Breast cancer starts when a tumor begins to develop in the breast. As the tumor grows, a person may be able to feel a lump. However, breast lumps are common, and not all of them are cancerous.

Many people find out that they have breast cancer after routine screening with a mammogram. However, for some people, the earliest symptom is a lump in the breast or under the arms, an inverted nipple, or other changes.

People with inflammatory breast cancer will not usually experience a lump, but there may be other symptoms.

In this article, find out what a breast lump feels like, what other symptoms can develop over time, and other causes of breast lumps.

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According to the American Cancer Society (ACS), the most common early symptom of breast cancer is a new mass or lump. However, this is not always the case.

A lump that indicates breast cancer is most likely to:

  • be painless
  • feel hard
  • have irregular edges

However, a breast tumor can also feel soft, round, or tender.

Some other possible symptoms include:

  • breast or nipple pain
  • swelling, irritation, or color changes of the breast or nipple
  • an inverted nipple
  • a new mole or a change in an existing breast or nipple mole
  • a sore on the breast or nipple that will not heal
  • tender or enlarged lymph nodes under the arm or in the neck area
  • nipple discharge
  • a change in the overall size, shape, or appearance of the breast or nipple

Angiosarcoma is a type of breast cancer that can involve a lump, but there may also be nodules on the breast that are a different color than one’s usual skin tone. There may only be nodules and no lump.

Not all types of breast cancer involve a lump.

What can a lump on the chest mean? Find out here.

Inflammatory breast cancer

Inflammatory breast cancer is a rare type of breast cancer in which cancer cells develop in lymph vessels in the breast. There is not usually a lump with this type, and the cancer may not be visible on a mammogram.

Instead, the following symptoms will affect one-third or more of the breast:

  • changes in skin color
  • swelling that can make one breast look larger than the other
  • inflammation
  • pain and itching
  • ridged or pitted skin
  • a feeling of heaviness, tenderness, or burning
  • an inverted nipple
  • swollen lymph nodes near the collarbone, under the arm, or both

The symptoms of inflammatory breast cancer will develop rapidly compared with those of other types of breast cancer.

It mostly starts before the age of 40 years. Rates are higher among Black people than white people, according to the ACS.

Learn more about how breast cancer affects Black women here.

Paget’s disease of the breast

This is another type of breast cancer that may not cause a lump. Some symptoms include:

  • flushed, crusty, or flaking skin around the nipple
  • a flat or inverted nipple
  • burning or itching in the nipple

This condition can resemble eczema.

Learn more about Paget’s disease of the breast here.

How breast lumps feel depends on their cause, location, and growth. They can vary from painful, hard, and immobile to soft, painless, and easily moveable.

Lumps are most likely to be cancerous if they do not cause pain and are hard, unevenly shaped, and immobile.

Other breast lumps can feel different:

  • Fibroadenoma lumps tend to be painless, easily movable, smooth, and rounded. They may disappear on their own.
  • Breast cysts are smooth but firm.
  • Breast abscesses and mastitis usually cause painful, swollen lumps, and there may also be a fever and flushing around the affected skin.

What causes sensitive nipples? Find out here.

The ACS no longer recommends breast self-examination, as some research has suggested that it may not be useful. However, it does urge people to be aware of the feel and appearance of their breasts and to seek medical advice if any changes occur.

Other organizations still consider self-examination worthwhile, as long as a person also has regular screenings. They suggest checking the breasts in the shower, in front of the mirror, and lying down.

How to feel for changes

Using the following steps, a person can feel for changes such as lumps, thickening, or pain:

  1. Using the pads of the fingers, move in a circular motion from the inside, near the nipple, outward.
  2. Cover the entire breast area from the cleavage line to the surrounding chest, collarbone, and armpit area.
  3. Do this both from side to side and up and down.
  4. Apply light pressure closer to the surface of the breast and nipple.
  5. Apply medium and firm pressure to check deeper tissue and tissue closer to the rib cage and back muscles.
  6. To examine the nipple, squeeze gently and check for discharge, lumps, and pain.

Carry out the same routine while lying down, allowing the breast tissue to rest evenly against the chest wall.

How to look for changes

Standing in front of a mirror, a person should look at the overall appearance of the breasts and nipples. Here are some questions to think about while doing so:

  • Are they similar in size, shape, and height?
  • Is one a different color than the other?
  • Are there any visible skin lesions, marks, color changes, or moles?
  • Are there any signs of swelling, lumpiness, pitting, or contour changes?
  • Are the nipples facing outward or inward?

A person should run through this checklist twice: once with their arms at their sides and once with their arms above their head.

Breasts are rarely identical, but noticing changes can help detect a problem early. Having an idea of the usual size, shape, appearance, and feel of the breasts can help a person be aware of any changes.

How can Medicare help with screening for breast cancer? Find out here.

The National Health Service (NHS) notes that most breast lumps are not cancerous but benign.

Benign lumps may be painful and cause breast changes, but they are not usually life threatening. Some lumps may need treatment or surgery.

Benign breast lumps can result from:

Learn more about the different types of breast lump here.

Experts do not know exactly why breast cancer develops, but the following risk factors may contribute:

  • being aged 50 years or above
  • having changes in the BRCA1 or BRCA2 genes or in other genes
  • starting puberty before the age of 12 years and starting menopause after the age of 55 years
  • having dense breasts
  • having a history of breast cancer or other breast conditions
  • having a family history of breast or ovarian cancer
  • undergoing past treatment with radiation therapy
  • not getting enough physical activity
  • having overweight or obesity
  • using hormone treatment for birth control or during menopause
  • never being pregnant or having a first pregnancy after the age of 30 years
  • never breastfeeding
  • consuming a lot of alcohol

The ACS predicts that there will be around 2,650 diagnoses of male breast cancer in 2021. The rate is around 100 times lower in white males than white females and 70 times lower in Black males compared with Black females.

Some symptoms include:

  • a lump or swelling in the breast
  • flushed, flaky, or dimpled skin
  • skin irritation in the breast
  • nipple discharge
  • an inverted nipple
  • nipple pain
  • skin color changes

Males often receive a diagnosis at a later stage. This may be because they are less aware of the risks and less likely to seek and undergo screening.

A person should contact a doctor if they experience any symptoms that may indicate breast cancer. Most lumps are not cancerous, but a doctor can help rule this out.

Screening can help detect changes before a lump becomes noticeable. At this stage, breast cancer is easier to treat.

Current guidelines from the American College of Physicians recommend that females speak with a doctor about breast cancer screening from the age of 40 years. They also recommend that females at average risk of breast cancer have a mammogram every 2 years from 50–74 years of age.

People with a higher risk, such as those with a family history of breast cancer, may need more regular screening.

It is worth noting that different authorities, such as the ACS, have different guidelines. A doctor can help recommend a suitable option.

A lump in the breast may be a symptom of cancer, especially if it is painless and hard and has an irregular edge.

However, there are many different symptoms of breast cancer, and inflammatory breast cancer does not usually produce a lump.

Being aware of breast changes, having regular screenings, and seeking medical help if changes occur are ways of reducing the risk or impact of breast cancer.

Read the article in Spanish.