It Might Not Be Breast Cancer

Suspicious lumps and bumps don’t always mean cancer. Have you ever had “a scare”? Maybe you were doing a breast self-exam or merely lotioning up after a shower. Whatever you were doing, it was no less than a shock when you felt a lump. You ask:
  • “Is that what I think it is?” 
  • “How long has it been there?” 
  • “Oh my goodness, I have cancer.” 
Because of effective breast cancer awareness campaigns—which have done wonders in helping increase mammogram prevalence and breast cancer survival rates—when women feel changes in their breasts, they may automatically assume it’s cancer. But that’s far from the reality. About 80 to 85 percent of all breast lumps are not cancer, according to the U.S. National Library of Medicine. So if a lump isn’t cancer, then what is it?

OUR CHANGING BREASTS
They may seem unchanging, but breasts are “very dynamic organs". “Breasts change during every monthly cycle, and they also change a lot throughout life, too.” Blame it on hormones, says Shahla Masood, M.D., president of the World Society for Breast Health. “The function of the breast is to provide nutrition to children. The life cycle of breast tissue completes with pregnancy, and the breasts are under continual change until menopause.” Still, that doesn’t mean you should ignore breast symptoms. 


It’s important for a woman to be familiar with her breasts. Breast self-exams should start in young women and annual mammograms at 40. If you notice anything, especially that’s changed, hurts or won’t go away, don’t hesitate to have it checked. It likely will be one of the following benign breast conditions.

CYSTS
WHO’S AFFECTED: Mostly premenopausal women, although cysts can occur after menopause as well, according to Susan G. Komen for the Cure.
WHAT THEY ARE: Cysts are fluid-filled sacs that can develop in many places in the body. Breast cysts are almost always benign and are usually too small to feel. Large cysts can be felt under the skin and are sometimes painful. They have no effect on breast cancer risk.
DETECTION: No biopsy needed. Cysts can be diagnosed with a breast ultrasound.
TREATMENT: Usually none is necessary. Cysts may come and go on their own. If painful or large enough to interfere with a clinical breast exam, cysts can be aspirated (the fluid removed) or removed entirely.

FIBROADENOMAS
WHO’S AFFECTED: Mostly young women ages 15 to 35.
WHAT THEY ARE: Fibroadenomas are well-defined lumps that can feel rubbery or hard. They are benign tumors that have no effect on breast cancer risk.
DETECTION: They are usually detected with mammography.
TREATMENT: “None is necessary, so you may choose to do nothing,” Masood says. “Removal with a minimally invasive procedure is available, though, if the mass bothers you.”

HYPERPLASIA
WHO’S AFFECTED: Undefined, although risk appears to increase with age.
WHAT IT IS: Hyperplasia refers to an abnormal multiplication of cells. It is typically found in the lobules (milk-producing glands) or in the milk ducts. There are two types of breast hyperplasia: usual and atypical. Both types raise the risk for breast cancer. Usual hyperplasia can increase risk by two times and atypical by five times.
DETECTION: Hyperplasia is generally detected after an abnormal mammogram or clinical breast exam and is diagnosed with biopsy.
TREATMENT: Usual hyperplasia is typically monitored closely, and atypical hyperplasia is generally treated with surgery to remove the abnormal cells and ensure there are no cancerous cells in the area. In either case, your doctor may recommend earlier or more frequent breast cancer screenings.

Intraductal Papillomas
Who’s affected: Mostly women between the ages of 30 and 50.
What they are: Small lumps in breast ducts. They do not raise the risk of breast cancer unless abnormal cells are present.
Detection: Intraductal papillomas are the most common cause of nipple discharge from a single duct. They are not easily seen on mammograms, if at all, but may be felt by a physician during a clinical breast exam.
Treatment: Intraductal papillomas can be removed with surgery.

Fibrocystic Breast Condition, or Fibrocystic Change
Who’s affected: “Fibrocystic change is a recurring process that is very common,” Masood says. The condition affects more than half of all women. It most commonly begins in the 30s and goes away after menopause.
What it is: Changes to the breast throughout the menstrual cycle that cause the breasts to swell, feel lumpy and be painful. Lumpy breasts are not the same as having breast lumps. No cause has been detected, although some women have reported that caffeine and diet may affect their symptoms.
Detection: Pain may come and go or may be present throughout your cycle. Breasts may feel thick or lumpy, but the lumps will move when you push on them as though they are not affixed to anything. Some women have nipple discharge, although if it is clear, red or bloody, see your doctor right away.
Treatment: No treatment is necessary. To reduce pain, take an over-the-counter pain reliever,
apply heat or ice and wear a well-fitting bra.

Mastitis (Infection)
Who’s affected: Usually women who are breastfeeding.
What it is: Bacteria enter the breast through a crack in the nipple, causing tissue to be inflamed. The swelling causes pain and redness and puts pressure on the milk ducts.
Detection: You may have a fever, pain and other flu-like symptoms. One breast may be enlarged. Clogged ducts cause the breast to be sore. You may notice small, red lumps on the breast that are sore to the touch.
Treatment: Infections are treated with antibiotics. Continue breastfeeding, and drain the breast as much as possible. Beforehand, massage the breast, starting at the outside and working your way in. Apply warm, moist towels to the area several times a day. After a few days, if the lumps do not go away or increase in size or redness, or if you have severe pain,
see your doctor.

When to Call Your Doctor
Never hesitate to call your doctor about any breast symptoms, the National Cancer Institute recommends. Be sure to make an appointment if you have:
  • A lump in your breast or underarm
  • Thick or firm tissue in your breast or underarm
  • A change in size or shape of your breast
  • Nipple discharge that’s not breast milk
  • An inverted nipple 
  • Changes in the breast skin, including itchiness, reddening, dimples or puckers 
When you see your doctor, be prepared to answer the following questions:
  • What are your symptoms?
  • When did you first notice the change?
  • Is it in one breast or both?
  • Have there been changes since the symptoms appeared?
  • When was your last period?
Our board-certified, breast radiologist specialize in women's health, and they are here to help you. To schedule an appointment, call 678-312-3444. To learn more about women's imaging, visit gmcimaging.org.

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