The care and feeding of lumpy breasts
February 25, 2013 8:52 AM   Subscribe

A recent scare has made me aware of breast cancer, but my boobs are hopelessly lumpy. Is it even worth doing self exams?

I have no family history of breast cancer and usually ignore the ladies. About a month ago I pulled a chest muscle at the gym, and TL;DR found a lump in my breast. I'm under the impression that any breast lump should be seen to immediately, so I went to my GP who confirmed there was a lump and referred me for an ultrasound.

The sonographer looked at the lump for about 5 seconds before sighing heavily and telling me (a) that it was just a 'stiffness' in the tissue and (b) I shouldn't worry because lots of women overreact about their breasts. He then tossed me a pamphlet on breast pain.

I started doing breast exams and, sure enough, on close examination, my breasts are very, very lumpy. I already feel a little overwhelmed trying to remember where all the lumps are. Where does this leave me in terms of preventative care? I feel deeply ashamed and embarassed after the ultrasound. I have no family history of breast cancer and I'm just 29. Should I just ignore them until I'm older?
posted by nerdfish to Health & Fitness (15 answers total) 6 users marked this as a favorite
You should do monthly exams and soon you'll get used to your lumps (some of us just have lumpy boobs, it's fine.)

Now you know where they are and what they feel like. Trust me, you'll notice when something seems off. If the lump is hard, or if it moves in a weird way, etc.

As for the sonographer, he/she is an asshole. You didn't over-react. You went to your doctor, who sent you for a sonogram to make sure everything was okay. (and YAY! It was!) Why would you feel ashamed and embarassed? YOUR DOCTOR sent you there! I'd write a STRONGLY WORDED LETTER! I would tell your doctor. That sonographer was unkind, and unprofessional.

I have lots of friends who developed breast cancer as young women and they're all survivors because they took their health seriously and so did their doctors.

FWIW, lots of lumps are discovered by your partner, so...yeah, another excuse to let your steady play with your boobs.

Do a monthly breast exam, it will give you peace of mind. Also, don't hesitate to have anything suspicious looked at.
posted by Ruthless Bunny at 9:00 AM on February 25, 2013 [9 favorites]

I have very lumpy breasts and no history of breast cancer in my family (well, one aunt had a lumpectomy, but we're mostly at risk for everything else).

I believe that the prevailing wisdom right now is that those very specific breast self-exams (the ones where you follow the diagram and do it in a spiral, or in a back-and-forth kind of square) are history.

The most important thing you can do is feel yourself up on a regular basis in a thorough, familiar way. (Or, you know, get a helpful partner to do it for you! For real!) You will know your body and what feels right or not. It's probably worth going to your doctor and feeling one of their self-exam "models" to feel what a bad lump really feels like: hard, possibly with non-smooth edges. The cystic sacs that make up most of my lumps (as far as I know) tend to have smooth boundaries.

I am 100% NOT A MEDICAL PROFESSIONAL IN ANY WAY but I think this is basically it.

And yes, the sonographer was an asshole, and don't hesitate to ask for second opinions if you feel something isn't right.
posted by Madamina at 9:01 AM on February 25, 2013

Please don't feel ashamed. Just because the tech has seen lots of false alarms doesn't make it any more terrifying for you to have one. Fuck him and his lack of bedside manner. I know everyone can have a bad day, but he's in the care profession, so he should fucking well, ya know, *care*.

Obviously, trust your doctor more than anything some chick on the internet tells you, but I'd suggest doing periodic self-exams (which can take the form of "idly stretching and fondling your own boobs", honestly, or can give you a reason to linger in the shower for even longer, or an excuse for pleasant mellow sexytimes if you've got a partner) and watch for anything that changes. Sure, you won't remember where everything is, but if something is strange and new, it'll probably stand out - a lump that's in an unfamiliar place, or with a very different texture, or that changes more than things around it, for instance.
posted by rmd1023 at 9:03 AM on February 25, 2013 [2 favorites]

Best answer: Wow. That sonagrapher was a dick. I'm sorry. Given how much there seems to be this very public community type aspect to breast cancer awareness and how much women are told to be afraid of breast cancer and to get EVERY SINGLE LUMP checked out or DIE it is kind of shocking how lonely the experience of getting a lump diagnosed can feel.

You should write a letter to the radiologist who works in that lab so he/she knows how the techs are treating their scared patients.

That being said... what do you do now? Lucky for you, you are at a situation where you know that your lumps are "normal". So, play with your girls more so that you know what "normal" is, and the subtle ways that "normal" changes, especially around your period. Don't try to remember where all the lumps are -- just try to learn what "normal" lumps feel like.

If you do find something that seems weird - a lump that feels "attached", especially closer to your armpit, something that moves differently than other things, something that hurts, something that is less round and more gnarly feeling - make note of it, and wait a week or two. Lots and lots of breast thingies will go away on their own, but if something persists through a menstrual cycle, it's worth while to at least get your primary care doctor to check it out. That's what I do, having been through the ultrasound rodeo a couple of times so I understand how much of a pain in the ass it is to make appointments and the like. I'm not sure how much difference a few weeks makes in terms of early cancer detection, but its a trade-off that I, personally, am willing to make.

