Finding a lump in your breast (ketulan di payudara) is frightening, but most breast lumps are not cancer. The most common causes are a fibroadenoma, a smooth, rubbery, non-cancerous lump that is common in women aged 15 to 35, and fluid-filled cysts. You cannot tell the cause by touch, so any new lump should be checked by a doctor, who may arrange an ultrasound, a mammogram or a biopsy. Most fibroadenomas need no treatment. This guide explains the common causes, what a fibroadenoma is, which changes need a prompt check and what to expect at the clinic.
Ketulan di payudara: is it cancer?
The NHS says most breast lumps are harmless, but some can be serious, so you should always get a lump checked. Breast lumps are often caused by:
- a non-cancerous tissue growth called a fibroadenoma;
- a build-up of fluid called a breast cyst;
- normal lumpy breast tissue, known as fibrocystic changes (MedlinePlus).
Sometimes a lump can be a sign of breast cancer. If it is, finding it early can make it easier to treat. The NHS advises not to try to self-diagnose the cause of a lump: always see a doctor.
Breast cancer is the most common cancer among women in Malaysia, and many cases are found late. Our guide to kanser payudara explains the warning signs, how to check your breasts and the recommended screening in Malaysia.
Punca ketulan payudara (common causes)
MedlinePlus explains that breast tissue responds to hormone changes, so lumps can come and go. Common causes of breast lumps in women include:
| Cause | What it is | What it often feels like |
|---|---|---|
| Fibroadenoma | A non-cancerous growth of breast tissue | Smooth, firm or rubbery, moves easily under the skin, usually painless |
| Breast cyst | A sac filled with fluid | Often like a soft grape; may be tender, especially before a period |
| Fibrocystic changes | Normal variation in breast tissue | Painful, lumpy breasts, often worse before a period and better after it starts |
| Injury (haematoma) | Blood collected under the skin after a bad bruise | Usually gets better on its own in days or weeks |
| Lipoma | A collection of fatty tissue | Varies; a doctor can check |
| Milk cyst | A sac filled with milk | Can occur during breastfeeding |
| Breast abscess or mastitis | Infection or inflammation, usually when breastfeeding or after giving birth | A painful, red, hot or swollen area, sometimes with fever |
| Breast cancer | Cancer cells in the breast | Cannot be told apart from harmless lumps by touch |
Sources: MedlinePlus, NHS and Breast Cancer Now. A doctor needs to examine the lump, and usually arrange a scan, to know the cause.
Apa itu fibroadenoma?
A fibroadenoma is a very common benign (not cancer) breast lump. Cleveland Clinic describes it as a smooth, round, solid lump made of fibrous and glandular tissue. It develops from a lobule, one of the milk-producing glands in the breast (Breast Cancer Now).
What it feels like:
- round or oval, with clear edges;
- smooth and firm or rubbery;
- it moves easily under the skin when pushed;
- usually painless, but it may feel tender in the days just before a period. Large fibroadenomas are more likely to be painful (Cleveland Clinic);
- usually about 1 to 3 cm, from the size of a pea up to a golf ball.
Who gets it: Cleveland Clinic says fibroadenomas are most common between ages 15 and 35, and up to 10% of women will have one at some point. Breast Cancer Now says they often start to develop during puberty and are commonly found in women in their 20s and 30s, but they can occur at any age, including after menopause. Very rarely, men can get them.
Cause: the exact cause is not known. It is thought to be linked to the hormone oestrogen, because fibroadenomas tend to grow during pregnancy or hormone therapy and are more likely to shrink after menopause (Cleveland Clinic, Breast Cancer Now).
Jenis fibroadenoma (types)
Doctors describe different types of fibroadenoma, according to Breast Cancer Now and Cleveland Clinic:
| Type | What it means |
|---|---|
| Simple fibroadenoma | The most common type, usually 1 to 3 cm. Under a microscope the cells look the same all over. Does not increase the risk of breast cancer |
| Complex fibroadenoma | Some cells look different under a microscope. More common in women over 35. Can very slightly increase the future risk of breast cancer |
| Giant fibroadenoma | Grows larger than 5 cm. Most commonly develops during pregnancy or breastfeeding |
| Juvenile fibroadenoma | Found in children and teenagers aged 10 to 18; rare |
| Multiple fibroadenomas | Most people have one, but it is possible to have more than one |
Can a fibroadenoma turn into cancer?
It is rare for a fibroadenoma to turn into cancer (Cleveland Clinic). Breast Cancer Now says:
- for most people, having a fibroadenoma does not increase the risk of breast cancer;
- a complex fibroadenoma can very slightly increase the risk;
- it is still important to be breast aware and to see a doctor about any change in your breasts, no matter how soon after you were told you have a fibroadenoma.
