Can You Really Feel the Difference Between a Breast Cyst and a Tumor?
There’s a pretty common belief out there that if a weird lump arises on your breast, you might be able to feel around to determine if it’s a benign cyst or a tumor.
Let’s be super-clear up front: Only a doctor can actually tell you what any new lump or bump on your breast might be, whether it’s a benign cyst or, more rarely, a potential sign of breast cancer. With that said, since all breast bumps aren’t created equal, different types sometimes have characteristic features that you can pick up on through your skin. While it’s important to get any new breast changes that worry you looked at by a doctor, there are a few things you can feel around for beforehand.
First, keep in mind that breast lumps aren’t always something to worry about.
Lumps are a catch-all term for any kind of bumpy irregularity in the breast, Dennis Holmes, M.D., breast cancer surgeon and researcher, and interim director of the Margie Petersen Breast Center at John Wayne Cancer Institute at Providence Saint John’s Health Center in Santa Monica, Calif., tells SELF. It’s true that a lump can be a sign of breast cancer, but describing lumps as irregularities doesn’t automatically mean they’re dangerous, Dr. Holmes says. It just means that something about your breasts is different than before.
Cysts are a common, typically benign cause of breast lumps. There are various types, including simple and complex, according to the American Cancer Society. A simple cyst is just filled with fluid, while a complex cyst has fluid and solid elements, so it may need to be biopsied to make sure it’s not cancerous.
Sometimes you can develop simple cysts throughout your breasts due to shifts in hormones, especially estrogen. This is known as fibrocystic breast changes, and it’s not associated with cancer. Along with these cysts, fibrocystic breast changes can create scar-like tissue that make your breasts feel bumpier overall. If you typically notice a lumpier texture to your breasts, it’s worth talking to your doctor about this possibility.
Your breast lump could also be what’s typically called a sebaceous cyst but what is also sometimes referred to as an epidermoid or pilar cyst. These can happen when skin glands get plugged by debris, like dead skin cells, or when a hair follicle gets blocked.
It’s true that benign cysts can sometimes feel different from tumors or other types of breast lumps, but it’s not an exact science.
A simple cyst may feel soft and compressible, while a complex cyst may feel a bit harder depending on its makeup, since it’s not solely filled with fluid. A tumor might feel like a small, hard marble inside your breast, and fibrocystic breast changes can make your chest feel almost rope-like in multiple areas, Therese Bartholomew Bevers, M.D., F.A.A.F.P., a professor of clinical cancer prevention and medical director of the Cancer Prevention Center and prevention outreach programs at MD Anderson Cancer Center in Houston, tells SELF.
You may be more easily able to move simple and complex cysts around in your breast than other lumps, especially an actual tumor, she adds. These cysts also tend to have smoother surfaces than tumors, so your skin might move over the former more easily than the latter, Dr. Holmes says.
Since sebaceous cysts are related more to the skin, not the breast, they’re a bit different. You can expect them to feel like small, round bumps underneath your skin, but with a tiny blackhead in the middle. Unlike other breast lumps, they sometimes excrete thick, yellow, foul-smelling discharge, according to the Mayo Clinic.
There’s also the question of pain. You may experience tenderness on or around a simple or complex breast cyst, while fibrocystic breast changes can cause general breast pain throughout your set. Sebaceous cysts, on the other hand, typically don’t hurt unless they become inflamed, and cancerous breast tumors typically don’t cause pain at all, Dr. Bevers says. In extremely rare cases, breast pain can be a sign of an uncommon and aggressive form of cancer known as inflammatory breast cancer, which usually presents with other symptoms like pitted breast skin and a rapid increase in breast size, according to the National Cancer Institute. Inflammatory breast cancer only comprises 1-5 percent of all breast cancer diagnoses in the United States, meaning that pain is a really uncommon sign of breast cancer.
So, let’s say you found a lump. What next?
If you discover a lump that doesn’t feel super hard, moves easily, is tender, and doesn’t really worry you, you may feel comfortable waiting a menstrual cycle to see if it’s just your body’s response to hormonal increases during that time, Dr. Bevers says. Of course, you do not have to wait to see a doctor if you’re at all concerned about it. In fact, most women don’t, Dr. Bevers says.
If the lump persists after that, or feels hard, doesn’t move, and isn’t painful, you should call your doctor to get evaluated, Katherine T. Johnston M.D., a primary care physician at Massachusetts General Hospital, tells SELF. Again, that’s the only way to know what’s going on for sure.
While doctors may have suspicions of what your bump might be, it’s impossible to know without a workup, which often involves an ultrasound of your breast. Evaluating a breast lump may also include other imaging tests (like mammograms or MRIs) and biopsies, depending on what they find.
If you’re worried about a lump in your breast and your doctor seems dismissive of it, insist on having an ultrasound or find a doctor who will give you one, Jane Kakkis, M.D., medical director of breast surgery at MemorialCare Breast Center at Orange Coast Medical Center in Fountain Valley, Calif., tells SELF. You’re probably fine, but it’s important to know what you’re dealing with, if only for peace of mind.