Finding a lump in your breast can be frightening. It's natural to feel anxious — but it's important to know that the majority of breast lumps are benign, and that with specialist assessment, the cause can almost always be identified quickly and clearly.

At Breast & Surgical Oncology at The Poche Centre, our specialist breast surgeons assess and manage breast lumps every day. Whatever you've noticed — a new lump, a change in texture, or an area of thickening — we're here to give you expert answers and, if needed, a clear treatment plan.

What should I do if I find a breast lump or notice a new breast problem?

Don't wait and hope it resolves on its own. The right step is to have it assessed promptly — even if you feel well and have no other symptoms. Early assessment is always the best approach.

The typical assessment pathway looks like this:

1. See your GP first. Your GP will take a history, examine your breasts, and consider your symptoms, age, and family history. They'll refer you for imaging and, if needed, to a specialist.

2. Imaging — mammogram and/or ultrasound. Imaging tells your doctors whether a lump is solid or fluid-filled, how it appears, and whether its features look benign or require further investigation. Ultrasound is typically used for younger women; mammogram is standard for women over 40. Often both are done together.

3. Biopsy. If imaging isn't conclusive, a biopsy provides a definitive tissue diagnosis. This is usually a core biopsy — a small, guided procedure performed under local anaesthetic — where a tiny sample of the lump is sent to a pathologist for analysis. In occasional cases a fine needle aspiration (FNA) is sufficient.

4. Specialist consultation. If your GP refers you to us, our specialist team will review your results, examine you, and explain exactly what has been found — along with any recommended next steps.

If the diagnosis is clear that you will need surgery you will be seen immediately by one of our specialist surgeons.  Sometimes the diagnosis is unclear, or thie issue is benign and does not require surgical intervention.  In these situations you may be seen by our expert bread physician for further investigation and work up or to develop an ongoing screening or surveillance programme for your breasts.

This three-part process — clinical examination, imaging, and biopsy — is known as triple assessment, and it is the gold standard for evaluating any breast lump.

What Causes Breast Lumps?

Breast tissue is complex and naturally changes throughout life in response to hormones, age, and other factors. Many different conditions can produce a palpable lump, the vast majority of which are entirely benign.

Common benign causes of breast lumps include:

Fibroadenomas — the most common cause of a breast lump in women under 40. Fibroadenomas are smooth, firm, mobile lumps made up of glandular and fibrous tissue. They are not cancerous and do not increase your risk of breast cancer. They typically feel rubbery and move easily under the skin, which is why they're sometimes called a "breast mouse." About one in six women will have a fibroadenoma at some point in their life, most commonly between the ages of 20 and 40.

Breast cysts — fluid-filled sacs within the breast tissue that can appear suddenly and feel smooth, soft to firm, and sometimes tender. Cysts are most common in women between the ages of 35 and 50 and often relate to hormonal changes. They are harmless, do not increase breast cancer risk, and can usually be confirmed on ultrasound. Symptomatic cysts can be drained with a fine needle for immediate relief.

Breast nodularity — areas of dense, lumpy-feeling tissue that fluctuate with the menstrual cycle. Often described as "fibrocystic change," this is a normal variation in breast tissue, not a disease. It can feel like multiple small lumps or generalised thickening, particularly in the days before a period.

Lipomas — soft, painless lumps of fatty tissue sitting just beneath the skin. They are completely benign and slow-growing.

Fat necrosis — a firm, sometimes irregular lump that forms when fatty breast tissue is damaged following injury, surgery, or radiotherapy. Despite sometimes looking suspicious on imaging, fat necrosis is benign and does not increase cancer risk. A full triple assessment is needed to confirm the diagnosis. Most cases resolve without treatment, though surgery to remove the lump is occasionally recommended.

Breast abscesses and mastitis — infection of the breast tissue can cause a localised area of swelling, warmth, redness, and tenderness that may feel like a lump. This is most common in breastfeeding women but can occur at any age. Treatment typically involves antibiotics, and if an abscess has formed, drainage.

When Is a Breast Lump More Likely to Need Further Investigation?

While most lumps are benign, there are features that warrant more urgent specialist review. You should seek prompt assessment if you notice:

• A new lump that is hard, irregular in shape, or fixed (doesn't move)
• A lump associated with skin changes — dimpling, redness, or puckering
• Nipple retraction or inversion that is new
• Nipple discharge, particularly if it is bloodstained or from one side only
• A lump accompanied by swelling in the armpit
• Any lump in a man's breast
• A lump that is growing or changing

Having one or more of these features does not mean you have cancer — but it does mean you should be seen by a specialist without delay. We offer urgent appointments when they are clinically needed.

How Are Breast Lumps Treated?

Treatment depends entirely on what the lump turns out to be. Many benign lumps require no treatment at all — just monitoring with periodic clinical review and imaging to ensure stability.

Fibroadenomas — most are managed with surveillance alone. Surgery to remove the lump is occasionally recommended if it is large (generally over 3–4 cm), growing, causing discomfort, or if the patient prefers removal. The decision is always guided by the individual's preferences and clinical circumstances.

Cysts — simple cysts that are asymptomatic require no treatment. Symptomatic cysts can be aspirated (drained) under ultrasound guidance. Surgery is rarely needed.

Fat necrosis — most cases resolve on their own over time. Surgical removal may be considered if the lump persists, enlarges, or causes ongoing concern.

Breast cancer — if a lump is confirmed as malignant, our team will guide you through all available treatment options, from surgery to adjuvant therapies, as part of a fully co-ordinated, individualised multidisciplinary care plan.

See a Specialist for Your Breast Lump in North Sydney

If you've found a breast lump or noticed an unusual change, don't put off getting it checked. Our specialist breast surgeons at The Poche Centre in North Sydney provide prompt, expert assessment — and the peace of mind that comes with knowing exactly what you're dealing with.

Urgent appointments are available for patients with concerning symptoms.