What Do Breast Cancer Lumps Feel Like?

Reviewed on 1/4/2021

What Is Breast Cancer?

Breast cancer occurs when cells in the breast become abnormal and grow out of control. Breast lumps aren’t always the earliest sign of breast cancer, as outlined below. When cancerous lumps do appear, they usually feel firmer than the other tissue, may move around or (less commonly) may be fixed on the chest wall. Lumps are usually painless, but not always.

What Are Symptoms of Breast Cancer?

The American Cancer Society’s warning signs and symptoms of breast cancer include:

  • Swelling or thickening of the breast
  • Irritation or dimpling of the breast skin
  • Pain in any area of the breast
  • Nipple pain
  • Nipple turning inward
  • Changes in the size or shape of the breast
  • Skin changes on the breast: redness, scaliness, flaky skin, or thickening of the nipple or breast skin
  • Nipple discharge that is not breast milk, including blood
  • Lump in the underarm area (armpit)
  • Breast lump
    • Not all lumps in the breast are cancerous; more than 80% are benign
      • It is impossible to tell by feel only whether a lump is cancerous or not
      • See a doctor if you notice any breast changes or lumps
    • Lumps that are tumors may feel firmer, versus normal spongy breast tissue
    • Lumps are usually irregularly shaped, not spherical (round)
    • Lumps usually can be moved around in the breast, however, in some cases a breast lump may be fixed, or stuck, to the chest wall
    • Lumps are usually painless (they may cause pain in some women)

What Causes Breast Cancer?

The cause of breast cancer is unknown, but certain risk factors are linked to the disease. 

Risk factors for breast cancer include: 

  • Being a woman
  • Age over 55
  • Inherited genes, including BRCA1 and BRCA2 and others
  • Overweight/obesity
  • Physical inactivity
  • Alcohol use 
  • Having a first child after age 30 or having no children
  • Use of hormonal birth control
  • Hormone replacement therapy (HRT) for menopause, particularly estrogen and progesterone (combined hormone therapy)
  • Family history or personal history of breast cancer
  • Dense breast tissue
  • Ethnicity: White women are slightly more likely to develop breast cancer during their lifetime, but African-American women are more likely to develop breast cancer under age 45
  • Certain benign breast conditions
  • Early onset menstruation (before age 12)
  • Menopause after age 55
  • Radiation to the chest 

How Is Breast Cancer Diagnosed?

In some cases, a woman may discover a lump or may notice changes in the breast. A doctor will perform a physical exam to look for breast changes such as:

  • A lump in the breast
  • Changes in the size or shape of the breasts
  • Dimpling skin on the breast
  • Pulling in of a nipple
  • Discoloration of breast skin

Tests used to confirm a diagnosis of breast cancer include: 

  • Mammogram (a special type of X-ray)
    • 3D tomosynthesis is a special new type of digital mammogram
  • Breast ultrasound 
  • Breast magnetic resonance imaging (MRI)
    • Not usually used to screen for breast cancer but may be used in the following situations:
      • Screening young women, espceially those with dense breasts, who have an increased risk of breast cancer (e.g., mutations in the genes BRCA1 or BRCA2)
      • Screening for breast cancer in women diagnosed with cancer of the lymph nodes (glands) 
      • Screening of women with newly diagnosed breast cancer with extremely dense breasts on mammograms
  • Biopsy, in which samples of tissue from the breast are removed and examined

QUESTION

A lump in the breast is almost always cancer. See Answer

What Is the Treatment for Breast Cancer?

Treatment for breast cancer usually involves a combination of surgery, radiation, chemotherapy, and other treatments. 

  • Surgery 
    • Mastectomy: surgical removal of the entire breast 
    • Lumpectomy: removal of the cancer and some tissue surrounding it
  • Radiation therapy 
  • Chemotherapy
  • Hormone therapy
  • Targeted therapy
  • Immunotherapy 

What Is the Staging for Breast Cancer?

Stage I and II breast cancers

  • Early-stage localized breast cancer 
  • Tumor is less than 2 cm (0.8 inches) in size and is node negative
  • Stage II tumors have spread to the axillary lymph nodes and/or a tumor size larger than 2 cm but smaller than 5 cm (about 2 inches)

Stage III breast cancers 

  • Locally advanced breast cancer
  • Large breast tumors (greater than 5 cm, or about 2 inches, across)
  • Extensive axillary (underarm) lymph node involvement (more than 10 lymph nodes with cancer), nodal involvement of both axillary and internal mammary nodes (behind the ribs of the breast with cancer) at diagnosis, or nodal involvement of the soft tissues above or below the collarbone (termed the supraclavicular and infraclavicular lymph nodes, respectively)
  • A tumor is also considered to be stage III if it extends to underlying muscles of the chest wall or the overlying skin
  • Inflammatory breast cancer is at least stage III even if it is small and does not involve lymph nodes

Stage IV breast cancer  

  • Metastatic breast cancer
  • Tumors have spread (metastasized) to areas outside the breast and lymph nodes to the bones, lungs, liver, or other organs
  • The primary tumor in the breast may be any size, and there can be any number of affected lymph nodes

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Reviewed on 1/4/2021
References
https://www.uptodate.com/contents/breast-cancer-the-basics

https://www.uptodate.com/contents/breast-cancer-guide-to-diagnosis-and-treatment-beyond-the-basics

http://www.cancer.org/cancer/breastcancer/overviewguide/breast-cancer-overview-what-causes

https://www.breastcancer.org/

https://blog.dana-farber.org/insight/2019/12/what-does-a-breast-cancer-lump-feel-like/