| Breast Lumps |
| Most breast lumps are not cancers
A lump that can be felt can be: |
| 1. Fibrocystic Change |
| Fibrocystic changes occur in the majority of women as they progress through various stages of life.
a. Breast pain Breast tissue changes before the menstrual cycle causing more lumpiness and pain. |
| Microcalcifications |
| Abnormal Density ( Mass ) |
| 2. Fibroadenoma |
| A fibroadenoma is a benign (non-cancerous) growth in the breast that is made up of breast cells and fibrous tissue.
a. More common in younger women A definite diagnosis can be made with a combination of breast ultrasound and a breast biopsy using a core or mammotome technique. Surgery is not usually required. |
| Mammogram |
| A cyst is a little pocket of fluid occurring when a milk duct becomes blocked not allowing the normal breast fluid to flow through the ducts.
a. Varies in size Mammography and ultrasound provide an accurate diagnosis. If the cyst is painful, it can be drained (aspirated) using ultrasound to guide the tiny needle. |
| A lipoma is a growth in the breast, which is fat and is surrounded by a fibrous band. a. May or may not be felt b. Does not become cancerous c. Does not need to be removed surgically The diagnosis can be made with ultrasound and sometimes a biopsy. |
| A papilloma is a tiny growth in a milk duct, which may cause a nipple discharge. a. Cannot be felt b. Spontaneous yellow/bloody nipple discharge usually c. Is not cancerous d. May or may not need to be removed The diagnosis can be made with a ductogram followed by mammography, ultrasound and a needle core biopsy or surgery. |
| Breast cancer is a cancerous growth starting in the milk duct.
a. May or may not be felt |
| a. A firm lump often felt at the edge of breast tissue, or deep in a breast is a rib, pectoralis muscle, or a ridge of fibrous tissue. Remember, there are ribs and muscle behind all the breast tissue.
b. Pregnancy - Usually associated with the pregnancy and not cancer. However, cancer can occur in rare instances. |
| 3. Cyst |
| 4. Lipoma |
| 5. Papilloma |
| Breast Cancer |
| 6. Other lumps |
| Mammography is able to detect abnormalities that may not be felt. Most of these abnormal areas are benign – not cancer. |
| 1. Mammographic Density
a. Specific shape-round, oblong, or spiculated (crab-like) |
| Abnormal Mammogram |
| Mammographic Abnormalities |
| With an abnormal appearing density, extra mammographic views are recommended such as cone compression (compressing a small area of the breast where the density is located) to determine if this is overlapping normal breast tissue or a definite abnormal area. If there is truly an abnormal density, it remains on this image and is usually more clearly defined.
A breast ultrasound will then be used to provide more information. |
| a. Tiny specks of calcium b. Scattered-usually benign fibrocystic change c. Clustered-usually benign-small chance of very early breast cancer called duct carcinoma in situ. d. Cannot be felt e. Seen only on mammography-not ultrasound f. Magnifications views to provide more detail g.Clustered calcifications-even slightly suspicious- can be biopsied with stereotactic core biopsy. h. Hot all calcifications need to be biopsied or removed surgically |
| Usually caused by interaction of hormones (estrogen and progesterone) and breast tissue.-Cyclic pain.
After menopause, hormone replacement therapy can cause pain. Seldom associated with breast cancer. Pain can increase during stress or certain times of the year. Caffeine, mushrooms, nuts, cheese, red wine, bananas, and chocolate in excess can increase breast discomfort. Suggestions:1. Limit caffeine It is always important to discuss breast changes and / or pain with your physician, have yearly mammograms beginning at age 40, and continue regular breast self examination. |
| 2. Calcifications |
| Breast Pain |
| Nipple secretions or discharge is experienced by many women.
Further evaluation necessary when the discharge is: 1. Spontaneous – Comes out by itself without vigorous squeezing or nipple manipulation. |
| 1. A tiny catheter is placed in nipple opening where discharge is seen. 2. A few drops of contrast material is injected. 3. A mammogram is performed. 4. An ultrasound may be performed if an abnormality is seen. 5. A needle core biopsy (ultrasound mammotomy) can usually remove and diagnose the problem. The discharge is usually gone. 6. Most women have minimal discomfort with this procedure. |
| Nipple discharge can be caused by
* Fibrocystic changes -common * Intraductal Papilloma -a tiny benign growth in the milk duct, which is also common |
