Breasts: Lumps and Bumps

Daisy*, a 20-year-old actress living in Los Angeles, CA., remembers the day she discovered a painful, walnut-sized lump on the side of her left breast. "I was scared," she says. "I thought it was cancer."

Daisy's gynecologist examined her and diagnosed her with fibrocystic breasts. Her lump was a benign, fluid-filled sac commonly known as a cyst. Over the next few months, Daisy's lump fluctuated in size, becoming noticeably larger and more painful right before her period. "I found that cutting out coffee and chocolate helped with the pain, but the bump didn't go away. I was worried," she says.

Friendly Pains in the Boob According to William Parker, M.D., a clinical professor of obstetrics and gynecology at UCLA School of Medicine who is in private practice in Santa Monica, CA, an estimated 50 percent of all women have fibrocystic breasts, a condition caused when fluid accumulates in the glands, creating lumps and bumps. Among younger women, this condition is even more common.

Here's the good news: Parker stresses that these cysts will "absolutely not" turn into cancer. "Cancer is cancer on day one. A cyst is benign on day one and there's no change," says Parker, author of A Gynecologist's Second Opinion (Plume, 1996).

Generally, non-cancerous breast lumps are:

  • Soft
  • Moveable
  • Tender

Cancer, on the other hand, usually feels like this:

  • Hard, jagged, and in Parker's words, "almost like a rock."
  • Fixed (i.e., the lump doesn't move around when you push it).
  • Not painful.

Fibroadenomas Another common breast lump is the creepy-sounding but harmless fibroadenoma. This benign tumor occurs when an overgrowth of connective tissue collects in the breast. Because fibroadenomas can become quite large, occasionally the size of an egg, some doctors like to biopsy them to rule out cancer.

Parker, however, believes that fibroadenomas are removed more often than they need to be. Since these tumors, like cysts, will never turn into cancer, he feels that it's usually best just to leave them alone.

Will They Ever Go Away? Even though a biopsy confirmed that Daisy's cyst was benign, her doctor wanted to remove it because of its size. But once she knew that she didn't have cancer, Daisy declined the surgery, opting instead to live with her lump.

Young women who have fibrocystic breasts often notice that their lumps feel more tender before their periods and improve immediately afterwards. While cysts usually don't disappear completely, women can ease breast pain caused by fibrocystic changes by trying the following:

  • Take 600 I.U. of Vitamin E daily.
  • Decrease or eliminate caffeine.

As for fibroadenomas, Parker says they never go away but they do shrink after menopause.

Don't Be a Boob: Take Care of Your Breasts Although 80 percent of breast lumps in premenopausal women are non-cancerous, Parker still recommends that women under the age of 35 get a professional breast exam once a year. He also urges women to check their breasts once a month. "Most patients don't do their own exams because it scares them," says Parker.

The goal of performing regular self-breast exams is not to be your own doctor, but to get to know your breasts so that you can distinguish the usual lumps and bumps from the new or changing ones. Because cystic lumps may change with hormone levels, it is best to examine your breasts around the same time in each menstrual cycle -- at the beginning of each period, for example. If you are concerned about a particular lump, bring it to your doctor's attention.

While annual mammograms are generally not recommended for women under 40, Parker suggests that a woman with a strong family history of breast cancer -- particularly in a sister or mother -- get her first mammogram ten years before her youngest relative was diagnosed.

Resources The American Cancer Society's Breast Cancer Resource Center offers information on breast cancer screening, prevention, and treatment. You can also call 800-ACS-2345.

  • This name has been changed to ensure anonymity.