1. NORMAL BREAST TISSUE ACCENTUATED BY CHANGES IN HORMONES:
This is the most common cause of breast change and occurs when a localised area of fat and fibro glandular tissue becomes tender.

This change is sometimes accentuated by hormonal changes related to your menstrual cycle, oral contraceptive pill or hormone replacement therapy (HRT). (If you’ve already gone through menopause, and you’re not on HRT, these hormonal changes are not common.)

HOW IT FEELS: A tender lumpy area which often feels different to the same area in the other breast.

WHAT YOU NEED: Investigations include clinical breast examination, imaging and sometimes needle biopsy. Hormonal breast change can usually be diagnosed without the need for surgery.

2. CYST:
Cysts are fluid-filled sacs and are a common cause of benign breast change. They usually occur in women aged 35-50 and can sometimes occur if you’ve already gone through menopause especially if you are on HRT.

HOW IT FEELS: Cysts often feel like discrete lumps and can vary in number, size, shape, tenderness and consistency. They range from soft fluctuant thickenings to firm tender lumps. Sometimes they can become inflamed or infected.

WHAT YOU NEED: Investigations include clinical breast examination, imaging often ultrasound and fine needle aspiration biopsy (FNA) under clinical or ultrasound guidance. This procedure can confirm the diagnosis and relieve any symptoms. It can also be useful to exclude rare cases when a cancer grows inside a cyst or within the adjacent tissue.

3. FIBROADENOMA:
Fibroadenoma is a common cause of benign breast change, especially if you’re under 25.

If you’re over 50, it is often discovered by chance during mammography.

A fibroadenoma is a lesion growing from the lobule of the breast tissue. It can sometimes enlarge due to hormonal changes during pregnancy, breastfeeding or HRT. Often it will return to its original size when the hormonal change is removed.

HOW IT FEELS: When you’re young, a fibroadenoma may feel like a smooth, firm, round or lobulated lump – which often moves around. When you’re older, it’s more difficult to distinguish a fibroadenoma from other breast changes on clinical breast examination alone.

WHAT YOU NEED: Investigations include clinical breast examination, imaging often mammogram and ultrasound and biopsy. FNA or core biopsy may be required.

For fibroadenomas smaller than 2 to 3cm, management options include surveillance (monitoring) or surgical excision. Factors which favour surgical excision include size greater than 3 cm, progressively increasing size and patient preference.