Symptoms - Lump or Mass

Some breast cancers form lumps or masses in the breast tissue. However, non-cancerous (benign) conditions can also cause harmless lumps in the breast. Lumps that are cancerous may feel hard, firm, or irregular. They may also feel like an area of thickened tissue or swelling. Breast cancer lumps may feel fixed to the surrounding tissue, rather than moveable within the tissue. Most lumps due to breast cancer are painless, but if tumors become large or spread to the skin and cause ulcers, they can potentially be painful.^1,2

Lumps may be found during a breast self-examination or by a clinical breast examination by a doctor. It is impossible to know just by palpation (touch) whether a mass is cancerous or not. Additional tests that are commonly used to evaluate lumps include:

• Mammography
• Ultrasound
• Biopsy

Where breast cancer lumps are most often found

If the breast is imagined as having four quadrants, with a horizontal and vertical line crossing over the nipple, the majority (about 58%) of breast cancers occur in the upper outer quadrant, that section of tissue closest to the armpit. About 14% occur in the upper inner quadrant, approximately 9% in the lower-inner quadrant, approximately 10% in the lower-outer quadrant, and another approximately 9% are found in or around the nipple.³

Breast self-exam

When it was first introduced, breast self-exam was believed to be a method where women could check their own breast tissue regularly and find breast cancers early. However, research has not shown that breast self-exam is an effective screening tool for early detection of breast cancer, and screening with mammography is more likely to catch breast cancers in their earliest stages.^4,5

Younger women with breast cancer may be more likely to have a tumor discovered by palpation (feeling the breast tumor) rather than it being discovered on a mammogram. An analysis of approximately 6,000 women with breast cancer found that women under the age of 50 were more likely to have a tumor discovered through touch (palpation) than through a mammogram, in comparison to women over the age of 50. The study found that 81% of the breast cancers that were found by mammography occurred in women over the age of 50 compared to 19% of those under age 50 have their breast cancer detected by mammography. Of the women whose breast cancer was found by palpation, 40% of them were under age 50.⁶
Screening mammograms are not generally recommended for women under the age of 40 who are at average risk for breast cancer, and recommendations for screening mammography can vary for women between 40 and 49.^5,6 While mammography remains the best screening tool to find breast cancers at their earliest stages, it is important for all women to know what’s normal for their breast tissue and bring any changes to the attention of their doctor.

Other symptoms of breast cancer

Besides a lump, breast cancers may cause symptoms, including⁷:

• Changes in the size or shape of the breast
• Changes to the nipple, such as a turning inward (or retraction) of the nipple
• Changes to the skin of the breast, including a dimple or puckering
• Discharge from the nipple (other than breast milk), possibly bloody fluid
• Changes to the areola (the darker area of skin around the nipple), including scaly, red, or swollen tissue
• Multiple dimples on the skin of the breast that resembles an orange skin (peau d’orange)