Medical Moment: When to worry about breast lumps

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.

As we observe Breast Cancer Awareness Month, Dr. Esther Dubrovsky, breast surgeon at Houston Methodist Baytown is answering some questions about breast lumps.

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 usually 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. Dubrovsky.

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 Dubrovsky. “More often than not, breast lumps are harmless. But any lump could potentially be breast cancer, and a woman can’t determine whether her lump is cancerous or benign just by feeling it.”

That being said, Dr. Dubrovsky 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
• Painless lump
  

“Even if you don’t have a family history of breast cancer, you should make sure to have any lumps checked,” warns Dubrovsky.

What should you do if you feel a breast lump?

Dr. Dubrovsky 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 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 one 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 Dubrovsky.

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

A woman’s risk for breast cancer is highest after age 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. Dubrovsky. “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. Dubrovsky 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 Dubrovsky.

For more information or to schedule a mammogram, call the Houston Methodist Breast Care Center at 346.292.PINK, or visit houstonmethodist.org/baytown.