What happens if I find a lump?
If any screening test does detect a lump, the most important thing to do is to remain calm. There are benign breast lumps, and often they require no medical attention other than careful observation to ensure that they do not become larger or begin to cause discomfort for the patient. As discussed in the section about risk factors, a woman’s fatty breast tissue begins to form lumps naturally as she ages, and so it is not unexpected that a mammogram or clinical examination would detect something that may not necessarily be cancer.
A good example of such a benign lump is a breast cyst, which may also be referred to as fibrocystic disease. A cyst is a fluid-filled sac that may develop in a woman’s breast. They are not cancerous in any way, but may signal a patient’s pre-disposition to developing cancer, so a breast specialist should be notified as with any other lump. Cysts are most common in pre-menopausal women and are known to resolve themselves after menopause, but they can develop at any age. Generally, women who are still menstruating may experience pain during the second half of the menstrual cycle. Additionally, this pain may be exaggerated by childbirth, stress and caffeine. A cyst may feel like a grape or firm lump during a self examination, but an ultrasound or aspiration can easily determine the nature of the lump and whether or not it is fluid-filled. If the cyst is painful to the patient, it may be removed as would any other breast lump or be aspirated, in which a needle is used to drain the sac of the fluid within it. There is a very low chance that a benign cyst will turn into a malignant lump, but cysts do indicate the potential for cancer to develop in the breast. This makes self-examination and regular mammograms especially important for these women.
Another similar benign breast lump is known as a fibroadenoma. This lump tends to be smaller and firmer than a cyst, and is slow growing. Women usually develop fibroadenomas during childbearing years, and they can also resolve themselves following menopause. Like breast cysts, they must also be analyzed further with techniques such as ultrasound or biopsy in order to confirm that they are not cancerous lumps. Like benign cysts, fibroadenomas may also be left in the breast and observed so long as they do not become too large in size or cause discomfort for the patient.
Phyllodes tumors are a rarer form of benign breast lump than cysts or fibroadenomas, and they develop in the connective tissue of the breasts rather than the lobules or ducts. In very rare cases, this lump may prove to be malignant, but in either scenario the best option for treatment is removal of the tumor. Depending on whether or not the tumor is malignant and the overall size of the tumor, a lumpectomy may be conducted with smaller margins removed in benign cases and larger margins for malignant tumors. If the tumor is too large, a mastectomy may be opted for instead. If a malignant phyllodes tumor has been found to metastasize, then a chemotherapy plan for soft tissue sarcomas may be used to combat this problem or to shrink tumor size before removal.
Breast Pain (Mastodynia):
There are a few other problems that women may encounter with their breasts that share some symptoms with cancer but are not malignant. The first of these problems is simply breast pain, or mastodynia. While this may seem to signal a serious problem with a woman’s breasts, this pain may also be cyclical in nature along with the menstrual cycle. This cyclical pain may be most intense before the start of a woman’s period due to fluid filling the breasts, and subside after the period begins. If the fluid does not completely drain, a compounding effect may occur over multiple periods, making the pain seem more constant.
Another commonly observed breast problem is nipple discharge. It is generally not serious, but should be discussed with a physician if it occurs in only one breast, or is a color other than white, such as yellow or green. Spontaneous discharge, called galactorrhea, is not cancerous and is usually colored milky white. Bloody discharge is usually related to infection or an overgrowth of ductal cells known as intraductal papillomas. In rare cases, bloody discharge can be caused by cancer, meaning that if it does occur it should still be reported to a physician.