A benign breast lump can occur due to inflammatory and non-inflammatory conditions, benign (non-malignant) breast tumors. It may result from injuries, surgical, or cosmetic procedures. The lump appears as a smooth or irregularly shaped area of increased tissue density. It may be accompanied by pain, deformation, nipple discharge, or other symptoms. The cause of a breast lump is determined through patient history, physical examination, ultrasound, mammography, MRI, biopsy, and lab tests. Self-treatment is not recommended—seeking medical attention promptly is essential.

Why does a benign breast lump appear?

Inflammatory Diseases

The most common inflammatory breast condition is mastitis, typically caused by nonspecific bacteria, most often Staphylococcus. The following types of mastitis are observed in clinical practice:

• Lactational Mastitis – Develops during breastfeeding due to milk stasis (lactostasis) and may occur even without prior signs of milk retention.
• Non-Lactational Mastitis – Can be acute or chronic, resulting from aseptic inflammation caused by trauma, bruising, burns, or hypothermia. Secondary infection is often observed.
• Non-Purulent Mastitis – Characterized by tissue infiltration with serous fluid or inflammatory infiltrates. The lump is more pronounced in patients with an infiltrative form of the disease.
• Purulent Mastitis – Manifests as breast abscess or phlegmon. After a few days, a fluctuating area forms at the center of the inflammatory infiltrate.
• Galactophoritis – A type of mastitis involving inflammation of the milk ducts.

Common symptoms of mastitis include pain, breast lump, tissue swelling, weakness, fever, and intoxication syndrome. Symptoms are more severe in purulent mastitis, especially during lactation. Non-lactational and non-purulent mastitis tend to have a milder course.

Specific infections

Breast lumps caused by specific infections are relatively rare.

• Tuberculosis of the Breast – The affected breast enlarges, and the skin over it turns red. The size of the pathological focus varies from a small mobile lump to a large immobile mass adhered to surrounding tissues. General symptoms of tuberculosis include weakness, sweating, weight loss, loss of appetite, and prolonged low-grade fever.
• Syphilis of the Breast – Can be primary, secondary, or tertiary.
  • Primary Syphilis – Presents as a nearly painless lump (hard chancre) with an ulcerated surface at its center.
  • Secondary Syphilis – Mostly associated with general symptoms and skin rashes.
  • Tertiary Syphilis – Leads to the formation of a gumma, a dense infiltrate about 2 cm in diameter, which eventually transforms into a painless ulcer. Diffuse breast induration resembling chronic mastitis is also possible.

Mastopathy

The main manifestation of mastopathy is small, grainy, often painful nodules in the breast tissue. The following forms of the disease are distinguished:

• Fibrous mastopathy – A type of diffuse adenomatosis, characterized by dense connective tissue nodules in the breast.
• Fibrocystic mastopathy – Another variant of diffuse pathology, where fibrosis is accompanied by multiple cysts.
• Nodular mastopathy – A focal form of the disease, leading to limited, mobile lumps that are not attached to surrounding tissues.
• Adenosis – A subtype of fibrocystic mastopathy, which can be diffuse or focal. It is characterized by breast pain, swelling, and abnormal discharge.

Benign Tumors

Benign breast tumors are considered various types of nodular mastopathy. They grow slowly, do not invade surrounding tissues, and do not metastasize:

• Fibroma – Originates from connective tissue. Appears as a dense, smooth, painless tumor-like formation. A feeling of fullness may occur before menstruation.
• Adenoma – Develops from glandular epithelium. Due to its small size and painless nature, it is often detected during routine check-ups. It feels like a round or spherical lump with a smooth, sometimes slightly irregular surface.
• Fibroadenoma – Composed of connective tissue and epithelial cells. It is mobile, painless, and can be smooth or bumpy.
• Lipoma – Forms from fatty tissue. It is smooth, elastic, and usually small. Some lipomas grow significantly, causing visible breast deformation.
• Fibrolipoma – Develops from both fatty and connective tissue. It is dense, mobile, elastic, and painless. It can be small and barely noticeable or large, leading to a visible cosmetic defect.
• Cyst – A fluid-filled cavity. When palpated while standing, it feels like a smooth, rounded, or irregularly shaped lump. Unlike solid tumors, it is often not palpable when lying down.
• Galactocele – A type of cyst caused by milk duct blockage. It contains unchanged milk or a curd-like mass. The cyst is soft, elastic, and often remains asymptomatic for a long time, usually detected when it becomes large.
• Intraductal papilloma – Develops within the milk duct and differs from other benign tumors by causing nipple discharge before a lump appears.

Phyllodes tumor

A phyllodes tumor is an intermediate condition between benign and malignant neoplasms. It can be solitary or multiple, affecting one or both breasts. It typically has a two-phase growth pattern: a slow-growing phase followed by a rapid growth phase, during which the lump can reach large or even giant sizes. The degree of malignancy does not correlate with tumor size—giant tumors can remain benign, while small ones may metastasize.

Traumatic injuries

The development of a lump is preceded by a fall at home, during sports activities, or impact against a car steering wheel in an accident. A breast contusion manifests as pain and soft tissue swelling. A painful swelling—hematoma—forms in the breast. Sometimes, clear or bloody nipple discharge is observed.

During hematoma resorption, a necrotic area often develops, which is later replaced by dense connective tissue. As a result, the lump may persist for the patient’s lifetime. There is an increased risk of malignant transformation of the affected tissues.

