllodes Tumour – This type of tumour is usually non cancerous but at times they can turn cancerous
- Fat necrosis – solid lumps that form due to scar tissue
- Sclerosing Adenosis – Small, painful and firm lump typically found on mammogram during breast screening tests.
- Duct Ectasia – Typically forms at the time of menopause. When the milk duct gets blocked, this type of lumps are formed and they turn the nipple inward.
How can you check for breast lumps by yourself?
It is advisable to check for breast lumps by yourself. But before that, you need to get trained by the gynaecologist on how to do it. You must also note that, lumps before menstruation are common and they should subside after the end of periods. So, you need to do self examination only after your periods are over.
Beast self exam is easy to do during bath. Apply a little bit of soap on your breast and move your fingers first gently and then a little harder on your breasts. You can feel the lumps if they are present. Don’t panic or run to your doctor if you find one. Observe them for few weeks. If you feel that they are not going away or if they are growing in number or size or if you see a discharge from the nipples with or without blood, then you must report to your doctor immediately.
Your doctor would then do an ultrasound test followed by a needle biopsy to check if the lumps are cancerous. Surgery may be done to remove them after diagnosis. In some cases, your doctor may ask you to go for a mammogram screening so that they will be able to see even the tiny lumps which the trained fingers can’t detect. There is a difference of opinion on when a woman should start going for regular mammogram tests. Check with your gynaecologist and take his/her advice. If your mother or sister was or is being diagnosed with breast cancer, you should not delay in seeing the doctor when you find even a very small lump.