Breast Lumps In Women (cont.)
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Breast lumps facts
- What are causes of breast lumps?
- Infections that cause breast lumps
- Injuries that cause breast lumps
- Non-cancerous growths that cause breast lumps
- Symptoms of breast cancer
- What determines breast cancer risk?
- How are breast lumps evaluated?
- How can a woman be certain that a lump is not cancer?
- How are breast lumps treated?
- Find a local Obstetrician-Gynecologist in your town
What are the symptoms of breast cancer?
The symptoms of breast cancer include painless breast lumps, nipple discharge, and inflammation of the skin of the breast. Sometimes breast cancer may not cause any symptoms.
Breast cancer usually causes no pain in the breast. Although women often worry about breast pain, most women with breast pain do not have breast cancer.
Nipple discharge that occurs without the nipple being touched can be caused by benign (non-cancerous) growths. Examples of these growths are intraductal papillomas (non-cancerous growths that protrude into the milk ducts) and dilated areas of milk ducts (ductal ectasia). Nipple discharge can also be caused by cancer of the breast tissue. Because nipple discharge can be a sign of cancer, it needs to be evaluated by a doctor.
Skin changes on the breast, including redness and warmth, can sometimes be a sign of breast cancer. A form of breast cancer that commonly causes these signs of inflammation is Paget's disease of the breast. However, most inflammation or rashes on the breast are not due to cancer. They may be caused by benign problems such as nipple eczema or a fungus infection. Still, any breast rashes should be evaluated by a doctor. Areas that are especially scaly and red, particularly if they are persistent, or if there is also nipple discharge, are often sampled (biopsied) to rule out cancer.
What determines breast cancer risk?
The chances that a particular breast lump could be cancerous depends on many factors, including a woman's past medical history, physical examination, and mammogram and ultrasound results. Some of the most important risk factors are outlined below.
Age is the biggest risk factor for breast cancer. In other words, most cases of breast cancer occur due to the fact that the risk of breast cancer increases with age. Most women with breast cancer do not have a history of breast cancer. A woman who has had a prior breast cancer or who has a family history of breast cancer is certainly at risk herself, especially if multiple family members are involved, the cases occurred at a young age, or if the cancer involved both breasts of a single family member.
Women who have received radiation therapy to the chest area as treatment for another cancer have a significantly increased risk for breast cancer.
About 5% to 10% of breast cancer cases have been shown to be related to inherited gene changes (mutations). The most common mutations are those of the BRCA1 and BRCA2 genes, although other genetic mutations may also lead to breast cancers.
Abnormal findings on previous breast biopsies
The finding of certain conditions on previous breast biopsies can also increase the risk for developing breast cancer. Pre-cancerous growths and growths noted on a breast biopsy that represent an increased risk for the development of breast cancer include the following:
- Ductal carcinoma-in-situ (DCIS) is an uncontrolled growth of cells that has not spread beyond the milk duct where it is located. DCIS consists of cancer cells that have not invaded other tissues. Therefore, DCIS is an early stage of breast cancer and is the most common type of noninvasive breast cancer. DCIS is not life-threatening, but must be treated. Women with DCIS have an increased risk for developing a recurrence of the cancer or for development of a new cancer in either breast.
- Lobular carcinoma-in-situ (LCIS) is considered to be a condition in which abnormal cells are confined to the lobules in the breast (the glands that produce milk). Unlike DCIS, LCIS is not considered to have a high probability of becoming a cancer, but it is a sign of risk for that breast or the opposite breast for developing a cancer. Therefore, women with LCIS have a greater chance of developing breast cancer in either breast.
- Proliferative disease of the breast is a benign condition, but it can be a signal that breast cancer may develop in the future. Ductal hyperplasia (the excessive growth of normal cells within the breast ducts) and atypical hyperplasia (overgrowth of abnormal cells in the ducts or lobules that is not serious or extensive enough to qualify as DCIS or LCIS) are examples of conditions that increase the overall risk for developing breast cancer. Not surprisingly, women with atypical hyperplasia have a higher risk than do those with usual ductal hyperplasia (without atypia, or abnormal cells).
Women with DCIS, LCIS, atypical hyperplasia, or proliferative disease are at even higher risk of developing breast cancer if they have a history of breast cancer in the family.
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