female patient and doctor discussing lump in breast

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—Tammalivis, Anchorage, Alaska

No, definitely not. In fact, among young women, breast lumps are common and much more likely to be noncancerous than cancerous. That said, anyone feeling something unusual in their breast—especially if it is changing over time, associated with other features (such as skin discoloration, discharge, or change of breast shape), or causing significant worry—should have it evaluated. As with other parts of our body, sometimes we need some help learning what is normal and what to look for when we do self-examination.

Normal breast tissue is somewhat nodular (lumpy), and more so for some than others. The density may vary with the menstrual cycle. People can sometimes have or develop a dense cluster of cells (fibroadenoma). Other times, people may have or develop less-focused areas of density that may be painful or tender and vary in size with menstrual cycling (fibrocystic changes). It is also common to have cysts in the breast. These are fluid-filled masses that sometimes occur together with fibrocystic changes. All of these are benign (noncancerous).

It is also possible to develop a breast abscess (mastitis), which is most common in women who are breastfeeding. An abscess is a collection of pus, which may be just under the skin surface or deeper into the tissue. These are typically painful, cause redness of the overlying skin, may include some drainage, and may be accompanied by fever or other systemic symptoms. If you have these symptoms, make an appointment with your healthcare provider to get checked out and treated.

In addition to these naturally occurring variations in breast tissue density, breasts are relatively prone to inflammation. A blow or other injury to the breast may temporarily cause localized increased tissue density. This will usually resolve itself with time.

Evaluation of a breast mass will always include a history and physical exam. If questions remain unanswered, your provider may order a mammogram, ultrasound, needle biopsy, or other tests as indicated. The best thing you can do for your breast health is to perform a monthly self-exam so that you become familiar with the normal variations in your breasts and can recognize any abnormalities.

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