This page was reviewed under our medical and editorial policy by
Daniel Liu, MD, Plastic and Reconstructive Surgeon
This page was reviewed on August 28, 2023.
A woman might feel breast lumps while doing a breast self-exam, or they might be noticed by a doctor during an examination or mammogram. Most of the time, these lumps are not cancer, but it’s important to be aware of them and have them checked out.
Breast lumps may seem easy to identify, but many women have questions about them, like how to know the difference between a benign lump and a cyst (answer: only a doctor can), and when it's time to see a doctor once a cyst has been identified. To answer those questions and more, this guide will cover:
If you've felt a breast lump and are interested in making an appointment for diagnostic testing at City of Hope, or if you've already been diagnosed with breast cancer and want a second opinion on your diagnosis and treatment plan, call us or chat online with a member of our team.
A breast lump will feel different depending on the type or cause, and in some cases it may feel like normal breast tissue. In others, a woman may feel a lump that's:
Although most breast lumps are painless, some may hurt. It's impossible to tell whether a breast lump is cancerous based on whether it's painful or not, so it's essential to see a doctor if any lumps are detected.
Breast lumps may be benign, precancerous or cancerous. While no lump can be officially diagnosed until it’s been examined through diagnostic tests, it can be helpful to know about each type.
A benign lump, sometimes called a fibrocystic change, is non-cancerous. While it’s understandable to worry about breast cancer, keep in mind that most breast lumps aren’t cancerous—only a small percentage of them turn out to be malignant.
A woman may notice lumps that appear through different seasons of her life. Sometimes, women who are menstruating feel swollen, tender breasts before or during their periods or when carrying excess fluid. Lumps may also occur when a woman is pregnant or breastfeeding from a condition called mastitis that causes blocked milk ducts, and this may result in breasts that feel lumpy or tender. A woman may notice lumps or changes when taking hormonal medication, such as birth control pills, and later in life when approaching menopause.
Cysts are another common cause of benign breast lumps. These are fluid-filled sacs that form when fluid builds up in the breast glands. They are common in premenopausal women and those taking menopausal hormone replacement therapy. While they’re most often found in women in their 40s, they can occur at any age.
They often feel like round lumps that are movable, and may also be tender to the touch. Due to hormonal changes, a woman may find that a cyst gets larger and more painful right before her menstrual period begins.
If a woman has a breast cyst, it may either be a microcyst or a macrocyst. Microcysts are smaller—they are generally too small to feel, so they're often found as a result of imaging tests. In contrast, macrocysts are larger, and women may be able to feel them. They can grow to around 1 to 2 inches in diameter.
Generally, cysts don’t need to be removed unless they’re causing discomfort. In such cases, cysts may be drained during a procedure using a long, hollow needle.
Fibroadenomas are common in women in their 20s and 30s, although they can happen at any age. After menopause, they tend to shrink. These lumps tend to feel firm and rubbery and are made of glandular and connective tissue. They’re a type of benign breast tumor, and they sometimes feel like a marble in the breast.
A fibroadenoma can be either simple or complex. Simple fibroadenomas tend to look identical to one another under a microscope, and their presence doesn’t increase the risk of breast cancer. If the fibroadenoma is complex, this means it has different features than the simple type. The complex types may slightly increase the risk of developing breast cancer in the future.
The care team will recommend an appropriate course of treatment, if any is needed, for a benign lump. Depending on the type of lump, the doctor may recommend having the lump removed or having a cyst drained, since these procedures may reduce discomfort. The doctor may also recommend monitoring the lump over time, watching to see if it changes or grows.
A precancerous lump doesn’t currently show cancer but has abnormal cells that may become cancerous in the future. Atypical ductal hyperplasia or atypical lobular hyperplasia are precancerous conditions characterized by abnormal cells in the milk ducts or lobules of the breast. Another condition, lobular carcinoma in situ (LCIS), develops when the abnormal cells form in a breast lobule. LCIS may raise the risk for cancer in either breast in the future.
Sometimes, lumps in the breast may be caused by cancer cells. While women may feel anxious about a new lump, the only way to diagnose cancer is with a biopsy, so it's important not to assume the worst after noticing a lump or change to the breast.
While not necessarily indicative of cancer, be aware of any of the following changes to the breasts:
Make an appointment with a doctor after noticing changes, lumps or symptoms related to the breasts. The doctor may schedule a mammogram, an X-ray picture of the breasts that can indicate whether precancerous cells may be present. This diagnosis may then be confirmed by a biopsy, which removes cells from the suspicious area for testing. Treatment will depend on the results of these tests.
Finding a breast lump can cause concern, but most of the time, it won’t lead to a cancer diagnosis. In fact, there are several types of benign (noncancerous) breast changes that may make a woman feel a lump.
A doctor can examine the lump and recommend next steps that should be taken.
Breast tissue has natural lumps and bumps that a woman may feel, and she might just be more likely than others to develop lumps in her breasts.
