Since most glandular tissue is concentrated in the upper outer quadrant of the breast this is often the most painful area. Many women experience both pain and engorgement or heaviness of their breasts as they approach menses. This cyclical variation is physiological and does not imply disease. When a distinct lump or irregular area is tender, itself this often implies a simple cyst or FAD is present. It is unusual for breast cancer to cause pain in the breast.
Exceptions do occur.
When a lump is perfectly round or oval it will often prove to be a simple cyst or fibroadenomas. Fibroadenomas are sometimes lobulated. These are completely benign lesions. When the surface of a lump is perfectly smooth or slightly lobulated it is usually benign. This characteristics may be difficult to ascertain if there is normal breast tissue overlying the lump.