Most organizations no longer recommend self-exams after studies showed that they weren’t effective in detecting breast cancer, self-checks could still alert some people to visit the doctor for a more thorough screening.
While it’s a good idea to report any abnormality to a healthcare provider, many breast lumps aren’t cancerous. Here are some indicators for when someone should schedule a screening appointment.
Look for Changes in Color, Shape, and Dimpling
A breast lump isn’t the only sign of breast cancer, and a cancerous lump is often accompanied by other abnormalities in the breast like color changes, dimpling, contours, retraction, or spontaneous discharge from the nipple.
In some cases, these changes may catch someone’s eye before they notice a lump, according to Freya R. Schnabel, MD, director of breast surgery at NYU Langone’s Perlmutter Cancer Center.
“Sometimes it can be difficult for people to tell on their own what’s the difference between just having normal, lumpy breast tissue and actually having a mass in the breast that could mean something’s going on, including cancer,” Schnabel told Verywell.
Sometimes people can look in the mirror and see a contour change, rather than a lump, she added.
How to Tell When a Breast Lump Is Abnormal
According to Schnabel, a cancerous lump tends to be distinguished by three qualities: persistent, consistent, and defined.
A persistent lump, she explained, means a lump that lingers over time and doesn’t go away. “It’s here today, it’s here tomorrow, it’s here the next day,” Schnabel said. “Every single time you go to examine your breasts, it’s there.”
A consistent lump is a lump that stays in the same place.
“The breast is a soft tissue organ. It’s not like liquid, but the tissue does have a little bit of elasticity and mobility to it,” Schnabel said. “If a woman has a mass that has zero mobility, that seems to be stuck to the tissue below, then that is something that is really, really concerning. But you can also have a lump that still has a little bit of mobility to it.”
A defined lump is one that has a beginning and an end. It has a distinct shape and doesn’t just blend in with the breast tissue, although its shape and size can vary. In addition to these characteristics, lumps are typically painless. If they grow in size, that’s also a sign of concern.
Best Practices for Breast Self-exams
Keep in mind that self-exams are not the equivalent of a doctor’s visit. Noticing an unusual lump is a sign to seek medical attention and it shouldn’t serve as a diagnosis.
Breast exams are best done at the end of someone’s menstrual cycle, or after they’ve completed a birth control pack, according to Shieva Ghofrany, MD, FACOG, a board-certified OB-GYN with Coastal OB/GYN in Stamford, Connecticut.
Particularly for premenopausal women, hormonal changes in the breasts can occur throughout the menstrual cycle. If they check their breasts in the middle of the cycle, they might notice lumps that are not of necessary concern.
“Many women, unfortunately, just examine their breast at random times, without paying attention to their cycle,” Ghofrany told Verywell. “If they are premenopausal, especially, this can lead to a lot of anxiety.”
Ghofrany said she highly encourages a “proactive, not paranoid” approach to breast self-exams.
“By calmly examining their breasts once a month, without overthinking it, they will get to know what their breasts generally feel like and any subtle changes can lead to a discussion with [their] doctor,” Ghofrany said.
She recommends checking for breast lumps in the shower, where people can use soap to guide their hands around their breasts. And it’s important to remember not all changes indicate cancer.
“It’s of paramount importance that they do not devolve to fear, and an assumption that a breast change or new lump means that they necessarily have cancer,” Ghofrany said.
People who do notice worrisome breast changes shouldn’t hesitate to seek medical care, according to Schnabel. But for those who are unsure, they can wait about a week to see if the lump maintains the three main characteristics: persistent, consistent, and defined. People who are in the middle of their menstrual cycle may wait a few days longer, she added.
When to Start Checking for Breast Abnormalities
According to Schnabel, people can start conducting breast self-exams in their young adulthood, but teenagers don’t typically need to worry about checking their breasts.
People with a family history of breast cancer may want to see a medical provider sooner, or check in even if they haven’t noticed an abnormality, she said. The age at which they should start paying attention to their breast cancer risk depends on the trends within that family.
For people in their 20s, breast cancer is rare but not impossible, Schnabel added. For this reason, self-checks can be useful for health maintenance, she said.
“The take-home message is that a palpable mass in the breast should be evaluated and should be investigated to actually confirm a diagnosis," Schnabel said. “We’re not trying to convince people that they can diagnose their own problems, we’re trying to figure out when they need to see the doctor.”
Correction - October 17, 2022: This article was updated to correct Dr. Shieva Ghofrany’s affiliation and clarify the optimal timing for a breast self-exam.
