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Does a Lump Always Mean Breast Cancer
Women should do self-breast exams at least once a month, but what happens if they find a lump? Does it automatically mean cancer? The short answer is no. In this important podcast, Dr. Meghan Garstka, breast surgical oncologist at UM Upper Chesapeake Health, discusses how to detect a breast lump, what a lump could be and what steps to take next.
Featured Speaker:
Meghan Garstka, MD
Dr. Meghan Garstka, a breast surgical oncologist at the Breast Center at UM Upper Chesapeake Health, has clinical expertise in benign and malignant diseases of the breast. She has a clinical interest in the management of patients with an elevated lifetime risk of breast cancer. Dr. Garstka has been active in clinical research and won awards for her achievements. With research interests that include various aspects of clinical outcomes in breast cancer treatment and surgery, including cost-effectiveness, patient-reported outcomes and quality of care, she is passionate about health equity and access to care. Learn more about Dr. Garstka. Learn more about the Breast Center at UM Upper Chesapeake Health. Transcription:
Does a Lump Always Mean Breast Cancer
Caitlin Whyte: Welcome to Live Greater, a health and wellness podcast brought to you by the University of Maryland Medical System. We put knowledge and care within reach, so you have everything you need to live your life to the fullest. This episode is sponsored by the Breast Center at the University of Maryland Upper Chesapeake Health, where quality care and compassion combine to create an individualized experience for women who need a mammogram or who are seeking treatment and support services for breast health concerns. We have the physician experts, including a fellowship-trained breast surgeon, general surgeons, a breast navigator and other specialists to guide you through the process. For more information, please call our dedicated breast line at (443) 843-PINK. That's (443) 843-PINK. Or learn more at umuch.org/breast.
Today, we are focusing on how to detect a breast lump, what a lump could be and what steps to take next with Dr. Meghan Garstka, a breast surgical oncologist at the Breast Center at UM Upper Chesapeake Health.
So Dr. Garstka, let's talk about breast lumps and bumps. How common are they? Do they come and go? Do they come at certain times of the month? What should I be keeping an eye out for?
Meghan Garstka, MD: Sure. Breast lumps and bumps are very, very common. In fact, the tissue that makes up the majority of the breast tissue is certainly something that can feel lumpy and bumpy at all times of the month. That's because the tissue is what we call fibrocystic tissue and it's made up of a type of tissue that itself can feel like it has this texture. Those feelings of lumps and bumps certainly can be more common during the time of the month leading up to your period due to the fact that that tissue can respond and really become larger and grow at the time of the month closer to your period.
Caitlin Whyte: So what exactly does a lump in the breast feel like? And what should I do if I feel one?
Meghan Garstka, MD: A lump in the breast can feel like something that just feels like it stands out compared to the rest of the lump and the bumpiness of the tissue. It might feel firm. It might feel like it's a bit bigger than the other lumps that you might feel in that area. It can have many different ways to present. But typically speaking, women will note that they feel a prominent lump, like a single spot that feels like it's larger in size compared to the others. Sometimes they might also notice a lump by their armpit, since we do know that you have axillary breast tissue as well, tissue that goes up towards the axilla.
If you feel one, you should definitely make note of it. And if it is something that you feel like it persists and is something that is concerning, you should certainly contact your physician about having a breast exam and having someone take a look at this lump more closely.
Caitlin Whyte: Now, it sounds like not all lumps mean cancer. So what else could a breast lump be?
Meghan Garstka, MD: There are plenty of different things that can be a lump in the breast besides cancers. You can have things such as a fibroadenoma, which is a benign breast tumor. You can also find things like a simple cyst in the breast, which is a fluid-filled essentially bubble of tissue that can grow and change in response to hormones.
There are a variety of things that are benign and common problems in the breasts besides cancers. And so it's important to have any lump checked out in order to make sure that it is something benign and not a cancer.
It's something that you should certainly be aware of if you do find a lump, but don't be alarmed because it might not be a cancer. It can be something that is benign and something that can be watched or something that might go away if it is a cyst. So there's plenty of different things that it could be besides a malignancy.
Caitlin Whyte: Well, yeah, that's my next question. If I head to the doctor, I'm a little concerned about this lump, what should I expect from that visit?
Meghan Garstka, MD: Sure. At your visit, the physician will take your history. They will ask you about such questions as you know, if you've ever had any breast biopsies in the past, if you've ever felt any lumps in the past. Let's talk about your general overall medical history and any medications that you take. They might ask you about your family history as well and just go through your basic medical exam.
