What Does Breast Cancer Feel Like?
It’s alarming to feel a lump in your breast. Should you get it checked out or wait? Is it something or just no big deal? Unfortunately, there are no absolutes; a breast cancer tumor can feel different from person to person.
For some, tumors are rigid with firm, angular edges. They feel more like rocks than grapes. Others experience smooth, softer nodules.
“Tumors might be tiny — they’re often felt by a doctor during an exam when they are as small as a half-inch in diameter,” said Tricia Merrigan, MD, breast surgeon with Avera Medical Group Comprehensive Breast Care. “Women often do not find them on their own when they are this small.” A cancerous lump is also less likely to move around when you feel it.
When a lump is new to you and you’re concerned, it’s time to make an appointment. Annual mammograms, clinical breast exams and regular self-exams, all help patients. Self-exams let women know their breasts’ usual look and feel.
“Some women have lumpier breast tissue,” Merrigan said. “Women who get screening mammograms often have their cancers found before they can be felt. It’s common to have tumors that are 2 to 3 centimeters in diameter by the time a woman can feel it in a self-exam.”
Merrigan uses a 3-D display (like the one above) in her office so patients can see and feel models of breast cancer tumors of various sizes.
All women should self-examine. Yearly clinical exams and screening mammograms are also vital. Mammography can miss things, and that’s why a combination works best.
How to Do a Breast Self-Exam
Self-exams, along with provider exams and yearly mammograms, all work together to give women the earliest possible detection of a tumor.
When women do self-exams, they should lie down, so gravity can flatten and spread out the breast tissue over the chest muscles.
“Normal, lumpy breast tissue evens out, but tumors remain rigid,” Merrigan said. “It’s important to remember that tumors can sometimes be found in or among the natural fibrous tissue. Self-exams done lying down let gravity help to spread the tissue out.”
While lying flat, stretch your arm up over your head. “You’ll spread the tissue over the muscle,” she said. “Don’t use your fingertips. Use middle portion of your fingers, brought together.”
When you squish the tissue between your fingers and chest wall, you are more likely to pass over normal bumps, yet still feel unusual bumps.
“You should also stand in front of a mirror. Visually examine your breasts,” said Merrigan. “Look for dimples or puckering, and look for lumps where you felt them when you were lying down.”
You may feel a lump even when imaging was normal. Consider getting a second opinion or following up with your provider if you feel a rigid bump. Don’t assume a recent negative mammogram means “everything’s fine.”
Schedule Your Mammogram
Mammograms are recommended annually for women age 40 and older, unless their physician advises something different.
What to Do if You Find a Lump in Your Breast
Report anything that wasn’t there last time. All women are different; some have recurring cysts, and know what they feel like. When you feel something strange: act.
“Screening mammograms still miss up to 10 to 15% of cancers,” Merrigan said. “You should always report any new lump and get a clinical exam.”
Merrigan said more imaging such as contrast-enhanced spectral mammography (CESM), breast ultrasound and MRI might be needed. It’s better to confirm “not cancer” with a trip to the clinic than think “no big deal” and allow a tumor to continue growing.
“We’d much rather reassure and find, through imaging, that the lump you felt was not cancer,” she said. “We’ll use all the tools to find your cancer, but the earlier we start, the more treatable it will be, if what you felt turns out to be cancer.”
The tumor’s biology, more than its size, is the defining factor in severity of breast cancer. Some half-inch tumors are more aggressive than those that are four times as big.
“Self-monitor for a week or two, and if it’s still there, get in for an appointment. But don’t let it go until your next annual exam,” Merrigan said. “In 85% of cases, breast cancer is diagnosed in women without family history. Don’t assume a lack of history means you’re OK.”
