Brenda Spriggs, MD, MPH, MBA
Every woman fears discovering a lump in her breast. All breast lumps, both in women and in men, could be cancerous and must be promptly evaluated by a physician. The diagnostic process takes time, however, and the uncertainty can be terrifying.
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If the breast lump is large enough to feel, you can get some clues about whether it is likely to be cancerous. If the lump feels hard or irregular, and not painful or tender to the touch, it is more likely to be cancerous. If the lump was discovered by mammography, however, it may be impossible to examine by feel.
If you have a nipple that seems to be pulled inward (an inverted nipple), it may be due to a cancerous lump. Also, a nipple discharge that is not milky may occur in association with cancerous lumps. Unusual nipple discharge should be evaluated by a physician even if you do not feel a lump.
The skin overlying the lump can provide a clue as to whether a breast lump is cancerous. If there is a dimple in the skin above the lump, or if the skin is flaky or red over the lump, it is more likely to be cancerous. Certain skin changes, such as a thickening of the skin with discoloration that resembles an orange peel, are highly likely to be associated with underlying cancer.
Lymph nodes that connect to the breast are found beneath the armpit. Lumps in the armpit on the same side as the breast lump may be a sign that there is breast cancer that has spread to the lymph nodes.
If the breast itself is abnormal or has changed in any way, that increases the likelihood of breast cancer. For example, if the breast has become swollen or painful, it could be a sign of underlying breast cancer.
The National Cancer Institute has a risk assessment tool that lists patient characteristics associated with breast cancer, such as age, family history and personal history. One in eight women will develop breast cancer during her lifetime, and the risk increases with a family history of breast cancer. The good news is that if breast cancer is detected early, there is a 98 percent 5-year survival rate. Do not wait to see your doctor if you are worried about breast cancer.