A breast nodule is a small lump that, in most cases, is not a sign of breast cancer, and is only a benign change, such as fibroadenoma or a cyst, that usually does not require treatment.
Breast cancer should only be suspected when the lump has malignant characteristics, such as changes in breast size and shape, or if there is a history of breast cancer in the family, especially in first degree relatives.
If a lump is found during breast self-examination, for example, it is important to consult a mastologist and perform tests such as an ultrasound or mammography, so the doctor can identify whether the lump is benign or malignant and define the most appropriate treatment.
Main causes for benign breast lumps
Lumps in the breast that are not linked to cancer are called mastopathy and may arise due to hormonal changes, disappearing after menstruation or arise due to the onset of a cyst or fibrosis of the breast tissue. Some of the most common causes of breast lumps include:
1. Fibrocystic changes
Fibrocystic changes are the most common cause of breast lumps and are related to hormonal changes in the woman's body, especially during her menstrual period or when you are following treatment with hormones.
Lump characteristics: usually appears in the week prior to your menstrual period and disappear one week after the end of your period. They may present as painful and hard lumps, appearing in only one breast or both.
2. Simple cysts
Cyst usually occurs in premenopausal women over the age of 40, a non-severe breast disorder that rarely develops into cancer and does not require specific treatment.
Lump characteristics: They are most common in both breasts and may change in size during your menstrual period. In addition, they can also be painful when the woman ingests caffeine through coffee, tea or chocolate, for example.
Fibroadenoma is the most frequent type of breast lump in young women between the ages of 20 and 40 and is caused by an exaggerated growth of the glands that produce milk and breast tissue.
Lump characteristics: they are round shaped, are slightly hard and can move freely through the breast, not being fixed in one place. In addition, they usually do not cause any kind of pain.
Lipoma results from the accumulation of fatty tissue in the breast and therefore is not serious and can be removed through surgery for aesthetic reasons only.
Lump characteristics: They are soft, similar to small fat pads, that can move through the breast. However, in some cases lipomas may also be hard, and can confused with breast cancer.
5. Breast infections
Some breast infections such as mastitis during pregnancy, for example, can cause inflammation of the tissues and ducts inside the breast which leads to the appearance of lumps.
Lump characteristics: usually cause breast pain, especially when pressed, and may lead to redness on the area of the lump.
6. Diabetic mastopathy
Diabetic mastopathy is a rare and serious type of mastitis, an inflammation in the breast that causes pain, redness and the appearance of one or more lumps in the sinuses, which can be confused with cancer. This disease appears only in people with diabetes who use insulin, mainly affecting women.
Lump characteristics: Hardened tumors appear which are painless in the beginning of the disease. Blisters can also appear on the skin and pus.
Examinations to identify the type of breast lump
Mammography and ultrasonography are the most commonly used for the diagnosis of a lump, but the doctor can also use palpation of the breasts in the appointment.
The result of the mammography is standardized using the BI-RADS classification system and, therefore, the result of the examination can be:
- Category 0: the exam was not able to characterize changes and other complementary tests are needed;
- Category 1: normal result, the exam should be repeated in 1 year;
- Category 2: benign changes, without the risk of cancer, and should be repeated in 1 year;
- Category 3: possible benign changes, with a cancer risk of 3% and it is recommended to repeat the exam in 6 months;
- Category 4: suspected malignant changes and the risk of cancer is 20%; biopsies and anatomopathological assessment of breast tissue are required;
- Category 5: probably malignant changes with a risk of cancer of 95%, being indicated surgery to remove the lump, and a preoperative biopsy may be done;
- Category 6: breast cancer diagnosis.
A lump in the hypoechogenic or hypoechoic breast is only an expression that appears in the reports of the imaging tests, not indicating the severity or malignancy of the nodule.
Treatment for a breast lump
Breast lumps usually do not need any treatment as they do not cause any change in the patient's health and do not increase in size. However, when the lump is very painful or has a large size the gynecologist may recommend taking a specific contraceptive pill for the lump type or aspirating it to relieve the symptoms.
Breast lump in men
A breast lump in the men is usually associated with male breast cancer, but it may also be benign, so if you notice a lump, you should tell your doctor to perform diagnostic tests to identify its origin.