They will also perform a breast exam, examination of both breasts, not just the one that has the lump. And then they will likely recommend that you undergo imaging usually with at least an ultrasound, if not also a mammogram in order to further evaluate the lump that you feel.
After that imaging, depending on what they find, they might recommend a biopsy or they might recommend something that you would follow over time with additional imaging or physical exam.
Caitlin Whyte: Well, let's talk about self-breast checks. I know every time I'm at the gyno, they ask me if I do them and I'm always like, "Not really," and I know I should be. So tell us about how important they are.
Meghan Garstka, MD: Sure. Well, breast self-exams are something that many women have questions about because they might've heard things that in the past, if women examine their breasts too much, that leads to too many biopsies and it doesn't find cancer early, that sort of thing.
So there's been a lot of confusion in the past about if breast exams are helpful. The answer that I give patients, and I think what many physicians feel is that it is important to become very familiar with the anatomy of your own breasts in order to find things that are abnormal for you. So what I recommend to patients is I recommend that they do perform a breast self-exam monthly. A lot of people think that the best time to do this is after your periods since so many things can be sort of tender and swollen prior to the period.
So about a week or two after your period, it would be a good time to just do a physical exam to check your breasts, not necessarily with your doctor, but you can actually do this, just sort of feeling for any differences in lumps or bumps that you would feel compared to one month prior.
So the thought would be, if you perform a breast self-exam every month, then you'd be able to identify any changes since you know your baseline. You know, obviously some women have lots of questions about it. So I always tell them if they do present to their doctor to get a lump checked out. And if you have imaging and you've had somebody take a look at the breast and be able to reassure you that there's no issues at that time, then that's a good baseline time to start doing this since you know that your exam is normal and your imaging is normal, or maybe you know that there's a lump in the breast that's been evaluated and is benign. So now you know where it is and you can follow it.
So in general, I think that breast self-exams are very important. And I think it's something that women should certainly think about doing every month. And again, if they have any changes in their exam, they should always talk to their doctor about it in order to determine if it's something that they should have imaging for or be followed more closely,
Caitlin Whyte: Is it important to perform them at the same time every month? Like if I start after my period, I should always do it after my period or is there flexiblility?
Meghan Garstka, MD: Sure. Well, I think the best recommendation would be to do it around the same time of the month. If you're not having periods, we tell women to pick a day of the month any day and to always check it on the same time, just so that they don't forget about doing it. So not only is it helpful to know the way that the breast feels at that particular time of the month, but also to not forget it. So I think that that's something to keep in mind. It's helpful to always practice it monthly so that you're able to remember to do it. But in general, I would say it's good practice to be familiar with it, so that you can compare it to the baseline if it's around the same time of the month.
Caitlin Whyte: Well, like you said, it's so important to know our own anatomy with these self-breast checks. But why is it important to also keep in touch with your doctor and get those regular screenings and mammograms by them?
Meghan Garstka, MD: So we know that mammography is the absolute best gold standard test that we have to identify breast cancers early. It's the best screening tests for all women. If you talk to your doctor, depending on your breast cancer risk, there might be other testing that has been suggested such as MRIs and things like that. But we know that for all women that mammograms are really truly the gold standard. They are important to do annually, and you can talk to your doctor more about recommendations for when you should start them and stop them.
But in general, we recommend that women start them around age 40 and then continue with them annually due to the fact that we know that this identifies breast cancers at a much earlier stage. We know that if you find the breast cancers early, they're very treatable. And it's a way that we can make sure that we identify and detect these early to proceed with early treatment.
So I would definitely advise women to speak with their primary care doctors or with any physician that sees you regularly about making sure that these are ordered due to the fact that it really truly is one of the best tests that we have, actually the best tests that we have to identify and detect breast cancer early.
Caitlin Whyte: Great. Well, doctor, as we wrap up here, is there anything else you'd like to share or add when we're talking about our breast health?
Meghan Garstka, MD: No, I would definitely encourage women to realize that, you know, it's totally natural to have questions about the health of your breasts. You know, women are always curious about if it's worth it to have a lump checked out. I always tell people we're always happy to do an exam and check on things, just because sometimes it is difficult to find things that might feel different yourself. I also always encourage them, even if they've seen a primary care provider, if the primary care is curious about a lump in the breast as well, we are always happy to see them as well to make sure that we have a second pair of eyes looking at it. So I think it's important to really be aware of your own anatomy with self-exams, but I think it's also important to definitely reach out to your physician at any time that you have a question about a lump in the breasts or about your mammogram screenings.
