I am 28. I had a lumpectomy eight months ago, and was told it was benign. Since the surgery, I have noticed more lumps. Is this normal, or is there a chance it could be breast cancer? My aunt died from breast cancer and my cousin is a survivor. Does it help that I breastfed two of my three children?

A.J.

Some women have very lumpy breasts. While lumpy, fibrocystic breasts do not increase the chance of breast cancer, they can make it more difficult to determine what's worrisome and what's not on a breast self-exam. Women with fibrocystic breasts often have to have more testing in the form of mammograms and breast ultrasounds, and they may have more frequent biopsies to determine whether a new or different lump is cancer.

A family history of breast cancer does increase one's risk of developing the disease, but this increased risk is significant only if first-degree relatives (mother, sister, daughter) have had breast cancer. If only second-degree relatives (aunt, cousin, grandmother) have had breast cancer, then there is no increase in the lifetime risk of breast cancer, which is 1:8. This 1:8 figure, by the way, means only that there is a 12.5 percent chance of developing breast cancer by the time you reach age 95. Having a first-degree relative with breast cancer increases one's risk of breast cancer to a lifetime risk of 17.5 percent. If multiple family members -- both first- and second-degree relatives -- have had breast cancer, that may indicate that the family carries one of the BRCA mutations, which increases the odds of developing breast cancer substantially.

Breastfeeding does afford some protection against breast cancer. Having one's first child before age 30 also seems to decrease the risk, and the earlier the first pregnancy, the greater the reduction in risk.

Even if you have had a biopsy showing a benign lump in the past, any new and different lumps should be evaluated. Evaluation may merely mean seeing your doctor for an exam and having that exam repeated in several months to make sure the lump has not grown. Be sure to check your breasts only after your period, as that is the time when they are the least lumpy and the least tender -- you want to get a consistent exam from month to month. Sometimes your doctor may want additional studies, such as an ultrasound. Ultrasounds are often more useful than mammograms in younger women with dense breast tissue. Sometimes a biopsy may be recommended as the only 100 percent certain way of ruling out a cancer.