Breast Lumps, Bumps and Pain: What's Normal and What's Not


Learning to distinguish your breasts' normal lumps is key to your long-term health. 

Like so many topics in health care, there’s controversy on how helpful breast self-exams are in finding cancers, but it’s great to know how your breasts normally look and feel so you’ll be able to tell if there are changes later. Once you’re in your twenties, you should begin doing a self-breast exam every month about the same time; 3-5 days after your menstrual period ends. This will help you get to know how your breasts feel normally. You will then be able to notice if any new or different lumps develop. Remember, some lumps are normal, but if you’re worried at any time, talk to your health care provider.

More than half of all women occasionally have lumpy, painful and swollen breasts. The good news is that nine out of ten breast lumps are not cancer but just benign conditions.

There are a variety of benign conditions that cause lumps and bumps. Here are several types of lumps, and what to do if you find one.


OVERALL LUMPINESS AND A ROPY OR GRAINY TEXTURE


What it is: Lumpiness in generalized areas of both breasts, usually in the area around the nipples and the upper, outer parts of the breast is often an indication of fibrocystic breasts. According to the National Cancer Institute, this condition is characterized by overall lumpiness and a ropy or grainy texture, rather than one single lump.

What to do: Don't risk it—ask your doctor or gynecologist for a clinical breast exam and consider a diagnostic mammogram and ultrasound screening. All lumps should be carefully monitored for changes, as fibrocystic breasts put you at increased risk for breast cancer. Be diligent about regular self-exams and yearly clinical exams. Report any changes immediately to your doctor.

TENDER, LUMPY BREASTS

What it is: Painful, lumpy breasts about 14 days before the onset of your period that fade each month. The condition can also be triggered by stress or excess salt or caffeine.

What to do: Don't risk it—ask your doctor or gynecologist for a clinical breast exam and consider a diagnostic mammogram and ultrasound. All lumps should be carefully monitored for changes, as fibrocystic breasts put you at increased risk for breast cancer. Be diligent about regular self-exams and yearly clinical exams. Report any changes immediately to your doctor.

A FIRM, UNMOVABLE LUMP
What it is: This is usually a symptom of breast cancer. While benign breast lumps -- sacks of fluid or lumps of fat, move with the breast, cancers defy gravity. Thickened or dimpled skin is a sign of a lump that's unmoveable -- and a cause for concern.

What to do: First, remember that 90 percent of women who catch breast cancer early survive. But to be one of them, you must get a proper diagnosis and treatment. See your doctor. She will examine you thoroughly, then follow up with a mammogram. If there's a possibility that it's cancer, she may perform a needle biopsy, inserting a small needle into the lump to retrieve a cell sample to be reviewed by a pathologist for a diagnosis.

In addition to lumps, there are several other conditions to look out for:

GENERAL BREAST PAIN
What it is: General pain and tenderness in both breasts is a common occurrence. It's sometimes accompanied by swelling due to water retention, occurring about two weeks before monthly menstruation and subsiding afterward. This is usually normal -- pain caused by hormonal changes in the monthly cycle.

What to do: Cut down on salt and fat intake to help reduce the swelling and tenderness, and keep your system hydrated by drinking lots of water. A good dose of exercise can help, too; it pushes out excess fluids and gives you a kick of endorphins, feel-good chemicals that give you an overall boost.

PERSISTENT PAIN
What it is: This pain is different than cyclical breast pain in that it's located in a specific spot and does not come and go with the monthly cycle. Sometimes -- but not often -- it can indicate cancer. It may be the result of a cyst or physical injury.

What to do: See your doctor. She will examine you thoroughly to determine the cause. If she suspects it's a problem, she'll then follow up with a mammogram. If there's a possibility that it's cancer, she may perform a needle biopsy, inserting a small needle into the lump to retrieve a cell sample to be reviewed by a pathologist for diagnosis.

Who is at risk for breast cancer?
Women with certain medical conditions, lifestyle habits, genes (information passed from one generation to the next), or traits (referred to as “risk factors”) may be more likely than other women to get cancer. However, having risk factors does not mean you will get breast cancer. Most women who develop breast cancer have no risk factors at all.

Overall, you are at a higher risk for developing breast cancer if you:
  • Have close relatives (mother, sister, grandmother, or aunt) who have had breast cancer
  • Have one of a few specific genetic mutations (mistakes in your genetic code) that are passed on from one generation to the next that increase your chances of getting breast cancer
  • Are obese, which is primarily linked with menopausal status
  • Drink alcohol excessively
  • How can I lower my risk for breast cancer?
How do I lower my risk for breast cancer?

You can lower your risk for breast cancer by keeping your lifestyle healthy. Don’t smoke, limit alcohol intake, exercise regularly, follow a healthy diet – eat lots of fruits and veggies, and have regular checkups with your health care provider.

Do I need to have a mammogram?

A mammogram is an x-ray of the breasts, usually done to try to find early signs of breast cancer. Teens do not need to get mammograms. In fact, mammograms don’t work well in teenagers and young adults because the breast tissue is too thick and too dense to get a clear picture. Most women start having mammograms when they are about 40. Some women younger than 40 years old have mammograms if they have a family history of breast cancer, if they have had radiation treatment for other cancers in the past, or if their health care provider recommends it for another reason.

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