So I would definitely encourage women to be in close communication with their providers about this topic, because really it's in the detection, the early detection of breast cancer, that we really have come a long way. And I think it's really from women doing a good job with breast cancer screening and also with self-exams and just really being good about communicating with their physicians. So it's very important.
Caitlin Whyte: Well, woman to woman, doctor, I'm so happy I got to be a part of this episode with you, just some critical information we went over today. Thank you so much for being with us.
Find more shows just like this one at umms.org/podcast. Thank you for listening to Live Greater, a health and wellness podcast brought to you by the University of Maryland Medical System. We look forward to you joining us again.
Does a Lump Always Mean Breast Cancer
Caitlin Whyte: Welcome to Live Greater, a health and wellness podcast brought to you by the University of Maryland Medical System. We put knowledge and care within reach, so you have everything you need to live your life to the fullest. This episode is sponsored by the Breast Center at the University of Maryland Upper Chesapeake Health, where quality care and compassion combine to create an individualized experience for women who need a mammogram or who are seeking treatment and support services for breast health concerns. We have the physician experts, including a fellowship-trained breast surgeon, general surgeons, a breast navigator and other specialists to guide you through the process. For more information, please call our dedicated breast line at (443) 843-PINK. That's (443) 843-PINK. Or learn more at umuch.org/breast.
Today, we are focusing on how to detect a breast lump, what a lump could be and what steps to take next with Dr. Meghan Garstka, a breast surgical oncologist at the Breast Center at UM Upper Chesapeake Health.
So Dr. Garstka, let's talk about breast lumps and bumps. How common are they? Do they come and go? Do they come at certain times of the month? What should I be keeping an eye out for?
Meghan Garstka, MD: Sure. Breast lumps and bumps are very, very common. In fact, the tissue that makes up the majority of the breast tissue is certainly something that can feel lumpy and bumpy at all times of the month. That's because the tissue is what we call fibrocystic tissue and it's made up of a type of tissue that itself can feel like it has this texture. Those feelings of lumps and bumps certainly can be more common during the time of the month leading up to your period due to the fact that that tissue can respond and really become larger and grow at the time of the month closer to your period.
Caitlin Whyte: So what exactly does a lump in the breast feel like? And what should I do if I feel one?
Meghan Garstka, MD: A lump in the breast can feel like something that just feels like it stands out compared to the rest of the lump and the bumpiness of the tissue. It might feel firm. It might feel like it's a bit bigger than the other lumps that you might feel in that area. It can have many different ways to present. But typically speaking, women will note that they feel a prominent lump, like a single spot that feels like it's larger in size compared to the others. Sometimes they might also notice a lump by their armpit, since we do know that you have axillary breast tissue as well, tissue that goes up towards the axilla.
If you feel one, you should definitely make note of it. And if it is something that you feel like it persists and is something that is concerning, you should certainly contact your physician about having a breast exam and having someone take a look at this lump more closely.
Caitlin Whyte: Now, it sounds like not all lumps mean cancer. So what else could a breast lump be?
Meghan Garstka, MD: There are plenty of different things that can be a lump in the breast besides cancers. You can have things such as a fibroadenoma, which is a benign breast tumor. You can also find things like a simple cyst in the breast, which is a fluid-filled essentially bubble of tissue that can grow and change in response to hormones.
There are a variety of things that are benign and common problems in the breasts besides cancers. And so it's important to have any lump checked out in order to make sure that it is something benign and not a cancer.
It's something that you should certainly be aware of if you do find a lump, but don't be alarmed because it might not be a cancer. It can be something that is benign and something that can be watched or something that might go away if it is a cyst. So there's plenty of different things that it could be besides a malignancy.
Caitlin Whyte: Well, yeah, that's my next question. If I head to the doctor, I'm a little concerned about this lump, what should I expect from that visit?
Meghan Garstka, MD: Sure. At your visit, the physician will take your history. They will ask you about such questions as you know, if you've ever had any breast biopsies in the past, if you've ever felt any lumps in the past. Let's talk about your general overall medical history and any medications that you take. They might ask you about your family history as well and just go through your basic medical exam.
They will also perform a breast exam, examination of both breasts, not just the one that has the lump. And then they will likely recommend that you undergo imaging usually with at least an ultrasound, if not also a mammogram in order to further evaluate the lump that you feel.
After that imaging, depending on what they find, they might recommend a biopsy or they might recommend something that you would follow over time with additional imaging or physical exam.
Caitlin Whyte: Well, let's talk about self-breast checks. I know every time I'm at the gyno, they ask me if I do them and I'm always like, "Not really," and I know I should be. So tell us about how important they are.
