What are the common causes of breast lumps?

There are several common causes of breast lumps in women:

1. Fibrocystic changes
   This is a benign (non-cancerous) condition where lumpy, dense tissue or cysts develop in the breasts, often related to hormonal changes. It is very common and affects over half of women.
2. Fibroadenoma
   These are solid, benign lumps made up of breast gland and connective tissue. They are movable and most common in younger women.
3. Cysts
   Fluid-filled sacs or cysts can develop in the breast tissue, forming smooth, mobile lumps. They often enlarge and become tender before menstrual periods.
4. Breast cancer
   While much less common than benign causes, a lump can potentially be a sign of breast cancer, especially if it feels hard, immobile and asymmetric.
5. Mastitis
   An infection in the breast tissue during breastfeeding can cause a painful, irregular lump to form.
6. Traumatic fat necrosis
   This develops after a breast injury, forming a firm lump from damaged fatty breast tissue.
7. Intraductal papilloma
   A small, benign growth that develops in the milk ducts near the nipple can feel like a firm lump.

Other less common causes include abscess, hematoma, lipoma, or phyllodes tumor.

Most breast lumps end up being non-cancerous, especially in younger women. However, any new or changing lump should be evaluated promptly by a doctor through clinical exam, imaging tests like ultrasound or mammogram, and potentially biopsy to determine the cause definitively.

What should I do if I find a breast lump?

If you discover a new lump or mass in your breast, it’s important to get it evaluated by a medical professional promptly. Here are the recommended steps to take:

1. Don’t panic. Many breast lumps end up being benign (non-cancerous), especially in younger women. But you should still get it checked out.
2. Note the details. Make note of the lump’s size, location in the breast, texture (hard, soft, movable), and if there’s any nipple discharge or skin changes.
3. Schedule an exam. Call your doctor’s office and schedule a clinical breast exam as soon as possible. Describe the lump and your concerns.
4. Get diagnostic imaging. After examining the lump, your doctor will likely order breast imaging tests like a mammogram, ultrasound, or both to get a better look.
5. Consider additional tests. If the imaging looks suspicious, you may need additional tests like a biopsy to remove cells/tissue from the lump for laboratory analysis.
6. Don’t try to remove it yourself. Don’t poke, squeeze or massage the lump, as this can lead to bleeding, bruising or infection.
7. Discuss your risk factors. Let your doctor know about any personal or family history of breast cancer that may increase your risk.
8. Follow up as recommended. Depending on the findings, you may need routine monitoring, follow-up imaging, or prompt treatment if breast cancer is diagnosed.

The key is to have any new, unusual breast lumps evaluated without delay by a doctor, who can order the proper imaging and testing to determine the cause. Early detection is important for effective treatment if it is breast cancer.

How often should I get a mammogram?

The recommendations for how often to get a mammogram can vary slightly based on different medical organizations, but here are some general guidelines:

For Women at Average Risk:

• Age 40-44: Annual mammograms are an option to consider
• Age 45-54: Annual mammograms are recommended
• Age 55 and older: Mammograms every 1-2 years

These recommendations assume you are at average risk for breast cancer with no personal history or strong family history of the disease.

For Women at Higher Risk:

• Start annual mammograms at an earlier age, typically around 30-35 years old
• Get supplemental breast MRI scans along with mammograms
• Discuss optimal screening schedule with your doctor based on your specific risk factors

Higher risk includes having a BRCA gene mutation, a first-degree relative with breast cancer, personal history of breast cancer or certain breast conditions.

Additional Considerations:

• Continue mammograms as long as you are in good health
• Clinical breast exams every 1-3 years from age 25-39, then annually from age 40
• Breast self-exams are an option to become familiar with how your breasts normally look/feel

The goal is to maximize early detection while minimizing risks from over-screening. Your doctor may recommend a more or less frequent schedule based on your individual breast cancer risk assessment.

It’s important to talk to your doctor about the benefits and limitations of mammograms and establish a screening plan that provides you with the best breast health monitoring based on your age and risk profile.