Breast lump and other conditions�

A breast lump is a swelling, protuberance, or lump in the breast.� If a lump or other change in breast or�nipple is noticed, causes may be any of the conditions described below.

Hormonal changes
Hormonal changes in the body make a woman’s breast feel different at various times during her menstrual cycle. Women who have been through menopause or who have had their ovaries removed, no longer have breast changes due to hormonal activity.

Hormonal changes may cause women to have swollen, painful or tender breasts at different times in their cycle and these are not a sign of breast cancer and usually do not require treatment.

Fibrocystic changes can occur in either or both breasts. These changes are common in women (especially during the reproductive years) and are considered a normal variation of breast tissue. Having�fibrocystic breasts�does not increase your risk for breast cancer. It does, however, make it more difficult to interpret lumps that you or your doctor finds on examination. Many women feel tenderness in addition to the lumps and bumps associated with fibrocystic breasts.

Cysts
A cyst is a fluid-filled sac. Fluid is produced and absorbed by the breast as part of the usual cycle of hormonal breast changes. Simple cysts are not cancer and do not change into cancer. However, in rare cases, cysts may have a cancer growing within or close to them. This can be noted through an ultrasound or noted after a cyst is aspirated or drained. Many women have a cyst or a number of cysts without knowing it and they do not usually require treatment. Some women first detect their cyst as a painful lump. This may be drained by inserting a fine needle into the cyst to draw out the fluid and is usually a simple and fairly painless procedure.

Fibroadenomas
A fibroadenoma is a smooth, firm breast lump made up of fibrous and glandular tissue. The term ‘breast mouse’ is also used to refer to a fibroadenoma. We do not know the cause of fibroadenomas; however, they are not cancer and rarely change into breast cancer. Fibroadenomas are more common in younger women and may become tender in the days before a period or grow bigger during pregnancy. Women have a choice about whether to have their fibroadenoma removed, but if it is monitored and continues to enlarge, it should be removed. Most often, younger women or those with smaller fibroadenomas will not have them taken out. The operation to remove a fibroadenoma is relatively simple. A general anesthetic is usually required.

Radial scar
This is a star-shaped abnormality in the breast tissue. No one knows why radial scars form, but they are thought to be benign (non-cancerous) changes caused by normal ageing. A small tissue sample needs to be taken because some radial scars contain small cancers or show pre-cancer changes. In some cases, the tissue sample can be removed with a needle instead of during an operation.

Microcalcifications
Microcalcifications are spots of calcium salts which show on a breast x-ray (mammogram) as white spots. These tiny spots can be scattered throughout the breast tissue or clustered together. Most microcalcifications are of no concern. Some of the causes include normal ageing or benign (non-cancerous) cysts. Sometimes calcification can indicate early breast cancer. You may need further x-rays or other tests.

Ductal carcinoma in situ (DCIS)
Microcalcifications can flag the presence of ductal carcinoma in situ (DCIS). In DCIS, the cells lining the milk ducts have turned cancerous. This means you are at high risk of developing an invasive breast cancer - one that spreads through the breast tissue - if the DCIS isn’t treated. The DCIS areas in the breast need to be surgically removed. In most cases DCIS is completely curable. Some increased risk still remains even when the area of DCIS has been removed, so you will need regular care after your treatment.

Atypical ductal hyperplasia (ADH)
Atypical ductal hyperplasia (ADH) means that the cells lining the milk ducts are growing in an unusual way. To confirm the diagnosis, a small tissue sample is taken from the breast and examined under a microscope. ADH is harmless for most women. For others, ADH might mean an increased risk of developing cancer in that particular breast some time in the future. In this case, breast screening every year is recommended.

Lobular carcinoma in situ (LCIS)
This is a benign condition, even though the word ‘carcinoma’ usually means cancer. Lobular carcinoma in situ (LCIS) is a growth change in the cells lining the very ends, or lobules, of the milk ducts. LCIS doesn’t show up on x-ray. It is usually discovered during the examination of a small tissue sample removed for another reason. LCIS is not cancerous, but it means you are at an increased risk of developing breast cancer in the future. Women with LCIS should discuss it with their doctor or a breast specialist.

Causes
There are many causes of breast lumps. Some of these causes are harmless, while others can be painful and/or dangerous. Causes of breast lumps include infections, injuries, non-cancerous growths and cancer.

Diagnosis
The following methods are used for proper diagnosis

• Biopsy of the lump
• Mammogram
• Needle aspiration of a cyst and examination of the fluid under a microscope
• Study of nipple discharge under a microscope
• Ultrasound to see if the lump is solid or a cyst
• Physical Examination

Treatment

• A�breast infection (mastitis)�in a breastfeeding woman is treated with warm compresses and antibiotics.
• An abscess of the breast often needs to be drained by a doctor because antibiotics alone cannot adequately treat an abscess.
• Fibroadenomas�are usually removed because they are difficult to distinguish from cancer until they are removed.
• Breast pain (mastodynia) is a common problem. As long as no mass can be felt by the doctor or patient and no breast lump is seen on a mammogram or ultrasound, breast pain is often concluded to be a normal condition. It is often thought that this pain is caused by natural hormonal fluctuations.
• Fibrocystic changes do not require medication or surgery. Often, a baseline mammogram is done. Then, no further treatment is needed unless a new lump arises, in which case an evaluation with a mammogram and possibly ultrasound is necessary.
• Breast cancer requires urgent treatment. Treatment depends on the type of cancer detected, its size and its location.

Hospitalisation if required will vary with the kind of procedure. If a surgical intervention is required to remove the lump, the patient is advised a minimum of 2 days depending on the procedure.

The other general surgery procedures are:

• Abdominal or Thoracic Aortic Aneurysm Surgery
  
• Abdominoplasty
  
• Hemorrhoidectomy�.� etc

Few Major Hospitals for Breast Lump Treatment are:

• Wockhardt Hospitals
  
• Apollo Hospitals
  
• Max Healthcare
  
• Piyavate Hospital
  
• Florence Nightingale Hospital
  

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