Meghan Garstka, MD: Sure. Well, breast self-exams are something that many women have questions about because they might've heard things that in the past, if women examine their breasts too much, that leads to too many biopsies and it doesn't find cancer early, that sort of thing.
So there's been a lot of confusion in the past about if breast exams are helpful. The answer that I give patients, and I think what many physicians feel is that it is important to become very familiar with the anatomy of your own breasts in order to find things that are abnormal for you. So what I recommend to patients is I recommend that they do perform a breast self-exam monthly. A lot of people think that the best time to do this is after your periods since so many things can be sort of tender and swollen prior to the period.
So about a week or two after your period, it would be a good time to just do a physical exam to check your breasts, not necessarily with your doctor, but you can actually do this, just sort of feeling for any differences in lumps or bumps that you would feel compared to one month prior.
So the thought would be, if you perform a breast self-exam every month, then you'd be able to identify any changes since you know your baseline. You know, obviously some women have lots of questions about it. So I always tell them if they do present to their doctor to get a lump checked out. And if you have imaging and you've had somebody take a look at the breast and be able to reassure you that there's no issues at that time, then that's a good baseline time to start doing this since you know that your exam is normal and your imaging is normal, or maybe you know that there's a lump in the breast that's been evaluated and is benign. So now you know where it is and you can follow it.
So in general, I think that breast self-exams are very important. And I think it's something that women should certainly think about doing every month. And again, if they have any changes in their exam, they should always talk to their doctor about it in order to determine if it's something that they should have imaging for or be followed more closely,
Caitlin Whyte: Is it important to perform them at the same time every month? Like if I start after my period, I should always do it after my period or is there flexiblility?
Meghan Garstka, MD: Sure. Well, I think the best recommendation would be to do it around the same time of the month. If you're not having periods, we tell women to pick a day of the month any day and to always check it on the same time, just so that they don't forget about doing it. So not only is it helpful to know the way that the breast feels at that particular time of the month, but also to not forget it. So I think that that's something to keep in mind. It's helpful to always practice it monthly so that you're able to remember to do it. But in general, I would say it's good practice to be familiar with it, so that you can compare it to the baseline if it's around the same time of the month.
Caitlin Whyte: Well, like you said, it's so important to know our own anatomy with these self-breast checks. But why is it important to also keep in touch with your doctor and get those regular screenings and mammograms by them?
Meghan Garstka, MD: So we know that mammography is the absolute best gold standard test that we have to identify breast cancers early. It's the best screening tests for all women. If you talk to your doctor, depending on your breast cancer risk, there might be other testing that has been suggested such as MRIs and things like that. But we know that for all women that mammograms are really truly the gold standard. They are important to do annually, and you can talk to your doctor more about recommendations for when you should start them and stop them.
But in general, we recommend that women start them around age 40 and then continue with them annually due to the fact that we know that this identifies breast cancers at a much earlier stage. We know that if you find the breast cancers early, they're very treatable. And it's a way that we can make sure that we identify and detect these early to proceed with early treatment.
So I would definitely advise women to speak with their primary care doctors or with any physician that sees you regularly about making sure that these are ordered due to the fact that it really truly is one of the best tests that we have, actually the best tests that we have to identify and detect breast cancer early.
Caitlin Whyte: Great. Well, doctor, as we wrap up here, is there anything else you'd like to share or add when we're talking about our breast health?
Meghan Garstka, MD: No, I would definitely encourage women to realize that, you know, it's totally natural to have questions about the health of your breasts. You know, women are always curious about if it's worth it to have a lump checked out. I always tell people we're always happy to do an exam and check on things, just because sometimes it is difficult to find things that might feel different yourself. I also always encourage them, even if they've seen a primary care provider, if the primary care is curious about a lump in the breast as well, we are always happy to see them as well to make sure that we have a second pair of eyes looking at it. So I think it's important to really be aware of your own anatomy with self-exams, but I think it's also important to definitely reach out to your physician at any time that you have a question about a lump in the breasts or about your mammogram screenings.
So I would definitely encourage women to be in close communication with their providers about this topic, because really it's in the detection, the early detection of breast cancer, that we really have come a long way. And I think it's really from women doing a good job with breast cancer screening and also with self-exams and just really being good about communicating with their physicians. So it's very important.
Caitlin Whyte: Well, woman to woman, doctor, I'm so happy I got to be a part of this episode with you, just some critical information we went over today. Thank you so much for being with us.
Find more shows just like this one at umms.org/podcast. Thank you for listening to Live Greater, a health and wellness podcast brought to you by the University of Maryland Medical System. We look forward to you joining us again.