Cleveland Clinic adds that, in very rare cases, a fibroadenoma may contain breast cancer, which is one reason doctors confirm the diagnosis with a scan and, if needed, a biopsy.
Kista payudara (breast cysts)
Breast cysts are sacs filled with fluid. MedlinePlus says they often feel like soft grapes and can be tender, often just before a period. An ultrasound can show whether a lump is a cyst, and what kind:
- Simple cysts are just sacs of fluid. They do not need to be removed and may go away on their own. If one is growing or painful, the fluid can be drained with a needle (aspiration).
- Complicated cysts contain a little debris and can be watched with ultrasound or drained.
- Complex cysts look more worrying on ultrasound, so a doctor may suggest a follow-up scan or a needle biopsy.
Breast changes that need a prompt check
See a doctor about any new lump in your breast or armpit. The NHS and MedlinePlus say to get checked promptly if you notice:
- a hard lump that does not move around;
- a lump in your armpit;
- dimpled skin on the breast, like orange peel;
- a nipple that has turned inwards or sunk into the breast when it normally does not;
- nipple discharge, especially if it is bloody, clear like water or pinkish;
- a rash on or around the nipple;
- a change in the shape of one or both breasts;
- bruising on the breast without an injury;
- a red, hot or swollen area, especially with a high temperature or feeling shivery, which can be an infection such as mastitis or an abscess.
Also go back to your doctor if a lump you have been told is a fibroadenoma or cyst gets bigger or changes (Breast Cancer Now).
What happens when you see a doctor
According to the NHS and Breast Cancer Now, this is what usually happens:
- Breast examination: a doctor will ask about the lump and your risk factors and examine your breasts. If they are not sure what is causing the lump, they will refer you to a hospital or breast clinic.
- Scan: an ultrasound or a mammogram (breast X-ray). If you are under 40, you are more likely to have an ultrasound, because younger breast tissue is often dense and can make a mammogram less clear.
- Biopsy: a needle is used to take a small sample of cells or tissue from the lump for testing. If you are under 25, you are less likely to need a biopsy for a typical fibroadenoma, but you may have one if there is any doubt.
The NHS says these tests are often done during the same visit, and they usually show that a lump is not cancer. Biopsy results take longer, often about a week.
About scan reports: breast scan reports often use a scoring system called BI-RADS. A five-year review at Hospital Universiti Sains Malaysia looked at 198 biopsied lumps graded as suspicious (BI-RADS 4): 26.8% were cancer. Among the benign results, fibrocystic disease was the most common, followed by fibroadenoma (Marthay et al., 2022). If your report shows a high score, your doctor will explain the next step, which is often a biopsy.
Where to go in Malaysia: start at a klinik kesihatan or a GP. They can examine you and refer you to the breast or surgical clinic at a government hospital, or to a private breast surgeon, for scans and a biopsy if needed.
Rawatan fibroadenoma: watch or remove?
Once tests confirm a fibroadenoma, most do not need treatment (Breast Cancer Now). What usually happens:
- Watching it: Cleveland Clinic says your doctor may arrange follow-up checks, usually after 3 to 6 months, with a breast exam or ultrasound. Breast Cancer Now says many people only need to go back if the lump gets bigger or changes.
- How it may change: most fibroadenomas stay the same size, some get smaller and some disappear over time. A small number get bigger, especially in teenage girls. They can also grow during pregnancy, breastfeeding or hormone replacement therapy (HRT), and usually shrink again afterwards (Breast Cancer Now).
When removal may be suggested: Breast Cancer Now and Cleveland Clinic say a doctor may recommend removing a fibroadenoma if it is giant, complex or juvenile, if it is painful, or if the scan or biopsy results are a concern. You can also ask to have one removed if it bothers you, although removing it does not always relieve pain.
| Method | What happens |
|---|---|
| Surgical excision (excision biopsy) | The lump is cut out in an operation, usually under general anaesthetic |
| Vacuum-assisted excision | For small fibroadenomas: under local anaesthetic and guided by ultrasound, a needle attached to a vacuum device removes the lump through a small cut. Bruising and pain may last a few days |
| Cryoablation | The lump is frozen; used less often (Cleveland Clinic) |
Breast Cancer Now says removal does not usually change the shape of the breast, although there may be a slight dent where the lump was. Cleveland Clinic says there is nothing you can do to lower your risk of getting a fibroadenoma.
Lumps during pregnancy and breastfeeding
Breasts change a lot during pregnancy and breastfeeding, and lumps can appear:
- an existing fibroadenoma can grow during pregnancy and breastfeeding, and usually gets smaller again afterwards; giant fibroadenomas most commonly develop at this time (Breast Cancer Now);
- milk cysts can form during breastfeeding (MedlinePlus);
- a painful, red, hot area with a hard lump is often mastitis, which can lead to a breast abscess. See our guide to mastitis (radang payudara).
