What Women Need to Know About Breast Lumps
How to tell what’s normal – and what’s not.
Finding a breast lump is scary, and often it can be hard to tell whether the bumpiness you feel is part of your breast’s natural anatomy or something more serious. “Some women just have lumpy breasts, which is different from having a breast lump,” explains Debbie Saslow, Ph.D., the director of Breast and Gynecological Cancer for the American Cancer Society. “But even if it’s a true lump, there’s an 80 to 90 percent chance that it’s not cancer.” In other words, don’t panic. But if you feel something, tell your doctor. In the meantime, here’s how to decipher various lumps and bumps beneath your breast’s surface:
Type: General lumpiness in both breasts or lumps that clear up with your period
What’s happening: Fibrocystic breasts are made of tissue that feels rope-like or bumpy in texture. Typically, breasts will feel lumpier and tender pre-period (thanks to hormones, particularly estrogen, affecting the breast tissue) and less so once your period starts. More than half of women experience fibrocystic breast changes at some point in their lives, according to the Mayo Clinic. If you notice a new thickening in the breast or lump or a lump that’s grown in size, tell your physician who can evaluate it with a clinical breast exam and an ultrasound.
Type: A hard, movable lump
What’s happening: “Sometimes lumps are obvious and feel like a pebble, pea, or grape,” says Saslow. See your physician and have the lump examined. Although there’s a chance it could be cancerous, most likely it’s a benign cyst (a fluid-filled sac), according to Saslow. It could also be a fibroadenoma (a solid, noncancerous growth), which is the one of the most common breast lumps in premenopausal women, according to the Mayo Clinic. Your doctor may schedule an ultrasound or mammogram to get a better look, followed by a fine needle aspiration biopsy to get a cell sample and check for the presence of cancer.
Type: Pimple-like bumps along the areola
What’s happening: If you’ve always had these bumps, they’re most likely part of your breast’s anatomy. But if they’re new, that may signal an infection or in rare cases, cancer, and should be checked out by a doctor. Other outward signs to watch out for and bring to your doctor’s attention: Nipple inversion (when the nipple suddenly turns inward), nipple discharge (or discharge on your bra), or an itchy, scaly sore or rash on the nipple. And, says Saslow, “About one percent of breast cancers involve a change in the breast’s skin, such an orange peel-like texture, along with warmth in the breast, which can be inflammatory breast cancer [a rare but aggressive type of cancer].”
How to protect yourself: Get a clinical breast exam – at least every three years in your 20s and 30s and once a year after age 40 – during your regular checkup with your ob-gyn or primary care physician. You should have a screening mammogram every one to two years starting at age 40. Perform breast self-exams (BSE) every month or so. Although there’s controversy as to whether BSEs save lives, it always pays to know your breasts well so you can better gauge what feels normal and if there’s been a change.
Rachel Grumman is a freelance health writer based in the New York City area.