Breast Lumps: Causes, Symptoms, and When to Seek Help

Breast lump

Hello Dr.
Chou,
I would like to ask about hard lumps in both breasts.
The lump on the left side feels larger, while the one on the right is smaller.
Since I was young, my left breast has always been slightly larger.
Occasionally, I experience a feeling of fullness or sharp pain in my breasts.
They are not very large, but it feels like the lumps occupy the entire breast.
I have read many articles stating that movable lumps are mostly benign, but I'm unsure how to assess this.
I can feel the lumps when I touch them, and they seem to move when I push them.
It seems like the lumps have been there since development, but there hasn't been a noticeable change over time.
Additionally, there is discharge from my nipples that appears to be solid and yellowish, rather than liquid.
I am quite worried that this could indicate something serious.
Thank you for your help.

Xiao Xiao, 20~29 year old female. Ask Date: 2015/10/01

Dr. Zhou Jiazhen reply Breast and Thyroid

1.
Breast self-examination involves using the pads of your fingers to press on the breast to check for any lumps, assessing whether the lumps are movable rather than pinching them.

2.
Based on your description, a fibroadenoma is the most common diagnosis; just monitor for any changes in size or symptoms.

3.
When examining nipple discharge, observe the color for any blood-stained or foul-smelling discharge; however, if symptoms persist, it is still advisable to follow up in an outpatient clinic.

Reply Date: 2015/10/01

More Info

Breast lumps can be a source of concern for many individuals, and understanding their causes, symptoms, and when to seek medical help is crucial for maintaining breast health. Based on your description, it appears that you are experiencing hard lumps in both breasts, with the left side being larger than the right. You also mentioned occasional pain and discharge from the nipple, which adds to your concerns.

Causes of Breast Lumps
Breast lumps can arise from various conditions, some benign and others more serious. Common causes include:
1. Fibrocystic Changes: This is a common condition characterized by lumpy, painful breasts, often linked to hormonal fluctuations during the menstrual cycle. These lumps can be mobile and may change in size and tenderness throughout the cycle.

2. Cysts: Fluid-filled sacs that can develop in the breast tissue. They are usually benign and can vary in size. Cysts can be tender, especially before menstruation.

3. Fibroadenomas: These are solid, benign tumors that are often movable and can occur in younger women. They are usually painless and can be monitored over time.

4. Infections or Abscesses: Infections in the breast tissue can lead to painful lumps and may be accompanied by redness, swelling, and discharge.

5. Malignant Tumors: While less common, breast cancer can present as a hard lump that is often immovable and may be associated with changes in the skin or nipple discharge.

Symptoms to Monitor
In your case, the presence of hard lumps, pain, and yellowish discharge from the nipple warrants careful observation. Here are some symptoms that should prompt immediate medical evaluation:
- Persistent Lumps: If the lumps do not change or continue to grow over time.

- Nipple Discharge: Especially if it is bloody or occurs without squeezing the nipple.

- Changes in Breast Shape or Size: Any significant asymmetry or alteration in contour.

- Skin Changes: Redness, dimpling, or puckering of the skin over the breast.

- Pain: If the pain is severe or persistent and not related to your menstrual cycle.

When to Seek Help
It is essential to consult a healthcare professional if you notice any of the above symptoms. A breast specialist or a gynecologist can perform a thorough examination and may recommend imaging studies such as a mammogram or ultrasound to assess the lumps further.
Given your description of the lumps being present since puberty and not showing significant changes, it is possible they are benign. However, the yellowish discharge you mentioned is concerning and should be evaluated. Discharge that resembles pus or has a solid consistency may indicate an underlying issue that requires attention.

Diagnostic Approach
Your healthcare provider may recommend the following steps:
1. Clinical Breast Examination: A thorough physical examination to assess the lumps and any associated symptoms.

2. Imaging Studies: Ultrasound is often the first step for evaluating breast lumps, especially in younger women. A mammogram may be indicated for older women or if there are concerning features.

3. Biopsy: If there is any suspicion of malignancy, a biopsy may be performed to obtain tissue samples for histological examination.

Conclusion
In summary, while many breast lumps are benign, it is crucial to monitor your symptoms closely and seek medical advice when necessary. Early evaluation and diagnosis can provide peace of mind and ensure appropriate management. If you have not already done so, consider scheduling an appointment with a breast specialist to discuss your symptoms and undergo the necessary evaluations. Your health and well-being are paramount, and addressing these concerns proactively is the best approach.

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