"Oh no, is that a lump?" When you feel something out of the ordinary in your breast, it's natural to feel worried. "Could it be breast cancer?" you wonder, your mind racing.

Relax. It's probably not breast cancer. In fact, 80% of breast lumps turn out to be benign and cancer-free. Let's review a few of the more likely lump suspects.

Cysts: Soft grapes - that's how breast cysts are often described. Or they're compared to small, inflated water balloons. If you find these small oval masses in your breast, you will know it is a cyst if it moves easily. Linked to cyclically fluctuating hormones, cysts tend to grow right before a woman's period and shrink right after.

Cysts may hurt or feel tender, but they are benign and do not raise cancer risk. They usually don’t require any treatment unless they are large, painful, or bothersome, in which case draining the cyst of fluid will help. Wear a well-fitted bra (or a sports bra when necessary) to lessen pain. Some women find avoiding caffeine and salt helps relieve symptoms.

Fibroadenoma: You may have fibroadenomas and not even know it. These firm, smooth, rubbery, non-cancerous tumours tend to be only about a centimetre or so in diameter, but they can be larger. If you put pressure on it, a fibroadenoma may feel like a marble. Like cysts, these round masses move around easily in the breast and can be influenced by the ebb and flow of a woman's reproductive hormones.

Complex fibroadenomas may increase a woman's breast cancer risk by a factor of 2 or 3, but they do not turn into breast cancer. Doctors may recommend surgery to remove fibroadenomas, a procedure called a lumpectomy.

Fibrocystic changes: When cysts appear along with other breast tissue changes - pain and tenderness and tissue that feels lumpy, thick, fibrous, and scar-like - a woman has what are called fibrocystic breasts. Fibrocystic changes are very common - half of all women experience these changes at one point or another throughout their lives. These common changes are believed to be linked to a woman's menstrual cycle and the fluctuations of hormones that accompany it. That explains why the changes tend to taper off after menopause, too.

The changes sometimes cause pain and tenderness but pose no breast cancer risk. Occasionally, fibrocystic changes make it more difficult to diagnose lumps on mammograms. As with breast cysts, fibrocystic breast symptoms may be reduced by wearing a supportive bra to lessen pain and by cutting back on or eliminating caffeine.

Lipoma: This type of little lump is a collection of fatty tissue can happen anywhere in the body and sometimes grows beneath the skin of the breast. Flat, soft, and doughy, a lipoma will move when you push it with your finger. They are non-cancerous, tend to be genetic, and cause no problems unless they grow large enough to impinge on a nerve that happens to be close by. If a lipoma causes pain, you may choose to have it removed. Less often, a woman may develop painful, immovable lipoma-like tumours - called liposarcomas - that can be cancerous.

Milk duct issues: Women who have recently given birth or are breast-feeding may note many changes to their breasts. From time to time, a lump can develop. In the case of milk cysts, a duct channelling milk through the breast has become closed and blocked. Breast infections, or mastitis, can occur in women who are breast-feeding.

For women who haven’t recently given birth or are not breast-feeding, a small growth inside of the milk duct on the areola (the area surrounding the nipple) may be an intraductal papilloma, a non-cancerous, painless bump that may be accompanied by watery, light coloured discharge from the nipple. Other types of nipple discharge can indicate breast cancer, so it is important to ask your doctor to check this symptom.

You should also consider that an injury to the breast can cause a pooling of blood that may feel like a lump. All that said, any lump or bump that you find in your breast should be examined by a doctor in order to rule out cancer. You should seek medical attention if...

  • the skin on your breast appears red, crusty, dimpled, or puckered
  • a lump is new or feels different from surrounding tissue
  • the lump is still there after your next period
  • the lump has grown or become more firm or defined
  • you have nipple changes, including bloody discharge or inversion of the nipple (this is not a concern if your nipple has always been inverted)

Your doctor will likely ask you some questions and thoroughly examine your breasts to look for any abnormalities. If anything seems off, your doctor may order further tests, which could include imaging like a mammogram, ultrasound, or MRI, or an extraction of breast tissue (biopsy) or fluid (fine-needle aspiration).

Amy Toffelmire