Some lumps are age dependent. Both male and female newborn infants have lumps of enlarged breast tissue beneath the nipple, which have been stimulated by maternal hormones. These disappear within a few months of birth.
Beginning as early as age 8, girls may develop tender lumps beneath one or both nipples (frequently only one). These lumps are breast buds and are one of the earlier signs of the beginning of puberty.
Boys at mid-puberty (usually around age 14 or 15) may develop tender lumps beneath one or both nipples, also in response to the hormonal changes of puberty. These tend to disappear over a period of 6 months to 1 year.
It is also important to remember that hormonal changes just prior to menstruation may cause a lumpy or granular feeling to the breast tissue.
The discovery of a lump in the breast usually brings the thought of cancer immediately to mind. However, it is important to remember that 80% to 85% of all breast lumps are benign, especially in women less than age 40 to 50. Benign causes include fibrocystic breast changes, fibroadenoma, fat necrosis (damage to some of the fat tissue within the breast), and breast abscess.
FIBROCYSTIC BREAST DISEASE
The term "condition" is preferred to "disease" by many providers since it occurs so frequently in the normal population. The cause is not completely understood but is believed to be associated with ovarian hormones, since the condition usually subsides with menopause and varies with the menstrual cycle.
The incidence is estimated at over 60% of all women. It is common in women aged 30 to 50 and is rare in postmenopausal women. The incidence is lower in women taking birth control pills. Risk factors may include heredity and diet (excessive dietary fat, caffeine intake).
FIBROADENOMA
While the cause is not known, some research suggests that increased fat consumption may play a role. The highest incidence is in women from their teen years into their 20s. Fibroadenomas rarely develop after age 30. Single or multiple fibroadenomas may develop in one or both breasts.
FAT NECROSIS
Trauma is presumed to be the cause. Bruising is occasionally noted near the lump and the area may or may not be tender. The mass may be associated with skin or nipple retraction as time progresses. A fat necrosis mass cannot be distinguished from breast cancer without biopsy.
BREAST ABSCESS
In breast-feeding women, a local breast infection introduced through the nipple may wall off into an abscess. Young to middle-aged women who are not breast-feeding rarely develop subareolar abscesses (located beneath the areola, which is the darker area around the nipple).
Potential abscesses in breast tissue other than the subareolar area are excessively rare in women who are not breast-feeding, and such abscesses should be surgically removed and biopsied.
BREAST CANCER
Breast cancer may occur in men and women, but it is much more common in women. While the cause is unknown, a number of predisposing factors have been identified.
Recent statistics say that 1 in 8 or 9 American women will develop breast cancer at some point in her life. Risk increases exponentially after age 30. The average age of women diagnosed with breast cancer is 60. In general, the rate of breast cancer is lower in underdeveloped countries and higher in more affluent countries (with the exception of Japan, where the rate is quite low).
In the United States, whites (especially those of northern European descent) have a higher incidence compared to other racial groups. However, the incidence in blacks is increasing, particularly in women less than age 60.
Other risk factors include: family history of breast cancer, particularly in mother or siblings; past medical history of breast, ovarian, uterine, or colon cancer; menstrual history consistent with early menarche (start of menstruation before age 12) or late menopause (after age 50); no pregnancies or first pregnancy after the age 40; and radiation exposure.
Postmenopausal estrogen therapy and oral contraceptive use are considered possible risk factors, but the majority of recent studies do not indicate such risk.
Although the majority of breast cancers occur in postmenopausal women, it can also occur in women who are in their 30s or 40s. This is rare. In these cases, the cancers may have a strong genetic link.