Do not assume a new lump is "just milk". If a lump does not go away, is getting bigger, or you feel unwell, see your doctor.
Sakit payudara: breast pain with or without a lump
Many women search for "payudara sakit" or "sakit payudara" together with a lump. The NHS says breast pain is common and not usually serious, and that breast pain by itself is unlikely to be a symptom of cancer.
Breast pain linked to periods usually:
- begins up to 2 weeks before a period, gets worse, then goes away when the period ends;
- feels dull, heavy or aching;
- affects both breasts and sometimes spreads to the armpit.
Our guide to PMS covers other symptoms before a period.
Other causes include injuries or strain in the neck, shoulder or back, medicines such as the contraceptive pill and some antidepressants, mastitis or a breast abscess, pregnancy and hormone changes during menopause (NHS).
What can help: the NHS suggests paracetamol or ibuprofen, or a painkilling gel, and wearing a properly fitted bra during the day and a soft bra to sleep in. It says there is little evidence that vitamin E tablets or evening primrose oil help with breast pain.
See a doctor if breast pain is not improving or painkillers are not helping, if there is a history of breast cancer in your family, or if you could be pregnant. Get an urgent appointment if the pain comes with any of the warning signs above.
Frequently asked questions (FAQ)
Adakah ketulan di payudara tanda kanser (is a breast lump always cancer)?
No. Most breast lumps are not cancer. They are often caused by something harmless, such as a fibroadenoma (a non-cancerous growth), a fluid-filled cyst or normal lumpy breast tissue. But you cannot tell the cause by feeling a lump, so always see a doctor about any new lump in your breast or armpit.
Apa itu fibroadenoma (fibroadenoma maksud)?
A fibroadenoma is a very common non-cancerous (benign) breast lump made of glandular and fibrous tissue. It usually feels smooth, firm or rubbery and moves easily under the skin. It is most common in women aged 15 to 35, and Cleveland Clinic says up to 10% of women will have one at some point.
Can a fibroadenoma turn into cancer?
This is rare. Breast Cancer Now says simple fibroadenomas, the most common type, do not increase the risk of breast cancer. A complex fibroadenoma may very slightly increase the risk. Keep checking your breasts and see a doctor about any new lump or change, even if you have already been told you have a fibroadenoma.
Perlukah fibroadenoma dibuang (does a fibroadenoma need surgery)?
Most fibroadenomas do not need treatment once tests confirm what they are. A doctor may suggest removing one if it is very large (giant), complex or a juvenile fibroadenoma, if it causes pain, or if the scan or biopsy results are a concern. You can also discuss removal if it bothers you. Options include surgery or, for small fibroadenomas, a vacuum-assisted excision through a small cut.
Boleh ke fibroadenoma hilang sendiri (can a fibroadenoma go away on its own)?
Yes, sometimes. Most fibroadenomas stay the same size, some get smaller and some disappear over time, especially in teenagers and after menopause. A few get bigger, for example during pregnancy, breastfeeding or hormone therapy. Your doctor may arrange a follow-up check to make sure it is not changing.
Kenapa payudara sakit (why do my breasts hurt)?
Breast pain is common and is usually linked to periods: it often starts up to 2 weeks before a period, affects both breasts and goes away when the period ends. Other causes include mastitis, pregnancy, menopause, some medicines and strain in the chest wall, neck or back. Breast pain on its own is unlikely to be a sign of cancer, but see a doctor if it does not improve.
Apa beza fibroadenoma dan kista payudara (fibroadenoma vs breast cyst)?
A fibroadenoma is a solid lump of breast tissue that usually feels smooth and rubbery and moves easily. A breast cyst is a sac filled with fluid that often feels like a soft grape and may be tender before a period. An ultrasound can tell them apart. Simple cysts often need no treatment, or the fluid can be drained with a needle if they are painful.
Disclaimer
This article is for general information only and is not a substitute for advice, diagnosis or treatment from a doctor. Health supplements are not intended to diagnose, treat, cure or prevent any disease.
References
- Breast lumps — NHS
- Breast pain — NHS
- Fibroadenoma — Breast Cancer Now
- Fibroadenomas of the breast — Cleveland Clinic
- Breast lumps — MedlinePlus, US National Library of Medicine
- Marthay K, Yahya MM, Tengku Din TADA, et al. A five-year review of the outcomes of Breast Imaging Reporting and Data System 4 lesions in Hospital Universiti Sains Malaysia. Cureus. 2022;14(3):e22757.
