An important aspect of breast health is knowing how your breasts feel and look. Part of that is being aware of any changes in your breasts that may be early signs of breast cancer.
The most common symptom of breast cancer, according to the American Cancer Society, is a lump or mass. A lump can be painless and hard with irregular edges or tender, soft or round.
Whenever a lump or mass is detected, it’s important to have it checked by a health care provider.
A thorough exam
Peggy Rogers, APRN, AOCNP, who specializes in genetics and medical-oncology at OSF HealthCare, provided the following insight regarding breast lumps and what women and men should do if a lump is detected.
Q. Why are self-exams important?
A. We advocate for a woman to perform monthly self-breast exams. Women should be familiar with how their breasts normally feel and then can report any changes in appearance, skin changes, or nipple discharge to a health care provider. This same holds true for men.
Q. What does a lump feel like? How does someone know they’re feeling something of concern?
A. It may feel like a hard lump, almost marble like. It’s not always about finding a lump. It can be any change from your normal self-exam.
Q. What about women with dense breasts – will they be able to detect a lump? What may they feel that would concern them?
A. It can be difficult to distinguish between a new lump and fibrocystic changes in the normal breast tissue. Dense breast tissue means there’s a greater amount of breast and connective tissue compared to fat. It can increase the chance that breast cancer may go undetected by a mammogram because dense breast tissue can mask a change in the breast. In addition to having 3D mammogram or tomosynthesis, we can also add automated breast ultrasound (ABUS) to screening, which can be beneficial with breast density.
In 2019, the state of Illinois began requiring notification to mammography patients that they have dense breast tissue. This mean any women with dense breast tissue is eligible for ABUS and their insurance should cover the cost.
ABUS exams provide a clearer image of breast tissue to find even the smallest cancers. When used in addition to mammography, ABUS can improve breast cancer detection by 55% over mammography alone. With an order from a primary care provider, ABUS can be scheduled to be completed during the same setting as an annual mammogram.
Q. When should you see a doctor?
A. You should have a yearly clinical breast exam by a physician or advanced practice provider and report any changes in your normal self-breast exam, such as a new lump, nipple discharge or skin changes.
Q. What can someone who has detected a lump expect, diagnostically?
A. If they’re under the age of 30, guidelines recommend ultrasound. If they’re older than 30, they would need a diagnostic mammogram and an ultrasound. Both of these are painless and quick and can be done at the same appointment.
Q. What about for men – is detecting a lump any different for them?
A. Men can get breast cancer, although it’s much less common. If they find a lump, or what is called a palpable mass, and they’re over the age of 30, guidelines recommend they receive a diagnostic mammogram with ultrasound, just like for a woman.
Q. Are there other conditions that can cause a breast lump?
A. For young women, it is common to have cysts in breasts or other benign conditions like fibro adenoma, which feels like a firm, smooth or rubbery lump, or a papilloma, a benign tumor. It’s possible also to have an infection of the breast. In any of these situations, they should see their health care provider.
Q. What are some other possible symptoms of breast cancer?
A. In addition to feeling or detecting a breast lump, a woman should see their health care provider if they experience any of the following:
- Swelling of all or part of a breast (even if no lump is felt)
- Skin dimpling (sometimes looking like an orange peel)
- Breast or nipple pain
- Nipple retraction (turning inward)
- Nipple or breast skin that is red, dry, flaking or thickened
- Nipple discharge (other than breast milk)
- Swollen lymph nodes (Sometimes a breast cancer can spread to lymph nodes under the arm or around the collar bone and cause a lump or swelling there, even before the original tumor in the breast is large enough to be felt.)
“The takeaway here is to be aware of the changes in your breast and reach out to your provider with any concerns,” Peggy said. “It is always better to have a new lump checked out rather than waiting. Ninety percent of the time, it’s benign, but if it is cancer, then catching it at its earliest possible time for treatment and a cure is the best option.”
OSF HealthCare now offers self-scheduling for screening mammograms. Don’t put this important screening off, schedule today. To learn more about breast cancer detection and diagnosis, download this helpful guide from the American Cancer Society.