Good for you for taking care of yourself.
posted by sparklemotion at 9:22 AM on February 25, 2013 [1 favorite]

You did the right thing! Don't worry about the tech, they were being jerky. Also, it's normal to have lumpy breasts -- a lot of women do. The thing I was taught (and this is not medical advice, but whatever) is to make a fist and touch your palm near the thumb -- that's what fibrocystic lumps usually feel like. Then, touch your bony knuckle -- that's more what worrisome lumps feel like. Worrisome lumps are hard, often with gritty edges.

Another way to keep up with lumpy breasts is to make a little map-drawing of where the lumps are, then put it in the drawer and on month two make a new map, and then you can compare the two.

And if the lumpiness is a result of fibrocystic breast tissue, you might talk to your doctor about ways to abate that. Some people think that lowering caffeine is helpful; evening primrose oil is also supposed to have some effect.
posted by feets at 9:37 AM on February 25, 2013

Best answer: This is not medical advice, I am not your or anyone's doctor. I am a nursing student, but I know most of this from being in a similar situation.

The sonographer was wrong. It's very common to have lumps in one's breast. Because of this, it's important to perform a monthly exam (about a week after your period ends) so if you get a new lump or an existing one changes in size you'll know it. There can be fluctuations throughout your cycle, so after your period is the best standard time to check, when you're at your ebb instead of flow. (Pun semi-intended)
posted by RainyJay at 9:48 AM on February 25, 2013

I too have lumpy breasts. My OB/GYN always told me to be on the look out for things that were unusually hard ("like a BB") or things that seemed to be adhered to the chest wall rather than lumps that moved freely (which is normal). Pain is another indicator that stuff should be checked out.

So yeah, it's probably worth checking everything few months.
posted by zug at 9:49 AM on February 25, 2013

Nthing everything above. I have lumpy breasts, too (I prefer to use the name my GYN uses - fibrocystic breasts [also commonly called nodular or glandular breast tissue]). It's common enough, and tends to run in families. There is absolutely nothing to be ashamed about. That technician was a jerk.

As far as preventive care, start examining your breasts as you would if they weren't fibrocystic. Get to know them. That way, if something were to change you'd know it.

My GYN told me that a regular mammogram is never going to be useful to me because of the fibroids. I was pretty happy with that, actually, knowing that I'll never have to have my boobs squished in a mammogram! Ultrasounds/sonographs all the way!
posted by cooker girl at 10:07 AM on February 25, 2013

Best answer: My breasts were once described to me by my GYN as "like a bag of jelly beans". So yeah, I have cystic lumpy breasts. The trick is definitely to feel yourself up a lot, and often in the hopes that you'd notice a change.

I never really can tell what's what, plus I have a family history of breast cancer, so my GYN sends me for a full breast sonogram check once per year. Don't be shy about asking for this every year!
posted by waterisfinite at 10:13 AM on February 25, 2013

Response by poster: Thanks for the responses! I'll definitely make an effort to feel myself up regularly.

The sonographer's behaviour didn't strike me as out of turn as I'm an expat in the brusque Netherlands, so I'm very accustomed to healthcare providers treating me as a malingerer until proved otherwise.
posted by nerdfish at 10:38 AM on February 25, 2013

Please do write a letter about that asshole tech, his behavior was definitely out of turn. You should never feel ashamed after a test or exam!

Others have covered all the good stuff to do when feeling up your boobs, so I'll just add that you don't want to check yourself too often, otherwise you might not notice gradual changes. Once a month is about right; frequent enough that you'll get to know your normal lumps, spaced out enough that you'll notice anything that changes. A week after your menstrual cycle is best, when your hormones are at an ebb and breast tissue is not swollen or tender.
posted by Specklet at 10:47 AM on February 25, 2013

From what I understand, if your lumps feel like peas in jelly you're cool. If they're hard or don't move then they're bad.
posted by spunweb at 1:23 PM on February 25, 2013

Yes. I have lumpy boobs and I do regular self exams. When I found my cyst, I knew immediately that it was abnormal because it felt so different from normal boob-pebblyness.
posted by windykites at 3:24 PM on February 25, 2013

Although when I was first developing breasts I ran crying to mom because they were lumpy. I thought I had cancer. I didn't even know what cancer was but I was scared. She told me that it's totally normal! So don't worry!
posted by windykites at 3:27 PM on February 25, 2013 [1 favorite]

WTF everyone recommending monthly exams. No! There is absolutely no medical benefit in doing them and it completely baffles me that so many people still think you should do them. They can and do cause harm in that they lead to unnecessary interventions such as biopsies.

There's not even any benefit in having manual breast exams by a doctor:

That said, having something investigated that you found IS a good idea, but the idea is that if you, say, felt something new while bathing or getting dressed you should have it checked out.

I'm sorry the sonographer treated you that way.
posted by Violet Hour at 3:30 PM on February 25, 2013 [1 favorite]

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