You felt something while touching your breast — a lump, a hard area, a slight irregularity. The first question is always the same: could this be cancer? The short answer is: probably not. The vast majority of lumps found in the breast are benign. But "probably" is not "certainly" — and understanding what is happening will help you consult at the right time, with the right documents, and make the right decisions.
Key point: Dr Jérémie Zeitoun is a breast and gynaecological oncology surgeon, trained at Institut Gustave Roussy. He consults at his Paris 8th practice and at Clinique Hartmann (Neuilly-sur-Seine). Teleconsultation available. Appointments usually within one week.
The most common causes of a breast lump
Fibroadenoma
The most common benign breast tumour, particularly in young women (aged 15–35). A fibroadenoma is a solid tumour made up of glandular and fibrous tissue — typically well-defined, mobile ("rubbery"), painless or slightly tender. Fibroadenomas do not become cancerous in the vast majority of cases. Monitoring is usually sufficient below 3 cm. Surgery is recommended if the fibroadenoma is larger than 3 cm, growing rapidly, painful, or if the diagnosis remains uncertain.
Breast cyst
A cyst is a fluid-filled cavity, more common between 35 and 50. It is often rounded, well-defined, sometimes tender, and may fluctuate with the menstrual cycle. A simple cyst is entirely benign and can be monitored or drained if painful. A complex cyst (thick walls, internal septations) warrants further investigation.
Fibrocystic change
Fibrocystic change is a common benign alteration causing painful, lumpy breasts — particularly in the second half of the cycle. It does not require surgical treatment, but can make self-examination harder to interpret.
Lipoma
A lipoma is a benign fatty tumour — soft, mobile, painless, and well-defined. Removal is only considered if it is large or causes discomfort.
When could a lump be cancer?
Some signs make a lump more suspicious and should prompt prompt consultation:
- Hard, irregular, poorly defined lump — unlike benign tumours, which are usually well-circumscribed
- Fixed lump — does not move under the fingers; attached to skin or deep tissue
- Painless lump — early breast cancers are often asymptomatic
- Skin changes — peau d'orange (dimpling), redness, thickening, or retraction
- Nipple changes — retraction, deviation, or persistent nipple eczema (Paget's disease)
- Nipple discharge — especially if bloody, unilateral, and spontaneous
- Axillary lymph node — a palpable node under the arm on the same side
- Recent and rapid change — a lump that grows noticeably over a few weeks
Remember: the absence of pain is not reassuring. Early breast cancers are most often painless. A hard, painless, fixed lump should be assessed as a priority.
What happens during a consultation?
Clinical examination
The consultation begins with a detailed history: how long have you noticed this lump? Has it changed? Do you have a personal or family history of breast or ovarian cancer? This is followed by clinical examination of both breasts — sitting and lying — including the axillary and supraclavicular lymph nodes.
Imaging
Imaging is essential to characterise a palpable lump. It typically includes ultrasound (first-line in young women with dense breasts) and mammography (reference investigation over 40). Lesions are classified using the ACR BI-RADS scale: ACR 1–2 (benign, monitoring), ACR 3 (probably benign, 6-month follow-up), ACR 4 (suspicious, biopsy required), ACR 5 (highly suspicious). This classification — not palpation alone — guides the decision to biopsy. See our benign breast surgery page for more detail.
Biopsy
If imaging identifies a suspicious lesion (ACR 4 or 5), a biopsy is required for a definitive histological diagnosis. It is performed under local anaesthesia under ultrasound or stereotactic guidance, as an outpatient procedure. It is the only test that can confirm with certainty whether a lesion is benign or malignant.
Have you found a lump in your breast?
Dr Zeitoun offers rapid consultations to investigate any nodule or palpable abnormality. In person in Paris 8th or at Clinique Hartmann (Neuilly-sur-Seine), and by teleconsultation.
Book an appointment →Does every lump need an operation?
No. Most benign lesions do not require surgery. Surgery is recommended when:
- Biopsy confirms cancer (in situ or invasive carcinoma)
- Biopsy reveals a risk lesion — atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH), lobular carcinoma in situ (LCIS), atypical papilloma, radial scar — surgical excision is usually recommended for complete analysis
- The lesion is growing on follow-up, even if apparently benign
- The lesion is large, painful, or causes persistent discomfort
- The patient requests removal after full information
Breast self-examination: how to check your breasts
Self-examination is a useful habit — it does not replace screening, but it helps you know your normal breast texture and detect changes quickly. Perform it once a month, after your period (when breasts are less tender). Examine in front of a mirror (arms down, then raised), then lying down with one arm above your head, using flat fingers in circular motions from the nipple outwards. Any new finding should prompt a consultation.
Dr Jérémie Zeitoun
Surgical oncologist, breast and gynaecological surgeon. Former specialist practitioner at Institut Gustave Roussy. Practices at Paris 8th (241 rue du Faubourg Saint-Honoré) and Clinique Hartmann, Neuilly-sur-Seine. RPPS: 10101463296.