Lumps in the breast

A 'lump' is a very common term, implying, a 'knot' or a 'mass' or a 'hard feeling' in the breast. Different women will have different interpretation of lumps. So here we discuss, what exactly is a lump? How to look out for a lump? And what to look out for, when examining for a lump.

The following way of explanation may sound very funny, but honestly, many women do not understand what a lump feels like and how to look out for one. Analogy is the best way to explain a lump. Hence an attempt to explain a bit in detail on how to watch out for a lump.


Feel of a normal breast

A sponge to a dough

The normal breast contains two main types of cells - fat cells and glandular cells. Depending on the amount of each present, the 'density' of the breast varies, and with density, the feel of a breast varies. This variation is both, from woman to woman, and from age to age. The breast should ideally be felt with the 'flat' of the hand. The 'flat' of the hand means the 'inner' surface of the fingers. The fingers should be placed on the breast tissue, and rotated in a clockwise manner, to have a 'feel'

Breasts, which are 'less dense' feel like a sponge. The fingers dip in easily. Breasts which are 'more dense' feel like a dough. The fingers cannot be dipped in that easily, and there is some resistance. Both are, however, soft to feel, and none of them feels hard at all. These are the two extremes and most women will have a breast tissue density, somewhere in between these two. The reason of discussing this breast density is that, it is essential to be familiar with the feel of the breast.

How does a 'lump' or a 'knot' feel?

A small tennis ball to a walnut

Now keeping in mind, the sponge and the dough above, imagine if a small tennis ball (not the large on shown in the figure) was placed within that sponge or within that dough, How would it 'feel' ?. When the flat of the hand feels the breast tissue, it will make out the most of the sponge or dough is fairly soft, but there is 'something hard' on which the examining fingers easily roll on. If you try to press the rest of the sponge or dough, it presses nicely (with differing resistance), but when you try to press the area where the ball is there, it doesn't press.

And a similar situation, when a walnut is placed within the sponge or the dough. A walnut is all the more hard! Imagine feeling the sponge or dough now, with the walnut hidden inside. When the fingers move over the walnut, a distinct 'hardness' will be felt, as compared to rest of the sponge and dough, which will be as soft as usual.

Most of such hard lumps can be 'distinctly' felt, and one can make out where the lump is ending and where the normal breast tissue is starting

Most lumps feel hard. But there are some 'soft' lumps as well. Imagine a water filled balloon placed in the sponge and dough, how would it feel? One can easily indent the balloon part and it feels as soft as the breast, except for a slightly different 'feel'. Such soft feel is felt in cysts or occasionally collection of pus inside the breast, and both are usually non cancerous conditions

Discussion:

  • The above discussion was to guide on how to feel for a lump and how to lookout for a lump, so that, on regular breast examinations, one can lookout for such lumps, and if felt, consult a doctor

  • All breast lumps are not cancerous. The chances of cancer depend on age. In younger age group, below 30 years of age, most hard lumps tend to be fibroids or cysts or benign breast diseases (none of these are cancerous). After age of 30 years, on an average, the chances of non cancerous lumps reduces and that of cancerous lumps rises. And after 40 to 45 years of age, most recently detected lumps will be cancerous. Soft lumps will usually be cysts or sometimes benign breast disease.

  • There will be some lumps, which may not be as hard, and there is only a 'lumpish feel' but no clear lump. This must be kept in mind. Even such a lumpish feel warrants a medical attention.

  • Most of these lumps are painless. Fibroids and benign breast lumps may be associated with pain during periods. But a majority of cancerous lumps are, by far, painless.

  • All cancerous lumps are not necessarily hard. Some of them may be just about little harder than the normal breast tissue, giving rise to 'lumpish feel' as mentioned above.

  • Since we are seeing a huge surge in young breast cancers, especially in the 30 to 50 year age group, any lady above the age of 25 years, and feeling a lump in the breast, is strongly encouraged to take an expert opinion of a Surgical Oncologist or a surgeon trained in breast diseases

  • Regular monthly breast self examination, keeping in mind what to look out for, will enable an early detection of abnormal signs and symptoms, and if so, one can consult a breast specialist