Pink Facts | Lumps: 7 Myths and Facts

22Mar10

By Kathleen Doheny

Reviewed by Louise Chang, MD

Breast lumps are common. Can you separate myth from fact?

About 40% of women will discover a breast lump at some point in their lives. Although a lump doesn’t necessarily mean cancer, what women do immediately after that discovery can mean the difference between survival or not.  So what do you need to know if you find a breast lump? Four experts interviewed by WebMD help separate myths from facts.

1. A Breast Lump Is Almost Always Cancer

This is a myth, thankfully, but a widespread one, says Stephen Sener, MD, past president of the American Cancer Society and professor of surgery at the University of Southern California’s Keck School of Medicine in Los Angeles.

Whatever the cause, it’s important to get any lump evaluated. Sener recommends a physical examination, a mammogram, and perhaps an ultrasound. “Most of the time you have a reasonable idea what is happening after that,” he says. Some women will need to get a biopsy.

2. Breast Cancer Is Always Accompanied by a Lump You Can Feel

Not necessarily, says Jennifer Eng-Wong, MD, a medical oncologist at Georgetown University’s Lombardi Comprehensive Cancer Center in Washington, D.C.

“Sometimes you pick up a cancer on a mammogram before you can feel [the lump] she says.

3. A Cancerous Lump Feels Different From a Benign Lump

Not always, says Eng-Wong. Cancerous lumps and noncancerous, or benign, lumps, can overlap. When a lump is cancer, she says, women often assume it will be a single lesion that feels hard and doesn’t move around. That could be, she says, but a cancerous breast lump could also feel smooth and be mobile, she says.

3. A Cancerous Lump Feels Different From a Benign Lump continued…

”You can’t always tell by how it feels,” says Love. ” Cysts, if they are deep, will feel scary. If they are near the surface, they often feel round and smooth. But if they are deep, they can push the breast tissue forward. Something that feels fairly benign and smooth and movable can be a cancer. Something that feels very scary can be benign.”

The best advice? “Anything that feels different to you should get checked out,” Love says.

4. A Small Lump Is Typically Nothing to Worry About

This is definitely not so, says Kruper. “Cancer can be very small when it first presents,” she says. “Size is never a good way to decide whether a lump is something to worry about.”

Kruper says she has seen women whose breast lumps have ranged in size from a pea to a grapefruit. The lumps found on mammograms, she says, can be extremely small. “When women actually feel a mass, it’s usually less than an inch in diameter, the size of a small cherry,” she says.

5. It’s OK to Watch a Lump and Call the Doctor Later

It’s NOT OK, and the older you are, the more this advice applies, doctors say. “You should always be evaluated by a health care practitioner,”  Eng-Wong says. “Sometimes they will recommend watching it for a couple months in women who are still menstruating,” she says. “You can have cysts [that feel like lumps], and they can change with the menses.”

Bottom line for older and younger women: “Get evaluated,” Eng-Wong says.

6. A Lump Can Be Cancer Even in a Woman With No Family History

Absolutely, says Love. “Only 5% or 10% of breast cancer is hereditary. The majority of women who get breast cancer have no risk factors.”

7. A Lump Can’t Be Cancer in Women with a History of Cysts

Not so, but some women are lulled into this false sense of security.  Women who have been told for years they have cysts often assume a new lump is nothing to worry about, Kruper says.

She tells women: “Whenever something new appears, we [physicians] need to know about it.” She cautions them not to assume that just because previous lumps turned out to be cysts — or nothing at all to worry about — that the new lump is the same story.

Click HERE to read the complete WebMD article.

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