A breast lump is a mass within the breast. Fluid-filled masses are known as cysts. Solid masses may be noncancerous tumors, or they may be breast cancer. Breast cancer occurs when a cell within a breast undergoes changes that cause it to grow and divide uncontrollably.
Breast cancer risks
The risk for any woman to develop breast cancer is significant, about 1 in 9 over a lifetime. Breast cancer is also seen in men but is much less common. About 5% to 10% of all breast cancers may be related to genes that are passed through families, called BRCA1 and 2. Research has shown that women are also at greater risk of developing breast cancer if the following conditions apply:
There is evidence that the following conditions also contribute to a higher risk for breast cancer:
There are other risk factors for developing breast cancer, but they are controversial. They include the following:
Women who smoke are more likely to develop breast cancer that is estrogen-receptor negative. These women don't benefit from antihormone therapy. They generally have a poorer outcome from the cancer.
Women who breastfeed their children may lower their risk for breast cancer. However, a woman may have every risk factor and never develop breast cancer. A woman may have no risk factors and develop breast cancer. At this time it is not possible to predict with absolute accuracy who will and who will not develop breast cancer.
Breast cancer screening
Breast cancer is the most common cancer faced by women and the second most common reason for cancer deaths among women. A woman's best defense is early detection of breast cancer by doing the following:
Women should become familiar with how their breasts look and feel. Beginning in the late teens or early 20s, a woman can start to perform monthly breast self-exams. If a woman does BSE regularly, she is likely to notice early changes in the size, structure, and texture of her breasts.
According to the American Cancer Society, all women over 40 years of age with or without symptoms should have a mammogram once a year. Other organizations have different recommendations. However, all of these organizations agree that every woman over the age of 50 years should have an annual mammogram.
Breast cancer screening with mammograms has reduced deaths from breast cancer in women 40 to 69 years of age.
Noncancerous breast lumps
Most breast masses are not cancer. Many benign, or noncancerous, breast conditions cause masses or lumps that can be felt. These include the following:
Diagnosis of breast lumps
Once a breast mass is found, it is important to learn if it is benign or cancerous. Healthcare providers generally evaluate lumps or masses as follows:
If any mass or lump is thought to be suspicious, a diagnostic mammogram is usually performed.
If the mammogram suggests the possibility of cancer, a breast biopsy is done. During a biopsy, a tissue sample is removed and checked for cancer.
If the mammogram shows a solid area that does not suggest cancer, the woman and her healthcare provider will decide whether an ultrasound or biopsy should be done. One to 3 months later, the woman may have a repeat mammogram. If a biopsy is done, a diagnosis can be made at the time. If a biopsy was not done, but the second mammogram shows that the mass has disappeared or gotten smaller, only routine follow-up is needed. The woman should continue to follow recommendations for routine screening by mammogram. If the second mammogram shows that the mass has not changed or has gotten larger, a biopsy is often recommended.
If the mammogram shows a fluid-filled cyst, it can be drained with a needle. This procedure is called fine needle aspiration. Depending on the results, further steps may be taken.
These general guidelines for managing breast lumps may not fit every case. Together, a woman and her healthcare provider should discuss options. A woman's emotional and physical health, as well as her medical details, are key to making these decisions.
Author:Susan Woods, MD
Editor:Ballenberg, Sally, BS
Reviewer:Fern Carness, RN, MPH
Miaskowski, Christine, Buchesel, Patricia, Oncology Nursing: Assessment and clinical care. Mosby, St Louis 1999 Pg. 412-415