Lumps are usually referred to as tumours, and they may be benign
or malignant. In a tumour, one particular type of cell (such as a
glandular, fat or muscle cell) has escaped the normal controls on
growth and started to multiply.
Benign tumours
Cysts: lumps filled with fluid. Common types
include sebaceous cysts on the skin, filled with greasy sebum, and
ovarian cysts
Nodules: formed in inflammatory
conditions such as arthritis, sarcoid and
polyarteritis
Lipomas: lumps of fat
cells
Fibromas and fibroademonas: lumps of
fibrous or fibrous and glandular
tissue
Haematoma: lump formed by blood escaping
into the tissues - simply a large
bruise
Haemangioma: lump formed by extra growth
of blood vessels
Papilloma: formed from skin or
internal membrane cells, for example warts
The most important characteristic is whether the tumour cells can
invade other adjacent cell types, and spread around the body. Benign
tumours do not invade or spread.
They can grow quite large without causing problems, although that
doesn't mean they're totally harmless because their growth may start
to damage the other tissues or organs around them.
This is a particular problem with a type of brain tumour called a
meningioma, which grows from cells in the membranes that surround
the brain (the meninges). Although benign, the pressure within the
skull from the growing meningioma can cause severe headaches and may
be life threatening if the tumour is not removed.
Benign tumours can cause others problems, from simply looking
unsightly to releasing excess hormones.
Malignant tumours invade the tissues around them and spread to
other parts of the body by sending out cancer cells into the
lymphatic system or through the blood stream.
These cells are deposited in other areas of the body,
particularly the lungs, liver, brain and bones, to start 'secondary'
tumours (also called metastases) at the new sites. Most malignant
tumours are life threatening.
Benign or malignant
- Benign: mostly happens at younger age, change
in the lump with the menstrual cycle, being more obvious just
before a period, tenderness, a round smooth lump with a border
that feels separate to the rest of the breast
- Malignant: mostly happens at older age, other
symptoms such as discharge from nipple. Family history of breast
cancer especially if at a young age. A craggy or irregular lump,
particularly if it tethers the skin
Women are advised to be on the look out for lumps in their
breasts. However, among younger women at least, lumps are far more
likely to be benign - in women under 40, more than nine out of ten
breast lumps are benign. But these lumps still cause a lot of
anxiety until they are sorted out.
The most common benign breast conditions are fibrocystic change,
benign breast tumours and breast inflammation. These are common
problems, in fact fibrocystic change used to be known as fibrocystic
disease but, as it affects more than 50 per cent of women at some
point, it was thought it could no longer be considered a
disease.
Fibroadenomas (sometimes called breast mice because they can be
moved around) are particularly common in women in their 20s or 30s.
They are benign and not cancerous.
In most cases these lumps are quite harmless, although now and
then they may cause troublesome symptoms such as tenderness
(especially as many are influenced by hormone levels and tend to get
more swollen and painful along with other menstrual symptoms).
Malignant breast tumours mostly occur in older women, and tend to
be accompanied by other symptoms such as discharge from the nipple.
The lump may feel craggy or irregular.
Women who have a family history of breast cancer, especially
breast cancer at a young age, have an increased risk of malignant
tumours.
Sometimes it's fairly clear that a lump is either benign or
malignant, but further tests may be required, including x-rays,
ultrasound or biopsy. Often the best way to get an answer is to
remove the whole lump and send it to the laboratory for
analysis.
Benign lumps may not need to be removed but this is usually the
most effective way to reassure someone because, whatever the
problem, it's gone.
If you find a lump
- Get a doctor's opinion - no one minds checking hundreds of
harmless lumps if it means that one malignant or cancerous lump is
caught early.
- Don't hide a lump or fret silently about it - if it does prove
to be malignant the sooner it's dealt with the greater the chance
of cure.
- Bear in mind that most lumps, especially in younger people,
are benign or relatively harmless.