While finding a breast lump is a shock NOT all lumps are a cancer!
But every lump should be investigated to know WHAT IT IS!
The commonest sore lump that suddenly appears in the breast is a BREAST CYST – a benign bubble of fluid which is a stretched milk duct filled with a hormonally generated secretion. These have a typical appearance on ultrasound and are called either SIMPLE or COMPLEX. A complex cyst is not necessarily abnormal. Any palpable cyst can be drained in the rooms by puncturing it with a needle. If a cyst cannot be felt but has unusual features on ultrasound it can be drained with an ultrasound. Women of any age can make breast cysts but they are commonest just before a period and will often settle themselves absorbing away when the period starts.
A SOLID breast lump needs a tissue diagnosis because while the ultrasound may suggest what it is this is safest proven. This is done with an ultrasound guided biopsy under local anaesthetic.
It is very rare a benign proven lump will become a cancer.
Benign solid lumps are excised if
- they enlarge
- they have a concerning appearance radiologically
- they are painful and this cannot be settled with herbal therapies
- they are a size that affects the cosmesis of the breast
- the patient requests the lump be excised – for their own peace of mind and not to have to continue monitoring the lump
Excision of a breast lump is usually undertaken as a day case surgery and involves fasting prior and having a short general anaesthetic. All benign lumps can be excised with the scar hidden at the nipple margin. The breast is remarkable at healing and careful surgery means benign lumps can be shelled out so there is no volume defect, no sensory change and no surrounding nerve injury.