I think I have a breast lump or is it just lumpy texture?
By Dr Evelyn Ho
When we speak of a “lump”, we always refer to some “bump” that we feel. So it is the same with the breasts.
However, did you know the texture of the breasts is such that it may be uneven or even feel AS IF it is full of lumps and bumps? In other words, a “lumpy” breast!
Therefore we must get our concepts clear! Otherwise, feeling our breasts will only produce anxiety, confusion or panic. Worse, this will make you lose confidence that the BEST PERSON to get to know your own breasts is yourself, yes YOU! YOU– yes you!
When you communicate with your doctor, please find out when the word “lump” is used, is it referring to something that can be felt or something that the radiologist (specialist doctor in imaging) sees only on ultrasound or the mammogram? This is important so that you do not feel that you are “no good” at detecting a “lump” when in actual fact it can only be detected on ultrasound or mammogram examination!
That’s why it is SO IMPORTANT for you to get to know your breasts—where it feels thicker, or more bumpy, where there may be depressions, size, shape, colour, “flow”, nipple positions and specific features of your own unique breasts. If you find a change that persists for some 2 menstrual cycles, you would want to go and get it checked with your doctor.
What determines if a “growth” can be felt?
The size, shape (how even, smooth, round or irregular) and consistency (how firm or soft) of the “growth” in the breast.
The surrounding breasts’ consistency—firm, soft or uneven?
How deep the lesion is from the skin surface?
Size, Shape & Consistency of the Growth (Tumour)
The larger the size of the growth, the more likely it can be felt. The shape also determines if it is easily felt. If it is “flattish” or oval in shape, it tends to blend along the planes of the breast tissue, but when it is angular in shape or round, it is more likely to be easily felt. A growth with an irregular margin will also be more easily felt. So will a growth that “irritates” the breast tissue around it or causes an “inflamed-like” reaction around the growth will make the growth feel larger than it really is.
The degree of hardness or firmness of the growth will also determine if it is easily felt or not. See consistency of surrounding breast below.
Consistency or Texture of the Surrounding Breast
The ability to feel a growth (a true lump) will also depend on whether the normal surrounding breast is of hard, firm, soft or of mixed consistency. If both the growth and the surrounding breast have the same consistency or texture, it will be difficult to differentiate the difference and the lesion will not be discernible to touch or palpation.
If the growth is harder than the surrounding tissue, then it will be more easily picked up by the hands. When it is softer than the surrounding tissue, one might think there is a lump or thickening when one feels the normal breasts and where the lesion is “soft”, the breast tissue would be more “compressible” when feeling it!
The Depth of the Growth/Lesion from the Skin Surface
The distance from the anterior margin of the growth/lesion to the skin surface will affect how easily a growth an be detected by self examination or your doctor’s examination.
A growth close to the ribs or in the back of the breast will need to be much larger before it can be felt as opposed to even a pea sized nodule that is so close to the skin, it can even cause a small bulge in the skin when one observes the breast closely.
In reality the ability to feel any growth will depend on ALL the factors mentioned above. Fortunately today with the advent of high resolution ultrasound scans, the lumpy textured breast can be investigated with ultrasound, where you can point out to the Radiologist (specialist doctor in imaging) where you thought or think there is a “lump”. A focussed ultrasound examination such as mentioned will be very good at differentiating a true growth from normal glandular pattern.
It is important to note that ultrasound is still not recommended as a cancer screening tool in breast cancer but has an important role to play in the young with lumps or lumpiness and as an adjunct or complementary investigation to the mammogram.
Remember, once you have reached 40 years old, regardless of whether you think your breasts are normal and have no signs and symptoms, go for the screening mammogram! Screening mammograms have a different role to play – one that is very important in early detection of non palpable cancers!
Click here to learn more about breast imaging