Breast Lump FAQsby PJ Hamel Patient Expert
Q. I found a lump in my breast. Should I call the doctor right away, or wait and see if it disappears?
A. The key word here is "found." You should examine your breasts regularly; yes, the monthly self-exam IS important; don't "forget" to do it. If you feel something in your breast-a lump, a thickening, swelling-that feels different than usual, call the doctor. Overall, there's a very good chance that whatever you're feeling isn't cancer, especially if you're pre-menopausal; but for your own emotional well being, it doesn't hurt to have it checked out.
Q. My breasts always feel lumpy. How do I differentiate what's "normal" from a lump that might be a tumor?
A. Every woman develops her own definition of normal breast tissue. Many of us have naturally lumpy breasts, ranging from tiny hard lumps, to large soft lumps, and everything in between. Learn to feel what's normal for YOU. And normal doesn't necessarily mean "exactly the same every day." It means over the course of your menstrual cycle, if you're pre-menopausal. You probably notice changes during your period, when your breasts may suddenly become full and a bit painful, or just "feel" different than they do during the rest of the month. That's normal. It's when your breasts don't follow their usual behavior that you should pay attention.
If you're post-menopausal, you're used to your breasts remaining fairly static week in and week out. So if a lump suddenly appears, it's worth having it checked out. Especially since the incidence of breast cancer increases as you age.
Bottom line: Identify and internalize what's normal for you (that's where the self exam comes in), so that if something abnormal happens, you'll notice it.
Q. OK, I think I've found a lump in my breast that's different than what's normally there. How worried should I really be?
A. Worried enough to call the doctor; not worried enough to panic. In pre-menopausal women, only 1 in 12 "dominant lumps" (that is, lumps that stand out enough to be discovered) is malignant. In post-menopausal women, whose breasts aren't constantly changing due to their period, the chance that a discovered lump is malignant rises to 50-50. But that risk is mitigated by the fact that post-menopausal women are much, much, MUCH less likely to discover a lump in their breast than women still menstruating, who are very much more likely to develop usually harmless cysts in their breasts.
Bottom line: If you discover a non-normal lump, be concerned. But understand that it doesn't automatically mean you have cancer.
Q. I'm really good about doing self-exams; I mean, I KNOW what my breasts feel like. And I've found a lump that shouldn't be there. When I saw the doctor, he said it feels like a cyst, and not to worry about it. But I'm still worried...
A. My opinion? Get a second opinion. Or insist on further examination: a mammogram or ultrasound, for instance. I'm no doctor, but I've had way too many friends tell me they felt a lump, the doctor said not to worry, and months later it turned out to be cancer. This is a fine line: how much do you question your doctor? She knows what she's talking about, right? Yes, but YOU know your own body.