Breast cancer lumps: Difference between benign and cancerous

Breast cancer is the world’s most common cancer. It rightfully needs increased awareness about detection, diagnosis and early treatment. Breast cancer commonly presents itself as a lump in the breast, and hence any lump apparently found in the breast is looked upon with suspicion. However, it is important for us to understand, not all breast lumps are cancerous. Come let us know more about breast cancer lumps!

Various classic distinguishing factors play a role in clinically differentiating the cancerous for the non-cancerous(benign). The investigations always follow in supporting or refuting the diagnosis.

For early detection of breast cancer, women are advised to have self-breast examination at least once a month and review with their obstetrician gynecologist in case of any lump. If no lump is felt, breast checks are advised with a gynaecologist as a part of routine one-year screening.

One should understand that once a breast lump is detected, it doesn’t always mean cancerous, and there is generally no need to panic. Around 90 percent of the breast lumps are only benign and caused by fibroadenomas or cyst or infections.

The lump felt in the breast needs evaluation with an expert. Once seen, a doctor might make basic differential diagnosis in terms of a cancerous vs non-cancerous lump based on certain characteristics of the lump.

How do you tell if a lump is benign or cancerous?

1. Alteration in the symmetry of breast

Cancerous lumps can grow much in a short whole and can show irregularities in the size and shape of the affected breast, compared to the normal breast. Benign lumps being generally very regular and slow to grow, mostly doesn’t alter the breast size drastically.

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2. Skin above the lump

In a benign lump, the skin overlying it is normal. However, skin overlying a cancerous lump over a period of time shows ulcers, colour change, increased blood vessels or the classic “orange peel appearance”.

3. Nipple changes

The nipple of the breast affected by a benign lump doesn’t show any particular change. However, in malignancy, the nipple may look retracted (in drawn),
and many a times shows evidence of altered discharge.

4. Easily mobile

A lump that is separate from adjoining structures and can easily be moved, is most likely a benign lump. However, if it seems to be stuck on the overlying
skin or to the underlying muscle, there is a high likelihood of cancer.

5. Armpit lump

The presence of an additional lump in the armpit (Axilla) in cancers and in infections, the lymphnodes may become secondarily enlarged and may present as a lump in the axilla (armpit). In infections, they may be generally painful. However, in breast cancer, the axillary lymphnode enlargement goes un-noticed until doctors’ evaluation, as they are generally painless.

Diagnosis of breast cancer lumps

Once a provisional diagnosis is made, it needs to be investigated using mammogram or sono-mammogram. If needed, a biopsy to confirm the diagnosis and start further treatment based on the same.

Benign lumps are treated based on the cause and size. Infections are treated with antibiotics and follow up. Benign lumps smaller in size are left alone with annual follow up. Larger masses can be operated, however, with a risk of recurrence.

Cancerous mass should be seen and operated upon or planned for chemo-radiation based on expert oncologic advice.

In this month of Breast Cancer Awareness, if we can teach each other the importance of breast examination and annual health checks, breast cancers can be detected at a very early stage and treated to the level of cure.