Breast Lumps - is it Cancerous or Benign?
by Jillian Scott, BreastHealthOnline's Mammography Director
This article's purpose is to give women an idea of what a breast mass feels like and how a cancerous mass can feel different than a benign mass. The information contained here is based on my own clinical experience as a diagnostic mammography technologist in Canada.
Please be aware that this outline does not apply to all masses that are felt in the breast. Although this is rare, some cancers can occur within a benign lesion. This is just one reason it is important to always check any new or unusual masses with your doctor. Every woman age 20 and older should do a regular monthly breast self-examination to get to know how her breasts feel. Once familiar with her breasts, she will more readily notice any changes that occur.
Many women feel that they can't do a proper breast exam because they don't know what a breast mass feels like. A breast mass will feel different than the surrounding tissue, and will be readily noticed by a woman who is comfortable performing her monthly self-breast examination. If you do feel a new lump in your breast, note your answers to the following questions and discuss what you feel with your doctor.
Is the mass tender?
Many women are surprised to learn that cancerous masses are usually not tender or painful at all. A benign mass is usually slightly to very tender on its own or upon palpation.
Is the mass mobile? Can the mass move freely, or is it fixed in position?
To determine if a mass is mobile, lay down on your back and turn slightly so the affected breast is lying flat against the chest wall. For example, if you feel the mass in your right breast turn slightly to the left. Using the hand of the opposite side (left hand if you are examining your right breast.), place your index finger on one side of the mass and your middle finger on the other side of the mass. Press your index finger towards your chest, then your middle finger. You may feel the mass move between your fingers. Mobility of a mass can be affected by the surrounding tissue. If the tissue around the mass is very dense, the mass will not be able to move as freely as if it were surrounded by fatty tissue. Most benign masses are slightly to very mobile. Masses that will not move and are very fixed in position are more likely of a malignant origin.
Does the mass feel smooth, like a marble, or irregular?
Benign masses will most likely have margins or borders that are very smooth. Cancerous masses usually feel very irregular, and no smooth margins can be felt.
Is the mass soft (fleshy) or hard?
Benign masses can be either soft or hard. Most cancerous masses are very hard and immobile.
When in the sitting position and leaning slightly forward so that the breast is hanging freely from the chest wall, is there any puckering of the skin around the mass?
Any puckering or dimpling of the skin around or at the site of the mass may indicate that the mass is cancerous.
Are there any skin changes, such as discoloring of the skin, an orange peel look and/or texture, or skin ulceration?
If you answer yes to any of the above, a cancerous mass is most likely indicated and should be discussed with your doctor right away. Please note that ulcerations of the skin can occur due to skin conditions and may not indicate a breast carcinoma. It is when a mass and skin ulceration occur together that the findings are suspect for breast cancer. If you do notice skin changes on the breast that occur with no palpable mass present, check with your doctor to rule out underlying pathology.
Has the nipple become inverted?
A nipple becoming inverted is a concern if:
* This is a new finding
* Only one nipple is involved
A cancerous mass that is growing behind or near the nipple may cause the nipple to become inverted. Occasionally, the nipples may become inverted on their own. If this happens at the same time on both sides, cancer may not be the cause, but always be sure to discuss any new changes in the breast with your doctor.
Please join us and post any questions you have regarding this issue on the Mammogram Support Board.