Most breast lumps are benign (non-cancerous). All women have lumpy breasts and many lumps that women find are nodular or lumpy are areas of normal breast tissue which can become more prominent and lumpy just before a period. Lumpy breasts used to be called fibrocystic disease or fibroadenosis. It is now realised that lumpy breasts are not diseased breasts but are normal.

There are some common causes of lumps:

• fibroadenomas
• cysts.

Fibroadenomas

These lumps are not strictly speaking disease at all but rather a simple overgrowth of the lobules or the leaf of the breast tree. They are most common in women under the age of 30. They move freely within the breast and can be diagnosed by a combination of clinical examination, ultrasound and removing cells by needle aspiration.

If a woman has a fibroadenoma, it may not need to be removed. If left alone, at least one in three of these lumps gets smaller or disappears within two years. If she is worried about the lump or it gets bigger, then she can opt to have it removed.

Cysts

Cysts are smooth, mobile lumps and some are large enough to be seen from the outside. They may be painful. They are most common in women between the ages of 40 and 50 but are less common in women who are in their 20s, 30s and 60s.

The breast goes through various stages during its development just like the seasons. During 'spring' the breast develops and it is during this phase that overgrowth of lobules - fibroadenomas - occur. The breasts then live through regular menstrual cycles and during this period women often notice pain and lumpiness immediately before their period. This is the 'summer' of the breast. During 'autumn' the leaves or lobules of the breast can become abnormal and can enlarge to form cysts.

Cysts are a form of ageing of the lobules rather like the way the leaves on the trees become yellow and change during autumn. Cysts can be diagnosed by ultrasound or by inserting a needle into the lump. The fluid removed from cysts varies in colour from yellow to green to blue-black. Only if the fluid is bloodstained will it be sent for tests.

Of every six women who develop cysts, three will develop only one cyst, two of the six women will get between three and five cysts during their lifetime and the remaining woman will have more than five cysts. Cysts do not need to be drained every time as they can be easily diagnosed on ultrasound.

Women who have cysts are at some increased risk of developing breast cancer but this risk is not considered significant.

• Pain across the lower part of the back that sometimes radiates into the buttocks, the back of the thigh or to the groin. The pain is usually worse on movement.
• Limitation in movement of the spine - especially bending forward and leaning back.
• Tense spasm of the muscles surrounding the spine and causing a stiff back.
• With severe pain and spasm, the back may tilt to one side causing a change in posture.
• The pain is sometimes accompanied by a tingling sensation or numbness in the back or buttocks or leg.