What is it?

A breast lump is a swelling, bulge, or mass in the breast tissue that feels different from surrounding tissue or the other breast.

Location

Can occur in any quadrant of the breast or near the nipple/axilla.

Size

May range from a few millimeters to several centimeters.

Consistency

Soft, firm, rubbery, or hard; movable or fixed.

Painful?

Some are painful (usually benign), others are painless (possibly suspicious).

🟢 Benign

Fibroadenoma, cyst, lipoma, abscess

Common in younger women; often movable and smooth

🟡 Hormonal

Fibrocystic changes

Related to menstrual cycle; may vary in size

🔴 Malignant

Breast cancer (ductal, lobular, inflammatory)

Usually hard, fixed, irregular in shape

🦠 Infectious

Mastitis, abscess (especially in lactating women)

Redness, warmth, tenderness, may have pus

🧬 Other

Phyllodes tumor, fat necrosis

May require biopsy to differentiate

1️⃣ Clinical Breast Exam

By doctor (palpation, inspection)

Initial assessment

2️⃣ Breast Ultrasound

First-line for women <40 or cystic lumps

Detects solid vs fluid-filled masses

3️⃣ Mammography

Standard for women >40 years or suspicious lumps

X-ray to detect masses, calcifications

4️⃣ MRI Breast

For dense breasts or high-risk patients

Better soft tissue contrast

5️⃣ Fine Needle Aspiration (FNA)

Removes cells for cytology

Simple, outpatient, quick assessment

6️⃣ Core Needle Biopsy

Removes tissue for histopathology

More accurate than FNA

7️⃣ Excisional Biopsy

Complete surgical removal for analysis

When imaging/biopsy is inconclusive or cancer is confirmed

Estrogen/Progesterone Receptors (ER/PR)

Determines hormone responsiveness

HER2/neu

Checks for aggressiveness and eligibility for targeted therapy

Ki-67

Measures proliferation index

Tumor Markers (CA 15.3, CEA)

Monitoring response to treatment

PET/CT Scan

Staging, if malignancy is confirmed

BRCA1/2 Gene Testing

If family history or early-onset breast cancer

Benign cyst

Often no treatment or aspiration if painful

Fibroadenoma

Monitoring or surgical removal if >3 cm or bothersome

Abscess/Mastitis

Antibiotics, drainage

Cancer (Malignant)

Surgery (lumpectomy/mastectomy), chemo, radiation, hormone therapy

Feel

Smooth, mobile, soft or rubbery

Hard, fixed, irregular shape

Pain

Often present

Rarely painful

Skin/Nipple changes

Usually absent

May be present (dimpling, discharge)

Growth

Slow or stable

Rapid or progressive

Age group

<40 years typically

>40 years typically