When to Worry About Breast Lumps

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So, you feel a lump in your breast. Or, is it a lump? You're unsure.

The one thing you are sure about is that you're worried — and that you've got a lot of questions.

If you're concerned about something that feels like a lump in your breast, Dr. Jitesh Joshi, medical oncologist at Houston Methodist Cancer Center, has answers to your questions about breast lumps, as well as some advice.

What does a breast lump feel like?

Breast tissue in and of itself can feel somewhat lumpy and sponge-like, so it can be hard to know if what you're feeling is an actual lump or just normal breast tissue.

"A breast lump will feel like a distinct mass that's noticeably more solid than the rest of your breast tissue. Lumps can range in size — from the size of a pea to larger than a golf ball — and may or may not be movable," says Dr. Joshi. "On the other hand, normal breast tissue will feel like consistent fibrous mesh throughout your breast."

Breast lumps are typically painless, but occasionally a woman may experience pain with a lump.

Which breast lumps should women worry about?

Breast lumps are frightening, but fairly common. And while you already know that a lump could potentially signal breast cancer, you've probably also heard that most lumps are noncancerous, or benign.

So how can you tell if a breast lump needs to be checked out by a doctor?

"All breast lumps need to be evaluated by a physician, regardless of your age or where in your breast you feel the lump," says Dr. Joshi. "More often than not, breast lumps are harmless. But, any lump could potentially be breast cancer, and it's impossible for a woman to determine whether her lump is cancerous or benign just by feeling it."

That being said, Dr. Joshi says that there are some features that make a lump particularly concerning, including:

  • Changes in the skin over the lump
  • Nipple changes, including enlargement or bloody discharge
  • Changes in the size of the lump

"Additionally, having a family history of breast cancer makes it more likely that a lump could be cancerous," warns Dr. Joshi.

What should you do if you feel a breast lump?

Dr. Joshi says your first action after feeling a breast lump should be to schedule an appointment with your primary care doctor.

Your doctor will look for a variety of features and characteristics in order to answer questions such as:

  • How large is the lump?
  • Does the lump move and slip under the fingers, or is it attached to the skin?
  • Is the lump painless or painful?
  • Is the lump accompanied by red, itchy or inflamed skin?
  • Is the lump affecting the nipple, causing inversion or discharge?
  • Is the lump changing in size?
  • Does the lump become more painful or change in size around your period?
  • Is there more than on lump?
  • Are there lumps in both breasts?

"Based on the physical and clinical characteristics of the lump, your doctor may or may not recommend follow-up tests to more thoroughly evaluate the mass, such as a diagnostic mammogram or biopsy," explains Dr. Joshi.

Why you shouldn't think twice about getting a lump checked

A woman's risk for breast cancer is highest after the age of 50, but even young women can develop breast cancer. Since any lump could potentially be cancerous, it's critical that you have any lump you may have felt evaluated by a doctor — no matter your age.

"While many lumps will end up being benign breast lump disease, many others won't be — and we don't want to miss out on diagnosing breast cancer," says Dr. Joshi. "Through mammograms and other imaging modalities, breast cancer is very easy to catch and diagnose, and when caught early breast cancer is very, very treatable."

In addition, Dr. Joshi says you shouldn't avoid having a lump checked just because you're worried about having a painful biopsy.

"Mammograms and breast ultrasounds are very powerful tools that can help us diagnose even the smallest breast cancers with very high specificity," explains Dr. Joshi. "We don't need to biopsy the lump in every case."

Lastly, if you're nervous about going to your doctor's office to have a lump checked during COVID-19, don't be. Houston Methodist doctor offices and imaging centers have enhanced safety measures in place and are taking extra precautions to keep you safe during your appointment or mammogram, including:

  • Screening all patients when scheduling appointments and upon arrival
  • Isolating COVID-19 patients from other patients, allowing us to treat everyone safely
  • Wearing masks and other personal protective equipment while providing patient care
  • Implementing enhanced cleaning and sanitizing processes to disinfect all equipment and surfaces
  • Redesigning waiting rooms and check-in lines to ensure social distancing

Oct. 1, 2020