If you feel a new breast lump, it is imperative that you have it evaluated by your primary care provider and with diagnostic breast imaging. Why? Breast cancer is common. Individual risk varies from person to person, but on average 1 in 8 women develop breast cancer. Many women have found breast cancer by feeling a new lump in the breast. However non-cancerous lumps in the breast are even more common than breast cancer.
The previous article discussing breast lumps focused on the patient who has not yet undergone diagnostic breast imaging to evaluate the breast lump. The goal with this article is to provide a more streamlined resource for women who feel a lump and have been told that cancer was not visible on the mammogram and breast ultrasound.
Women are often surprised when they are told that the breast lump is not a breast cancer. For many women the lump isn’t actually a mass at all; you may be feeling variations in normal breast tissue. The breast tissue is made up of two different types of tissue: fatty tissue and glandular tissue. Often women who feel breast lumps are feeling the interface between these two types of tissue. If there is an area in the breast with a higher concentration of glandular tissue, this will feel different, sometimes even mass-like, when compared to the rest of the breast where fatty tissue predominates. Hormonal stimulation of the breast tissue often exaggerates the lumpy feeling of the glandular tissue. This may occur during the menstrual cycle, perimenopause, and with hormonal therapy.
Other non-cancerous possibilities for a breast lump include:
- Fluid-filled cyst
- Fibrous benign tumor (fibroadenoma)
- Fatty benign tumor (lipoma)
- Sebaceous cyst (these occur when a hair duct becomes blocked, and the body secretions that normally exit the body along the hair are trapped in a small cyst just under the skin)
Most women have some lumpy bumpies when they feel their breast tissue; the key is to be comfortable with what is normal for you. If you are comfortable with your normal breast tissue, then you will feel more confident when a change occurs. Monthly self-breast exams are strongly encouraged to become comfortable with your normal breast tissue and to monitor for any changes in your breasts.
“I have a breast lump and was told my breast imaging evaluation showed no evidence of cancer. Does that mean I am absolutely cancer free?”
No one can say with 100% certainty that a small developing cancer is not present somewhere in your breast given the known limitations of mammography. What can be said is this: cancers that have grown to the size necessary for you to feel are unlikely to be invisible on the mammogram and ultrasound. All breast lumps with no abnormality seen on imaging should be monitored for changes. If the lump increases in size, feels harder, or skin changes develop, further evaluation by your primary care provider including a clinical breast examination should be done.
Although one negative imaging evaluation for a lump is reassuring, this does not give you lifetime immunity to breast cancer. Because of this fact we strongly encourage annual screening mammography and monthly self-breast exams. Consistent vigilance with screening mammography and self-breast exams is necessary to catch breast cancer at the smallest size possible, increasing the chance of a cure.