可疑乳腺肿块

概述

乳房肿块是乳房内的组织增生。大多数乳房肿块并不危险。但及时到医生或其他医疗护理专业人员处接受检查至关重要。

症状

乳腺组织通常可能感觉有肿块或结块。月经期也可能伴有时有时无的压痛。

如果您有累及乳房的健康问题，可能会注意到乳房的正常触感发生变化。这些变化可能包括：

• 圆滑、结实的乳房肿块。
• 感觉是实心且容易在皮下移动的大肿块。
• 形状异常且发硬的乳房肿块。
• 一块颜色改变或呈现红色的皮肤区域。
• 皮肤像橘子一样凹陷。
• 乳房大小或形状发生变化。
• 乳头漏液。

When to see a doctor

Make an appointment to have a breast lump checked, especially if:

• The lump is new and feels firm or fixed.
• The lump doesn't go away after 4 to 6 weeks. Or it has changed in size or in how it feels.
• You notice skin changes on your breast such as a change in skin color, crusting, dimpling or puckering.
• Fluid comes out of the nipple suddenly on more than one occasion. The fluid might be bloody.
• The nipple recently turned inward.
• There is a new lump in your armpit, or a lump in your armpit seems to be getting bigger.

病因

乳房肿块可由以下原因引起：

• 乳腺囊肿。乳房内这些充满液体的囊状物呈圆形，光滑而坚硬。乳腺囊肿的大小从几毫米到橘子大小不等。周围的组织可能会有触痛感。乳腺囊肿可能出现在月经前，之后会变小、变大或消失。乳腺囊肿往往在月经周期前后迅速发作。
• 纤维囊性乳房变化。这类变化可能令您的乳房有膨胀感。有些部位可能出现肿块或索状物。乳房可能有触痛感。与月经周期有关的纤维囊性乳房变化很常见。月经来潮后，症状往往会有所好转。
• 纤维腺瘤。这类实体乳腺肿瘤不是癌症。它们很光滑，触摸时很容易在皮肤下移动。纤维腺瘤可能会随着时间的推移而变小或变大。可能与纤维腺瘤生长物有关的因素包括怀孕、使用避孕药等激素治疗或经期。
• 受伤或术后。乳腺组织严重受伤或乳房手术后的并发症都可能造成乳房肿块。这种情况称为脂肪坏死。
• 感染。乳腺组织中出现被称为脓肿的感染性液体聚集也会导致乳房肿块。肿块通常与乳房疼痛、该部位皮肤发红或其他颜色变化以及皮肤肿胀有关。
• 导管内乳头状瘤。这是一种长在乳腺导管中的皮赘状生长物。它不是癌症。导管内乳头状瘤可导致乳头渗出透明或血性液体。它通常无痛感。在对乳头下方区域进行乳腺超声波检查时可能会看到它。
• 脂肪瘤。这类肿块可能摸起来很软。它包含脂肪乳房组织。通常无害。
• 乳腺癌。如果乳房肿块无痛、坚硬、形状异常且与周围的乳腺组织不同，则可能是乳腺癌。覆盖肿块的皮肤可能会变厚、变色或发红。还可能像橘子皮一样出现片状、凹陷或坑洼。乳房的大小和形状可能会变化。可能会发现乳头有液体渗出，或者乳头向内翻转。腋下或锁骨附近的淋巴结可能会肿大。

请咨询医生或其他医疗护理专业人员，了解可能需要做哪些检查，以及您的乳房肿块属于哪种类型。

风险因素

Risk factors for breast lumps caused by conditions that are not cancer include the following:

• Age. Some conditions that cause breast lumps are more common in the 30s and 40s. These include fibrocystic changes and fibroadenomas.
• Menstrual periods. Before or during your period, you may feel a breast lump due to extra fluid in the breasts.
• Pregnancy. Your breasts may feel lumpy during pregnancy. That's because the glands that make milk grow in number and get larger.
• Premenopause. As you get closer to menopause, hormone changes might make your breasts feel lumpier and tender.

Some risk factors for breast cancer are within your control to change. These include:

• Alcohol. The more alcohol you drink, the higher the risk of breast cancer.
• Overweight or obesity. The risk of breast cancer rises if you're overweight or obese after menopause.
• A lack of exercise. If you don't get physical activity, it may make you more likely to get breast cancer.
• Not giving birth. The risk of breast cancer is slightly higher in people who haven't had children or who didn't have children until after age 30.
• Not breastfeeding. The risk of breast cancer may be slightly higher in people who don't breastfeed their babies.
• Hormonal birth control. Birth control methods that use hormones to prevent pregnancy may slightly raise breast cancer risk. These include birth control pills, shots and intrauterine devices.
• Hormone therapy. Long-term use of estrogen combined with progesterone can raise the risk of breast cancer.

Other risk factors for cancerous breast lumps can't be controlled. These include:

• Being born female. Women are much more likely than men to get breast cancer.
• Aging. The risk of breast cancer rises with age. Most often, tests find breast cancer in people 55 and older.
• Gene changes. Some types of breast cancer are caused by genes changes passed from parents to children, also called inherited gene changes. A change in the BRCA1 or BRCA2 gene is the most common cause of inherited breast cancer.
• Family history of breast cancer. You're more likely to get breast cancer if a close relative such as a parent or sibling also had the disease.
• Dense breasts. This means your breasts have more glandular and fibrous tissue, and less fatty tissue. People with dense breast tissue have a higher risk of breast cancer than those whose breast density is average.
• Early menstrual periods or later menopause. Starting your period at an early age, especially before 12, is linked with a slightly higher breast cancer risk. Going through menopause after 55 also is tied to a slightly higher risk of breast cancer.
• Certain breast conditions that aren't cancer. Some benign breast conditions that cause lumps can make breast cancer more likely later on. These conditions include atypical ductal hyperplasia and atypical lobular hyperplasia, which involve too much cell growth in certain breast cells. Another condition called lobular carcinoma in situ (LCIS) happens when cells grow in glands that make breast milk. LCIS also can raise the risk for breast cancer.

并发症

Some conditions that cause breast lumps may lead to other health concerns, also called complications. The complications depend on the type of breast lump that you have. For example, without treatment, some breast infections can cause pockets of pus to form in the breast.

Other breast conditions that are not cancer still can raise the risk of breast cancer later on. These include conditions that can cause lumps, such as atypical ductal hyperplasia, atypical lobular hyperplasia and lobular carcinoma in situ. If you have a breast condition that raises the risk of cancer, it doesn't mean that you'll definitely get breast cancer. Ask your healthcare professional what the risk means for you and whether you can make lifestyle changes to lower it.

Some breast lumps don't cause complications. For example, small cysts and simple fibroadenomas sometimes go away on their own over time.

预防

There's no clear way to prevent many breast lumps. Breast lumps that are not cancer often are linked with natural changes in the body, such as hormonal changes over time.

But some risk factors for cancerous breast lumps are within your power to change. Take the following steps to lower your chances of breast cancer:

• Drink less alcohol. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men.
• Eat a balanced diet. Fill your plate with lean proteins, whole grains, and fruits and vegetables. Eat less sugary, salty and processed foods.
• Exercise. The American Cancer Society recommends that adults aim to get 150 to 300 minutes of moderate-intensity exercise a week. Or you can try to do 75 to 150 minutes of vigorous activity a week. If you're not active now, ask your healthcare professional to help you get started.

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