Finding a breast lump is concerning, especially for individuals with implants. While implants enhance size or shape, their presence adds considerations when a lump is detected. Understanding potential causes, whether implant-related or not, is important for informed decisions and seeking medical attention.
Lumps Associated with Breast Implants
Breast implants can contribute to palpable lumps through various mechanisms. Capsular contracture, a common cause, occurs when the scar tissue capsule around an implant tightens and hardens. This can make the breast feel firm, painful, or distorted, leading to a palpable lump. It often develops within two years of surgery but can emerge later.
Fluid or blood collections can also manifest as lumps. A seroma, serous fluid around the implant, causes swelling, pain, or a palpable fluid wave. Seromas can appear days to weeks after surgery, or later. A hematoma, a blood collection, usually appears soon after surgery, causing swelling, bruising, and pain. Hematomas can also occur months or decades after implant placement.
Implant rupture, where the outer shell tears, can lead to lumps. If a saline implant ruptures, the breast typically deflates noticeably and immediately, with changes in size or shape. A silicone implant rupture is often “silent” as it may not cause immediate, obvious symptoms. Over time, silicone rupture can lead to new lumps, pain, changes in breast shape, or increased firmness as leaked silicone interacts with surrounding tissues.
A rare but significant concern is Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). This non-Hodgkin lymphoma can develop in the fluid or scar tissue surrounding breast implants, primarily with textured surfaces. Symptoms often include persistent swelling, lumps, pain, or asymmetry in the affected breast, typically appearing an average of eight years after implant surgery. BIA-ALCL is diagnosed by examining fluid collected around the implant for specific markers.
Lumps Unrelated to Breast Implants
Individuals with breast implants can develop lumps for reasons unrelated to the implants, similar to those without. Many common benign (non-cancerous) conditions can cause lumps. Fibrocystic changes, for instance, involve lumpy or rope-like tissue that can feel tender, swollen, or painful, often fluctuating with the menstrual cycle. This common condition does not indicate an increased risk due to implants.
Cysts are a frequent cause of benign lumps; these fluid-filled sacs feel round, smooth, and sometimes firm, and their size can change, particularly around the menstrual period. Fibroadenomas, solid, non-cancerous tumors, commonly occur in younger women and typically feel firm and movable. These benign conditions are prevalent in breast tissue and are not caused by implants.
Individuals with implants can still develop breast cancer. A cancerous lump often feels hard, may have irregular edges, and can be painless. Other signs include changes in breast size or shape, skin alterations like dimpling or redness, or nipple changes such as discharge or inversion. Breast implants do not prevent breast cancer, and any new or suspicious lump warrants prompt evaluation.
Detecting a Lump
Regularly checking your breasts is important for maintaining breast health, even with implants. Become familiar with the normal feel and appearance of your augmented breasts, as implants can alter how breast tissue feels during self-examination. Implants may push breast tissue forward, making changes easier to feel. Monthly self-examinations, ideally a few days after a menstrual period when breasts are less swollen, can help identify new developments.
During a self-examination, look for specific changes:
- Any new lumps, especially if they feel firm or fixed in place.
- Alterations in the overall size, shape, or texture of your breasts, or if one breast appears significantly different from the other.
- Skin changes, such as dimpling, puckering, redness, or a texture resembling an orange peel.
- Changes in the nipples, including discharge, inversion, or scaling.
- Any swelling or lumps in the armpit area.
If you discover a new lump or other suspicious changes, seek medical attention promptly. Do not assume a lump is harmless or implant-related without professional evaluation. Any new lump that feels firm or fixed, or one that does not resolve within four to six weeks, should be assessed by a healthcare provider. Early detection and evaluation are important for proper diagnosis and management.
Medical Evaluation and Diagnosis
When a lump is detected in an augmented breast, a thorough medical evaluation determines its cause. The process begins with a consultation where a healthcare provider reviews your medical history and discusses symptoms. This initial assessment guides diagnostic test selection. Imaging techniques are commonly used to visualize breast tissue and implants.
Mammograms, a standard screening tool, can be more challenging with breast implants because implants can obscure some breast tissue, making abnormalities harder to see. Specialized implant displacement views are often taken, gently pushing the implant back for better imaging of natural breast tissue. Despite these challenges, mammograms are important for breast cancer screening, and the risk of implant rupture during the procedure is very low.
Ultrasound is frequently the initial imaging choice for evaluating a palpable lump in an augmented breast. This non-invasive technique uses sound waves for detailed images. It is effective for assessing fluid collections like seromas, checking for implant ruptures, and identifying masses within breast tissue. Ultrasound is also valuable for guiding biopsies if a suspicious area is identified. Magnetic Resonance Imaging (MRI) offers more detailed images, often used to assess implant integrity, particularly for silicone implants, and to provide a clearer view of breast tissue obscured on other imaging.
If imaging reveals a suspicious area, a biopsy may be performed to determine the lump’s nature. This involves taking a small tissue sample for laboratory analysis. For fluid collections like a seroma, fluid aspiration may be performed, and the fluid analyzed for specific markers, particularly if BIA-ALCL is suspected. The biopsy type, whether core needle or excisional, depends on the lump’s characteristics and imaging findings.