This is the new kid on the block.
All breast lumps are not cancerous. In fact, in the younger women, a vast majority of breast lumps are non cancerous. And indeed, they are quite common. Such non cancerous lumps do not get convereted into cancer. But it is essential to know about these non cancerous lumps as well, so that they can be detected and treated appropriately; and so that, there is no unnecessary apprehension. Also, if we ignroe them, sometimes they grow to larger sizes, where the cosmetic outcome after a surgery will be a little inferior, as compared to outcome, if operated when small.
In Medical Terminology, a non cancerous lump is called as 'Benign' and a cancerous lump is called as 'Malignant'. It's easy to divide them into non infected lumps and lumps due to infection. So let's read more on the common benign breast lumps.
All the types of lumps listed below are not associated with any infection. They usually form due to hormonal changes in the body. Many of them might just settle down on their own without any treatment:
A fibroadenoma is, by far, the most common lump occuring in women, especially in the younger age groups. It is known to form due to effects of a hormone called estrogen on the cells of the breast. It feels 'firm' - like a tennis ball, as mentioned in the section on lumps. Fibroadenomas are very mobile usually, and one can move them 'side to side' in the breast by fingers. Fibroadenoma is not a cancer and fibroadenomas do not turn into cancers. Doctors usually end up seeing women for fibroadenoma in two situations:
The woman felt a lump by hand and came to the doc: This is the most comon scenario. A woman feels some lump in the breast, usually during bathing, or changing clothes, and goes to a doc. Fibroadenomas are usually painless, but occasionally, there may be pain too. Doc assesses it and tests and diagnoses it as a fibroid. Most of these fibroadenomas which are 'felt' by hand, will usually need surgery. Since, some of them can grow to really large sizes, and we can't predict, in whom it will grow and in whom it won't. So, if it is large enough that we can feel by hand (usualy a size of 2 CM or more), best is to operate it.
The woman does not feel any lump, but some small fibroadenomas are there on Mammography: Many women undergo a routine screening mammography and the report mentions of a few fibroadenomas here and there, and all seem to be small (in millimeters). In this case, the doc makes sure it is not enlarged, and makes sure we are not missing out anything. For small fibroadenomas, surgery is not needed and one can closely follow up.
A cyst in the breast means a collection of 'liquid' in an area in the breast. It is like a 'balloon', a thin wall outside, enclosing some fluid inside. Cysts in the breast are a very common finding, and a vast majority of them are noted as routine findings in a Mammography (Ultrasound). Rarely do they grow to larger sized, in which case they will feel like a lump and a woman is likely to consult a doctor for the same. Breast cysts will not cause any problem, unless they become big in size. If a cyst is not felt by a hand, it can be safely left alone. If a cyst can be felt with hand and is larger, then it may need intervention. Sometimes, especially in older age groups, such cysts are full of liquid, but show some 'solid' srea at one side, in which case, it is beter to excise, as there could be a hidden cancer in that solid area.
So you read about Fibroadenomas (which are 'firm' to feel) and you read about cysts (which are soft or firm to feel). In between these two, there ae a range of 'feels' of the breast, all of which have been clubbed into a term called 'Benign Breast Disease'. The reason is, a 'feel' of the lump or tissue, when not clear, will vary from person to person - a little soft or a little hard or a little firm. So they came out with a single term to include these benign lumps and 'lumpish feels' mainly because, the cause of all of them is almost the same and the treatment remains same. Many of these benign lumps may also be associated with pain in the breast (earlier this was called Fibroadenosis - swelling like situation in the breast). A majority of BBD will settle on their own, some larger lumps will need surgery.
Some benign breast lumps forum because of infection (bacterial infection). Half of such infection related lumps happen in women who are breast feeding. The other half happen in other women, some young, some old.
Breast Feeding: Milk is a very ripe medium for any bacteria to grow. During breast feeding, cracks on the nipple are common, through which bacteria can enter into a duct and cause the infection.
Inverted (retracted) nipple: Usualy, the nipples pout out. In a few women, the niplle may not pout out but rather, 'go in' and cannot be pinched out. And this situation is usually since a long time. Inverted or retracted nipples, tend to block ducts and cause infection.
Diabetes Mellitus: This is usually in middle aged or elderly women, who have Diabetes (raised blood sugars). Here, without any apparent cause, some area of the breast becomes infection (bacteria love sugar and sugary mediums).
Everything is fine. One fine day, due to any cause mentioned above, infection starts in the breast or milk ducts
In the initial three to four days, the area of breast which is infected becomes tender and painful and feels 'hard' or 'swollen'. There can be some reddish inflammed colour of the overlying skin as well. Many women will also have a fever and feel weak.
With these symptoms, most women are likely to go to their doctors. The doc, after assessment is likely to give her some antibiotics and pain killers.
In half the women, the antibiotics will settle down the infection and things will becomes normal again.
But in the other half, especially the ones who are breast feeding, the infection does come under control, and pus starts forming. The area which was hard and swollen earlier, now becomes a little 'softer'
At this stage, a Surgeon will need to take a call. If there are signs that infection is not settling, the lady may be admitted, given intra venous antibiotics and may undergo a small surgery to drain pus. In others, admission may not be needed, a simple aspiration of pus is done. In any case, this pus is sent to a Microbiologist for examination of bacteria and to know which antibiotics can work against them. With this drainage, the infection will settle down, for most women.
This is the new kid on the block.