Consequences of diseases, injuries, and surgeries

Breast lumps can form due to various conditions, tissue damage from trauma, surgeries for large formations, or aesthetic procedures. Possible causes include:

• Fat necrosis – Occurs after trauma or medical procedures. Accompanied by the formation of a dense infiltrate. The lump is round, painful, and adherent to the skin. Sometimes, breast deformities and nipple retraction are observed.
• Calcifications – Develop due to milk stasis, diseases, age-related breast changes, or hypercalcemia. In most cases, they are asymptomatic and detected accidentally. If located near the surface, they can be felt as painless, dense nodules.
• Capsular contracture – Develops after breast implant placement. Connective tissue, which naturally forms around any foreign object in the body, grows excessively, thickens, and compresses the implant. The degree of breast deformation ranges from mild to severe.
• Polyacrylamide gel nodules – Form after breast augmentation with this substance. Over time, the gel becomes encapsulated, leading to areas of lumpiness and multiple small nodules resembling a cluster of grapes.

Other breast pathologies

Other conditions that may cause the symptom include:

• Lactostasis – Painful lumps form during breastfeeding, accompanied by a feeling of fullness and heaviness in the breast. Symptoms of lactostasis become less pronounced after feeding. Prolonged milk stasis may lead to localized fever and overall hyperthermia.
• Duct ectasia – Typically develops due to hormonal changes or other breast diseases. Symptoms include swelling, pain, itching, burning sensations in the nipple-areolar region, and whitish or greenish discharge.
• Nipple inflammation – Caused by bacteria, less commonly fungi or viruses. Characterized by areolar thickening, pain, nipple swelling, redness, and secretion of clear, purulent, or bloody fluid.
• Nipple eczema – Occurs in the first weeks of lactation, presenting with itching, erosions, and peeling. Superficial lumps may form due to secondary bacterial infection of the skin.
• Breast involution – Observed after the age of 50 and involves the formation of small, self-resolving nodules. Involution can also follow a fibrocystic pattern, with elastic, mobile, round lumps of varying diameters.

Sometimes, breast lumps develop due to non-mammary diseases and can be found in both women and men:

• Non-Hodgkin’s lymphoma – If lymphoma is located in the breast region, a diffuse lump or a well-defined node can be palpated.
• Parapleuritis – A rare condition resulting from the spread of inflammation to the surrounding tissues in patients with tuberculous pleuritis. A dense swelling is felt on the front or anterolateral surface of the chest at the level of the 4th–6th intercostal spaces.
• Gynecomastia – Enlargement of the male breast glands is accompanied by increased tissue density.

How to diagnose a breast lump?

A mammologist conducts diagnostic procedures. The specialist determines when and under what circumstances the symptoms appeared and examines the disease’s progression. The mammologist evaluates the nipple-areolar area, skin, underlying tissues, detects deformities, determines the lump’s location, size, consistency, and mobility, and examines regional lymph nodes. To clarify the diagnosis, the following tests are performed:

• Ultrasound (Sonography) – A safe, primary method for examining the breasts. It detects tumors, inflammation, and structural abnormalities. More informative for young women, as their breast tissue is denser and better visualized during ultrasound.
• Mammography – A type of X-ray imaging. Preferred for older women. It confirms fibrotic changes and tumor-like formations. To improve diagnostic accuracy, it may be supplemented with ductography. If results are inconclusive, digital tomosynthesis is performed. Patients with cysts undergo pneumocystography.
• Breast biopsy – Tissue samples are obtained via fine-needle aspiration, core needle biopsy, or trephine biopsy under ultrasound or X-ray guidance. Samples are sent for microbiological analysis to identify pathogens, as well as cytological or histological examination to rule out malignancy.
• Other imaging methods – MRI and scintigraphy help determine the size and location of malignant tumors and guide surgical planning. Patients with breast implants may undergo MRI monitoring as needed.
• Laboratory tests – Includes hormone level assessment, tumor marker analysis, blood tests to evaluate inflammation severity, and microbiological analysis of breast secretions.

Benign breast lump treatment

Pre-hospital care

A breast lump is often a sign of a serious condition, and delaying treatment can lead to dangerous complications. Self-treatment is unacceptable. In cases of severe pain, a single dose of an analgesic may be taken. If a lump is detected, an immediate consultation with a mammologist is necessary to exclude the malignant growth.

Conservative therapy

Treatment strategies depend on the underlying pathology that caused the lump. Therapy may include etiological, pathogenetic, and symptomatic treatments, as well as physiotherapy methods. The most commonly used drug groups include:

• Antibiotics – Required for mastitis and other infectious breast diseases. Initially, broad-spectrum antibiotics are prescribed, and then the regimen is adjusted based on microbiological test results.
• Hormonal drugs – Anti-estrogens are recommended for patients with mastopathy. These medications minimize the effects of female hormones on the breast and help prevent the progression of pathological changes.
• NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) – Indicated for mastitis, injuries, and post-traumatic conditions. They reduce inflammation, swelling, and pain.

Surgical treatment

The choice of surgical intervention depends on the specific characteristics of the pathology. The following procedures are performed for breast lumps:

• Mastitis – Incision and drainage of mastitis, aspiration and drainage of an abscess.
• Cysts – Excision, sclerotherapy, laser vaporization, incision and drainage of an infected cyst.
• Post-surgical complications – Removal of breast implants.