A lump in your breast can sometimes be a sign of breast cancer. It could also be a harmless cyst, or a temporary change in breast tissue caused by the natural hormonal fluctuations that occur during a menstrual cycle.
So, how do you know if a breast lump is cancerous? We asked three patients to share their experiences, then went to breast surgical oncologist Ana Paula Correa Refinetti, M.D., for more details.
One size, shape or texture does not fit all
Some people describe their breast cancer by comparing its size, shape or texture to everyday objects, like a green pea or a seedless grape.
“Mine felt like a marble at first,” says Tenchita Urteaga, who was 38 when she first noticed a lump in the shower. “But it grew very rapidly, and by the time I was diagnosed with breast cancer the following year, it felt more like a golf ball.”
Still, cancerous breast lumps don’t feel the same to everyone.
“It’s impossible to say, ‘If you feel this, it’s definitely breast cancer,’” explains Refinetti. “Everyone’s breasts are different. So are their tumors. And what feels mushy to one person might feel hard or solid to another.”
Some breast cancers feel like distinct lumps or bumps in the tissue. Others feel like a “shelf” just beneath the skin. Some can be easily moved around under the surface. Others can’t. And while some have well-defined edges, others don’t.
“Ductal carcinoma is usually more defined on exam than lobular carcinoma, but people can also have a mix of these two types of breast cancer,” adds Refinetti. “The only way to conclusively determine if someone has breast cancer -- and what type of breast cancer it is -- is through breast imaging and breast biopsy.”
What does ‘normal’ breast tissue feel like? It varies.
There are many ways both normal breast tissue and breast cancer can feel. That’s why doctors encourage people to practice breast self-awareness. This doesn’t mean you need to perform a conventional self-exam. Instead, learn what your own breast tissue feels and looks like through everyday activities, such as showering and getting dressed.
“The key is to know your own normal,” says Refinetti. “‘Normal’ is very subjective. And breast tissue can feel spongy or dense, fatty or lumpy. It can even feel different at various points in your cycle. But no one is going to know your own breasts better than you do. And anything that’s not normal for you should be checked out.”
Do breast cancer lumps ever hurt?
Most breast cancers don’t cause any pain, even if they first appear as a lump or a bump. But pain can still bring a lump to your attention, when an object hits the side of your breast just so, or you accidentally brush it past something that compresses it.
Dave Dudak was 71 when he noticed a tiny bump under his left nipple in just this way in 2016. It led to a male breast cancer diagnosis the following year.
“It didn’t really bother me unless I bumped it up against something,” he explains. “Then, it hurt like the dickens.”
“Patients have told me they only noticed a lump after a grandchild hit them in the chest with a toy or a dog sat on them and it hurt,” Refinetti adds. “But most of the time, breast pain is not related to cancer. And pain alone is not a sign of breast cancer.”
People can feel pain or tenderness in their chest area for any number of reasons.
“Breast pain can be caused by a number of factors, whether it’s hormonal changes, bad posture while sitting at a computer, or the extra strain put on upper bodies by carrying around heavy items, like purses, backpacks, children or grocery bags,” she says. “The chest cage can get chronically ‘angry’ as a result. That’s why if I press the side of someone’s chest wall, nine times out of ten, they will say, ‘Ouch.’ It’s a common issue.”
Trust your own instincts
Refinetti stresses the importance of trusting your own instincts and knowing what’s normal for you. People often notice changes in themselves that no one else would.
That was the case for Dr. Julie Hildebrand, who was 37 when she found a lump in 2010. She didn’t receive a breast cancer diagnosis until three years later.
“Initially, my doctor just blew me off,” she says. “I mentioned the lump again the following year, but I didn’t have a family history of breast cancer. I also have fibrocystic breast disease, so I couldn’t get anyone to listen.”
When Julie was 39, she insisted on having a mammogram and an ultrasound. Her doctor didn’t see anything on the films and couldn’t feel anything during a physical exam. “But I knew I had breast cancer, and the year I turned 40, my mammogram finally proved it,” Julie says.
“I can’t tell you the number of times patients have come to me saying, ‘I felt this tiny little thing. It was only the one time and I can’t find it again right now, but it just didn’t feel right,’” adds Refinetti. “It’s only because they know their own bodies so well that they can notice these minimal changes.”