BENIGN BREAST LUMPS

Breasts are made up of ducts, lobes, fibrous tissue, and underlying bone; therefore, they can feel lumpy or uneven. Before your menstrual period begins, and sometimes during your period, you can have some tenderness, pain, or lumps in your breasts. This could be due to the extra fluid that collects in the breast tissue (cyst) as well as changes in the body's hormonal levels. This is normal. But if the lumps do not disappear before your next period, contact your doctor as soon as possible.

Any noticeable change, thickening or localized swelling in your breast that was not there before may be a lump. Eighty-five percent of all breast lumps found are benign. Some common benign breast problems that appear as lumps are:

• Cystic Disease (fibrocystic breast disease) is the most common cause of breast lumps in women. These lumps or cysts are fluid-filled sacs that enlarge and become tender and painful before the menstrual cycle. This condition is responsible for at least half of all breast biopsies performed. It tends to involve both breasts. These lumps are movable, and if large may feel round and firm. Cystic disease usually disappears after menopause.

• Lipomas develop as single, painless lumps. They can vary in size. Lipomas consist of fatty tissue and are commonly found elsewhere in the body.

• Fibroadenomas, single solid tumors, appear most often in young women. They occur twice as often in African American women as in others. These breast lumps are firm, rubbery, movable, often oval-shaped, and usually painless.

• Papillomas are small, wart-like growths in the lining of a mammary duct near the nipple. These can produce a bloody discharge of the nipple.

• Injury to the breast, or trauma, may result in blood accumulation (hematoma) or destruction of fatty tissue (fat necrosis). Both conditions can appear as lumps. Sometimes the skin around these areas appears red or bruised. No evidence exists that traumas can cause breast cancer.

There are other, not as common benign breast lumps caused by a variety of breast problems such as sclerosing adenosis, etc.

NIPPLE DISCHARGE

Many women will have during their lifetime a nipple discharge. It can be either in one breast or both. Most nipple discharge are not serious. A clear nipple discharge is considered normal and most of the time will not require further work-up. If it persists or increases, your physician will probably want to investigate the matter further. A bloody nipple discharge is different. Although most women with a bloody nipple discharge will be found to have a benign tumor inside one of the milk duct (intraductal papilloma), it has to be proven. A bloody nipple discharge can occasionally be the symptom of a breast maligancy and should be thouroughly investigated. Some surgeons will first order a Galactrography which is an Xray of the ductal system of the breast. This may help clarify the cause of the discharge. Most of the time a breast biopsy is warranted to obtain the diagnosis.