Breast lump appears each month — problem?

Originally Published: December 18, 2009
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Dear Alice,

I've noticed recently that about two weeks before my period starts, in one breast I have a very tender lump. However, as soon as my period starts the lump disappears. Then the next month it returns again right before my period. Should I be alarmed by this?

Dear Reader,

Although the presence of a lump may be alarming most breast lumps — roughly four out of five biopsied — are benign.

Breast tissue regularly changes with the menstrual cycle. At its most "normal," glandular breast tissue feels bumpy, especially in the upper outer region of the breast towards the armpits. Because the nature of your lump is cyclical and seems to be influenced by menstruation, you may be feeling the regular bumps of your breast tissue, which can swell with fluid before menstruation. These non-cancerous lumps are called fibroadenomas and are more common among women in their 20s and 30s.

You might also have a breast cyst, a benign fluid-filled sac that develops when glands and connective tissue block a milk duct, causing it to dilate and fill with fluid. Cysts can be painful and tender and you can feel them through your skin with your fingertips. They often feel round or oval with firmness like a grape, and tend to increase in size before the period, decrease after it, and disappear altogether after menopause. The Go Ask Alice! question Breast Lump details what a benign breast cyst is and how it's affected by hormonal changes. Cysts don't require treatment unless they are large and painful or uncomfortable. In that case, draining the fluid can ease symptoms. Breast cysts are common in women in their 30s and 40s and are not associated with an increased cancer risk. But that doesn't mean you shouldn't visit a health care provider if you're concerned. Columbia students can make an appointment with Primary Care Medical Services by calling x4-2284 or by logging into Open Communicator. Making an appointment is a good idea if:

Some women perform a monthly breast self-exam (BSE), which can help you become familiar with normal lumps and be attuned to potentially concerning changes. For directions, check out the American Cancer Society's How to Perform a Breast Self-Exam.

Other ideas to ease your situation are:

  • wear a supportive braduring tender times,
  • avoid caffeine, which may be linked to breast cysts,
  • consume less salt to reduce excess fluid in your body,
  • exercise more to help fluids more efficiently circulate in and be excreted from your body,  
  • take a supplement of evening primrose oil, an over-the-counter fatty acid that may help minimize breast cysts and other symptoms associated with hormonal fluctuations during the menstrual cycle.

Knowing what is normal for you and your body will help you to determine when concern might be in order. The lump you've found may be a harmless, hormonally-affected breast cyst or fibroadenoma, but it still might be a great idea to have it looked at by a health care provider so you know for sure.

Towards breast health and best health,

Alice