If the same lumpiness can be felt in both breasts, or there isn’t one lump that’s firmer than the others, it’s most likely normal breast tissue. That said, if a lump is detected that feels harder, in only one breast, or one that just feels different than usual, address it with a doctor.
Several causes (such as breast cysts or fibroadenoma) can account for breast lumps that aren’t related to cancer.
A cyst is a pocket of fluid that can develop in the breasts. While cysts are usually too small to feel, sometimes they grow large enough to feel like a lump. Cysts don’t put a patient at an increased risk for cancer and don’t typically require any treatment.
The most common benign tumor that feels hard but is mobile when pressed is a fibroadenoma. In this case, the doctor may want to remove it, but having these don't lead to cancer for most patients (occurrence comes with a slightly increased risk).
While in most cases a breast lump doesn’t signal cancer, it’s still important to see a doctor as soon as possible. They may ask questions about the patient's history, like whether anyone in the family has been diagnosed with cancer, and whether she's having other symptoms.
A doctor will likely do a physical exam and may suggest some other diagnostic tests, if they can’t determine what the lump is from touch alone. Sometimes a biopsy is needed, along with certain imaging tests to make an accurate diagnosis. Some of the most common tests used to determine whether a lump may be cancerous are listed below.
Breast biopsy: Biopsies are performed in several ways: taking a sample of breast tissue—or surgically removing the breast lump itself and testing it in a lab under a microscope. The type of biopsy recommended may depend on how concerned the doctor is about the patient's cancer risk.
Mammogram: A mammogram (which is typically used for breast cancer screening) uses X-ray images of the breast from different angles to see more details of the lump.
Breast ultrasound: This type of imaging uses sound waves to tell if the lump is solid or fluid-filled. Tumors are solid, whereas breast cysts are a type of fluid-filled mass.
Breast MRI: A magnetic resonance imaging test produces an image with radio waves and a magnet that is often used when more information is needed to make a diagnosis.
Finding a breast lump may be scary. That's why many women choose to seek out a breast cancer expert who can provide answers with the sense of urgency and commitment to accuracy they deserve.
Many patients come to City of Hope for a breast cancer diagnosis—and for second opinions—because of our expert, comprehensive cancer care. We specialize in treating cancer at City of Hope, and our Breast Cancer Centers recognize the value in dedicating a multidisciplinary team of experts to a specific cancer type, especially one as complex as breast cancer.
At the Breast Cancer Centers at each of our City of Hope hospitals, located across the nation, our cancer experts are devoted to a single mission—treating breast cancer patients with compassion and precision. Each patient’s care team is led by a medical oncologist and coordinated by a registered oncology nurse, who helps track the various appointments, follow up on tests and answer questions that come up along the way. The care team also may include a breast surgeon, radiation oncologist, radiologist, pathologist and a plastic and reconstructive surgeon with advanced training in helping patients restore function and appearance. Fertility preservation and genetic testing are also available for qualifying patients who need them.
Our pathologists and oncologists are experienced and trained in tools designed to diagnose, stage and treat different types of breast cancer, from early-stage ductal carcinoma in situ to complex diseases such as triple-negative and inflammatory breast cancer.
If test results indicate a lump is cancerous, seeking a diagnosis at a center that specializes in breast cancer is more likely to allow oncologists to develop a treatment plan more quickly than at a general hospital that may require further follow-up appointments. We also provide our services under one roof, which means patients in treatment with us see their providers (breast surgeon, radiologist, supportive care providers, etc.) in one building and may be able to receive a diagnosis and, if the results indicate cancer, review their personalized treatment plan within a couple of days.
Our breast surgeons offer microsurgical approaches such as nipple-sparing mastectomy and reconstructive flap surgery, and our radiation oncologists employ technologies designed to reduce the risk of radiation exposure to the heart and other critical organs. The Breast Cancer Center is also involved in clinical trials on precision treatments and innovative technologies, including targeted therapies. These trials may offer participants options that may have otherwise been unavailable to them.
As part of our patient-centered care model, our multidisciplinary care team may recommend various evidence-informed supportive therapies, such as naturopathic support, psychosocial support, nutritional support, physical and occupational therapy and pain management, to help manage side effects such as fatigue, hair loss, nausea and/or loss of appetite. Addressing these issues early and vigilantly may help patients maintain strength, stamina and resilience, so they’re better able to reduce the risk of treatment delays. The entire team works together with a whole-person focus, which is at the heart of our centers’ dedication to personalized, comprehensive care.
No matter where a patient decides to go to assess a breast lump, while researching the options, it's important to look for a facility and a care team with the expertise and the credentials to provide the best possible care.
If you've felt a breast lump and are interested in making an appointment for diagnostic testing at City of Hope, or if you've already been diagnosed with breast cancer and want a second opinion on your diagnosis and treatment plan, call us or chat online with a member of our team.