Common causes of breast lumps
- Fibroadenoma: a smooth, rubbery, mobile lump – the most common benign lump in women under 35.
- Cysts: fluid-filled sacs, common in the 35–50 age group, which may change with the menstrual cycle.
- Fibrocystic change: lumpy, tender breasts, often before periods.
- Breast abscess: a painful, red swelling, often during breastfeeding.
- Lipoma, fat necrosis or phyllodes tumour: less common causes.
- Breast cancer: often a hard, painless, irregular lump; may be associated with skin dimpling, nipple changes or discharge, or a lump in the armpit.
Triple assessment
Every breast lump is evaluated with three tests, which together are highly accurate:
- Clinical examination of both breasts and armpits.
- Imaging: ultrasound (preferred under about 35–40 years) and/or mammography (usually over 40). Results are reported using the BI-RADS scale.
- Biopsy: an ultrasound-guided core needle biopsy, or fine-needle aspiration for cysts, to confirm exactly what the lump is.
When is surgery needed?
Many small, confirmed fibroadenomas can simply be monitored. Surgical removal (excision) is usually advised when:
- the lump is larger than about 2–3 cm or is growing;
- it causes pain, discomfort or cosmetic concern;
- biopsy results are uncertain or suggest a phyllodes tumour; or
- the patient prefers to have it removed.
If cancer is diagnosed, treatment is planned by a breast team and may include breast-conserving surgery or mastectomy, sentinel node biopsy, chemotherapy, radiotherapy and hormone therapy.
The procedure
Excision of a benign lump is typically a day-care operation under general or local anaesthesia, taking 30–45 minutes. The surgeon places a small incision along the natural skin lines or the edge of the areola (circumareolar) for the best cosmetic result, removes the lump and closes the skin with dissolvable stitches. The tissue is always sent for histopathology.
For selected small lumps, vacuum-assisted excision through a few-millimetre cut under ultrasound guidance avoids a larger scar.
Recovery
- Go home the same day; wear a supportive bra day and night for 1–2 weeks.
- Mild pain settles with simple painkillers within a few days.
- Return to office work in 2–3 days; avoid heavy lifting and strenuous exercise for 2 weeks.
- Review with the histopathology report in about 7–10 days.
Frequently asked questions
Can a fibroadenoma turn into cancer?
Simple fibroadenomas carry very little if any increased risk of cancer. Complex fibroadenomas carry a slightly increased long-term risk, which is why biopsy is important.
Will there be a scar?
A small scar is unavoidable, but incisions are placed along skin creases or the areola edge so they fade well over 6–12 months.
Is breast lump surgery done for men?
Yes. Men can develop gynaecomastia (enlarged breast tissue) or, rarely, breast cancer. Any lump in a man's breast should also be assessed.
Last reviewed: October 2026. This page is general information and does not replace advice from your own doctor.