Breast lumps & changes

Most breast lumps are not cancerous. Changes occur naturally in the breast during menstrual cycles, pregnancy, breastfeeding and ageing. However, because 1 in 9 New Zealand women develop breast cancer in their lifetime, see your doctor if you notice any changes in your breasts.

Key points

  1. Most breast changes aren't cancerous. Lumps and changes may be caused by benign (non-cancerous) such as fibrocystic change (firm fibrous tissue), cysts or breast calcifications (tiny deposits of calcium in breast tissue).
  2. However, sometimes it is breast cancer. Finding breast cancer when it is small improves the chances of treatment being successful.
  3. You can help find breast cancer by being ‘breast aware’. This includes knowing what is normal for your breasts and knowing what changes to look and feel for.
  4. This is not the same as breast self-examination, which is a more formal and structured technique of examining your breasts. This is no longer recommended. 
  5. See your doctor straight away if you notice any changes in your breasts.
  6. Also make sure you have your mammograms. In New Zealand, women aged 45 to 69 are eligible to have a free mammogram every two years with BreastScreen Aotearoa 0800 270 200.

What are breasts made of?

Your breasts are made up of the following:

  • milk glands, which are made up of many milk sacs throughout your breast
  • milk ducts to carry milk to your nipples
  • fibrous tissue, which covers and supports your whole breast
  • fatty tissue, which gives your breasts shape and size.

In your breast, armpit and neck there are collections of lymph nodes. These are small glands, each about the size of a pea, that help your body fight infection. Your chest muscles and ribs lie beneath your breasts. 

You may notice that your breasts are slightly different in shape or size or that one is slightly higher than the other. If your breasts have always been like this, these differences are normal. 

What is breast awareness?

To be breast aware, you need to:

  • know what is normal for you
  • know what changes to look and feel for
  • report any changes to your doctor straight away
  • go to mammography screening if appropriate for your age group
  • know your family history of cancer.

Look and feel for breast changes regularly, such as when dressing or showering, so that you get to know your breasts and how they change at different times of the month and as you age. 

If you notice any change in your breasts that is unusual for you see your doctor straightaway. For example:

  • a new lump or thickening
  • a change in breast shape or size
  • pain in your breast that is unusual
  • puckering or dimpling of your skin
  • any change in one nipple, such as a turned-in nipple or a discharge that occurs without squeezing
  • a rash or reddening of the skin that appears only on your breast. 

Although these changes do not necessarily mean you have breast cancer, any breast change should be checked by your doctor. Read more about breast cancer

What are normal breast changes?

Most women have changes in their breasts during their lifetime. Many of these changes are caused by hormones. Other breast changes can be caused by the normal aging process.

Menstrual cycle – your breasts may feel more lumpy or tender at different times in your menstrual cycle. Before or during your menstrual periods, your breasts may feel swollen, tender  or painful. You may also feel one or more lumps during this time because of extra fluid in your breasts. These changes usually go away by the end of your menstrual cycle.

Menopause – as you near menopause, your menstrual periods may come less often. Your hormone levels also change. This can make your breasts feel tender, even when you are not having your menstrual period. Your breasts may also feel more lumpy than they did before. They may also may lose tissue and fat and become smaller and feel lumpy.

Pregnancy – During pregnancy, your breasts may feel lumpy. This is usually because the glands that produce milk are increasing in number and getting larger.

Breastfeeding – While breastfeeding, you may get a condition called mastitis. This happens when a milk duct becomes blocked. Mastitis causes the breast to look red and feel lumpy, warm, and tender. Learn more about mastitis

Hormone medications – If you are taking hormones (such as menopausal hormone therapy or birth control pills or injections) your breasts may become more dense.

However, if you are unsure about any changes, see your doctor.

What are harmless breast lumps?

All breast lumps should be checked by a doctor. Most breast lumps that develop before menopause are benign (not cancerous), but you need to get any lumps checked to rule out cancer.

Benign breast problems include pain, lumps or masses, infections, nipple discharge and skin changes. Common benign lumps include the following:

  • Lipomas – these are lumps made up of fatty tissue and can be found just under your skin anywhere on your body.
  • Cysts – these are fluid-filled sacs. You may have a single cyst or a number of different sized cysts. Your doctor may use a needle to remove the fluid in these.
  • Fibroadenomas – these lumps are smooth, hard and movable, rather like a marble dropped into your breast tissue. They are common in women aged 18–30.

Read more about benign breast conditions (Breast Cancer Foundation, NZ)

Why should I not do routine breast self-examination?

Breast self-examination is a formal, structured technique by which women feel for breast lumps and or changes on a regular basis, usually every month. 

However, this is no longer recommended, because:

  • there is no evidence that doing breast self-examination will reduce your chances of dying from breast cancer
  • it can lead to anxiety and unnecessary breast biopsies, particularly among younger women.

Learn more

Breast awareness Breast Cancer Foundation, NZ
Breast lumps NHS, UK

References

  1. Information on breast awareness National Screening Unit, Cancer Society, Breast Cancer Foundation, NZ, 2013
  2. Understanding breast changes – a health guide for women  National Cancer Institute, US, 2014
  3. Benign breast problems and conditions The American College of Obstetricians and Gynecologists, US, 2017
  4. Benign breast conditions Breast Cancer Foundation, NZ
Credits: Health Navigator Editorial Team.