What should I do if there is a small fleshy lump next to my nipple?

Women’s nipples are very fragile and need special protection. Especially after pregnancy and childbirth, women have to breastfeed their children, so it is necessary to ensure the normal development of the breasts. Some women find that there is a small lump of flesh next to their nipples, but they don’t feel any pain when touched. This situation is most likely caused by a tumor in the breast and requires specific examination in the hospital. So, what should you do if a small lump grows next to your breast?

Breast fibroadenoma is a benign tumor composed of a mixture of glandular epithelium and fibrous tissue. It is common in young women and is related to an imbalance in sex hormone levels in the patient's body. This disease is also known as adenofibroma and adenoma, which is due to the different degrees of fibrous components and glandular epithelial hyperplasia that make up the tumor. When the tumor is mainly composed of glandular epithelial hyperplasia with fewer fibrous components, it is called fibroadenoma; if fibrous tissue accounts for the majority of the tumor and the glandular duct components are relatively small, it is called adenofibroma; when the tumor tissue is composed of a large number of glandular duct components, it is called adenoma. The above three classifications only differ in pathological morphology. Their clinical manifestations, treatments and prognoses are no different, so they are collectively called fibroadenomas. Breast fibroadenomas are common in the upper outer quadrant of the breast. They are round or oval in shape, clinically 1 to 3 cm in size, and grow slowly, but may grow rapidly during pregnancy or lactation. Fibroadenomas that occur in a very small number during adolescence can rapidly increase in size within a short period of time, with a diameter of up to 8 to 10 cm. These are called giant fibroadenomas and are still benign tumors. It is extremely rare for fibroadenoma to transform into fibrosarcoma or breast cancer, less than 1%.

Causes

The ovaries are functioning vigorously, the estrogen levels are too high, and the regulation is unbalanced. In addition, the patient is sensitive to estrogen. Under the long-term stimulation of estrogen, the breast epithelial tissue and fibrous tissue proliferate excessively, the structure becomes disordered, and a tumor is formed. Since breast fibroadenoma is related to vigorous secretion of sex hormones, it mostly occurs in young women and is rare in women before menstruation or after menopause.

Clinical manifestations

It is mainly a painless breast lump, rarely accompanied by breast pain or nipple discharge. Lumps are often discovered accidentally, while bathing, or during a physical examination. Most lumps are single, but they can also be multiple, or they can be felt in both breasts simultaneously or successively. Most of them are round or oval, with a diameter of 1 to 3 cm, but there are also smaller or larger ones, and occasionally huge ones. The boundaries are clear, the edges are neat, the surface is smooth, elastic, there is no tenderness, the range of motion is large, and there is no adhesion to the skin.

examine

1. Color Doppler Ultrasound

It can display the structures of each layer of the breast and the shape, size and echo condition of the mass. Breast fibroadenomas are mostly round or oval, uniformly hypoechoic masses on color Doppler ultrasound. Smooth and clear capsule echoes are often visible. The echo behind the mass is normal or slightly enhanced. Lateral acoustic shadows can be seen, and coarse calcifications accompanied by acoustic shadows can be seen inside the mass. Color Doppler showed no blood flow signal or only a small amount of blood flow signal in the mass, and RI < 0.7.

2. Mammography

Adolescent girls with dense breasts are not suitable for mammography. In breast X-rays of middle-aged women and above, fibroadenomas appear as round or oval masses, or lobed masses, with a diameter of 1 to 3 cm and smooth and clear edges. Compared with normal glands of the same volume, the masses have equal or slightly higher density and may be surrounded by a low-density halo. Calcification can be seen in some lesions. Calcification is mostly located in the center or edge of the tumor and is mostly coarse granular, dendritic or spotted. It can also merge into large masses, occupying most or all of the tumor, which is different from the clustered sand-like calcification foci of breast cancer.

3. Breast lesion biopsy

For breast lumps that are difficult to identify based on medical history, physical examination, or imaging examination, a biopsy or surgical resection can be performed for histopathological examination to confirm the diagnosis.