What you need to know now if you DO find a lump in your breast (*The most important thing is that there is only a 10% chance that it is cancer)

Strictly judge Shirley Ballas revealed last week that she ‘worries every time the phone rings’ as she awaits the results of a biopsy on her left breast.

Shirley, 63, has revealed that a routine mammogram revealed abnormalities in her left breast, and when a new mammogram discovered ‘lumpy tissue’, doctors decided to investigate further with a biopsy.

Shirley only went ahead with the mammogram, she says, after being pushed to do so by Strictly professional dancer Amy Dowden, 33, who was diagnosed with breast cancer last year.

Around 55,000 women are diagnosed with the condition in the UK every year and in 90 per cent of cases the condition can be treated successfully if caught early.

Many women may think it’s just lumps to look out for, but breast cancer can cause other symptoms, such as dimpling or rash on the breast, nipple discharge, or a change in the size and shape of the breast, explains Lester Barr. a breast cancer surgeon at the private Christie Hospital in Manchester, who is also founder and chairman of the charity Prevent Breast Cancer.

“The existence of a lump alone does not necessarily mean it is cancer,” Mr Barr reassures. ‘If ten women come to the breast clinic with a lump, there is a good chance that nine women will have it caused by something other than the disease.

“The key is not to dismiss anything new or unusual.”

Any woman who discovers a lump in her breast should seek medical attention if it is still present after fourteen days (or sooner, if you are concerned).

But while it is normal to fear that a breast lump means cancer, this is only true in a minority of cases. And today, modern scans usually make it possible to quickly determine whether it is a life-threatening cancer or a harmless cyst.

Here, Mr. Barr explains what else may be in the breast.

Hard lump after an injury, perhaps with bruising

POSSIBLE CAUSE: Hardened fat.

If you have suffered an impact to the chest, for example from a seat belt pulling against you, or from a blow to the chest, this can lead to swelling known as fat necrosis or hardened fat, especially if there is also bruising.

As the swelling of the bruise decreases, the underlying fatty tissue hardens and forms a lump, usually about 2-3 cm in diameter, which can sometimes be painful.

THERAPY: Fat necrosis can look like cancer on a mammogram, so a core biopsy (a procedure in which a needle is inserted through the skin to remove a sample of tissue from a mass or lump) is usually taken. ‘However, once fat necrosis is confirmed, there is no need for treatment,’ says Mr Barr. ‘The lump can be safely left alone as it will gradually disappear, although it may take months for it to completely settle.’

A painful, tender bump suddenly appears

POSSIBLE CAUSE: A breast cyst.

These are tender sacs full of fluid – the surrounding skin may look a little red – and the cyst can appear suddenly during the night. These are most common in women aged 40 to 60 and are thought to be caused by changing hormone levels.

In breastfeeding mothers, another form of this type of bump can occur, which is not full of fluid, but full of milk. This is called a milk cyst or galactocele.

THERAPY: This is a matter of choice, Mr. Barr explains. ‘The fluid can be drained with a small needle, but some patients prefer not to have this done, possibly because they do not like needles.’

Left alone, he adds, within a few months about a third of cysts will shrink in size, a third will remain the same size, and a third will grow larger.

Cysts are less common in women over 70 years of age. However, if they occur at this age, the fluid can be sent for examination.

‘Sometimes in this age group a cyst can hide a small cancer that is producing the fluid,’ explains Mr Barr.

Soft lump no larger than 5-6 cm in diameter

POSSIBLE CAUSE: A hamartoma.

This is a benign growth of any type of normal breast tissue that has grown in a disorganized manner (compared to cancer, which is an overgrowth of abnormal cells). It feels like normal breast tissue.

These lumps, which can appear anywhere in the body, can be hereditary. The exact cause is unknown.

THERAPY: ‘There is no need to do anything,’ says Mr Barr, ‘unless the hamartoma becomes very large and painful. In that case they can be surgically removed.’

Hot, painful lump during breastfeeding

POSSIBLE CAUSE: A breast abscess.

When a baby drinks, bacteria from the mouth can enter the breast tissue and cause an infection. This can lead to an abscess: a small pocket full of pus that can grow up to 5-10 cm in size.

THERAPY: The pus can be squirted out with a needle after the area has been numbed in a clinic with local anesthesia, combined with a course of antibiotics.

‘Abscesses tend to come back after a few days, so the process may need to be repeated a few times before they disappear. However, breastfeeding also has a protective effect against cancer,” says Barr.

Oval-shaped lump that moves

POSSIBLE CAUSE: Fibroadenoma.

Most common in women between the ages of 20 and 30, although they can occur at any stage of life, a fibroadenoma occurs when healthy glands and connective tissue in the breast clump together. This causes a lump about 1-2 cm wide, which can move within a small area in the breast.

(If they occur in women in their late teens or early twenties, these lumps can develop into a ‘giant’ fibroadenoma, which can be 8-12 cm or more.)

A fibroadenoma can feel like peas clumped together. There is no clear reason why this happens, although it may be that some women have so-called ‘sensitive’ breast tissue, which responds to changes in hormone levels, and this can cause the growth of fibroadenomas.

‘In some patients they can become quite large,’ adds Mr Barr.

THERAPY: ‘Fibroadenomas do not increase the risk of cancer, so we tend to leave them alone,’ says Mr Barr, ‘although we will remove them surgically if they are very large or if they start to grow.’

Small lump that moves

POSSIBLE CAUSE: A lipoma.

These happen when fat cells clump together under the skin. The cause is unknown – it has nothing to do with weight – but they can run in families.

These painless lumps, which are soft and tender to the touch, can be found all over the body, except on the palms of the hands and the soles of the feet (because there is no fat in these areas).

THERAPY: Small lipomas of 1-2 cm can remain, because they are harmless. Larger ones may be removed because as they grow larger (they can grow to about 18 cm), they can press on other surrounding structures and cause discomfort or pain. This can almost always be done under local anesthesia.

Firm, round lump that moves

POSSIBLE CAUSE: Phyllodes tumor.

Similar to fibroadenomas, but much rarer, these tend to grow larger – up to 2-5 cm on average. They are formed from glandular and connective tissue of the breast, which helps support and shape the breast.

They are rare and can occur anywhere on the chest.

Strictly professional dancer Amy Dowden, 33, who was diagnosed with breast cancer last year, recently appeared on Loose Women to discuss her experiences

‘The vast majority of these types of lumps are harmless (benign), but around 10 per cent may be cancerous, known as malignant phyllodes tumours,’ says Mr Barr.

THERAPY: The lump is usually removed surgically and then tested for cancer, because core biopsies cannot always determine whether a phyllodes tumor is cancerous.

Small bump under the nipple

POSSIBLE CAUSE: A papilloma in the breast.

These are formed by a clump of gland cells. The glands are located just behind the nipple and produce milk during breastfeeding.

The nodules feel smooth and round, like fibroadenomas, but are not mobile, that is, they do not move.

There is often discharge, which may be clear or even contain blood, which is not specifically related to breastfeeding.

They usually do not grow larger than the size of a marble and can occasionally be painful.

THERAPY: A core biopsy will be needed to prove they are benign, although it is not always easy to tell.

“If there is a question mark, these are surgically removed,” Mr Barr said.