Discovering a lump on your chest can be a source of immediate concern. While concerning, many chest lumps are not serious. The chest area includes various tissues—skin, muscle, connective tissue, and glands—all capable of developing growths. This article provides general information on common causes, symptoms, and the medical evaluation process to help you understand what to observe and when to seek professional advice.
Common Causes of Chest Lumps
Many factors can contribute to the formation of a chest lump, and a significant number of these are benign, meaning they are not cancerous. One common type is a cyst, which is a fluid-filled sac that can develop due to benign changes in breast tissue, known as fibrosis, or from a blocked milk duct (galactocele). These cysts may feel soft and smooth if close to the skin, but deeper ones can feel harder, and they are usually painless unless they grow very large.
Another frequent benign cause is a fibroadenoma, a solid, painless lump composed of glandular and fibrous tissue, often found in individuals aged 14 to 35. These lumps are typically firm, smooth, and movable when touched, and they tend to shrink after menopause due to their association with hormones. Lipomas, which are slow-growing, painless clumps of fatty tissue just beneath the skin, are almost always benign.
Infections can also lead to chest lumps, such as an abscess, a collection of pus that can form a hot, swollen, and tender lump, sometimes with overlying skin redness. Hematomas, which are blood-filled masses, can result from an injury or surgical procedure to the breast. Swollen lymph nodes in the chest or armpit area can also present as lumps, sometimes indicating an infection. While most chest lumps are benign, some can be malignant, such as breast cancer, which often presents as a hard, irregular lump. Other malignant chest wall tumors, though rare, can arise from bone, cartilage, or soft tissues.
Accompanying Symptoms and Characteristics
The characteristics of a chest lump, along with any other symptoms, can provide clues about its nature. A lump might feel soft, squishy like a grape, or as hard as a rock. Its texture could be smooth, bumpy, or firm, and it might be movable under the skin or feel fixed in place. The size and shape of the lump can also vary, from as small as a pea to a more noticeable mass.
Pain or tenderness can accompany a lump, sometimes fluctuating with the menstrual cycle. Observing changes in the overlying skin, such as redness, dimpling (like an orange peel), puckering, or scaling, is important. Nipple changes, including a nipple turning inward or any discharge, particularly if it’s clear or bloody, should also be noted. Swelling of the breast, even without a distinct lump, or swollen lymph nodes in the armpit or collarbone area, are additional signs to watch for.
When to Seek Medical Evaluation
It is always advisable to seek medical evaluation for any new chest lump or breast change. If a lump is newly discovered, or if an existing lump changes in size, shape, or texture, professional medical advice is warranted. Lumps that persist after a menstrual cycle or those accompanied by pain also require attention.
Any associated skin changes, such as redness, dimpling, or puckering of the breast skin, should prompt a visit to a healthcare provider. Nipple discharge, especially if it is bloody, or a nipple that has recently turned inward, also require medical assessment. If a lump is accompanied by fever, chills, or difficulty breathing, immediate medical care is recommended. Self-diagnosis is not recommended; a healthcare professional can accurately determine the cause of the lump and guide appropriate next steps.
The Diagnostic Process
When you consult a healthcare professional about a chest lump, the diagnostic process begins with a physical examination. The doctor will examine your chest, including the armpits and collarbone area, to assess the lump’s characteristics, such as its size, shape, texture, and mobility. You will also be asked about your medical history, including when you first noticed the lump, how it has changed, and any other symptoms.
Following the physical exam, imaging tests are ordered to further evaluate the lump. A mammogram, which uses low-dose X-rays, is often a first step, particularly for breast lumps. An ultrasound uses sound waves to produce images and help determine if a lump is solid or fluid-filled, distinguishing between cysts and solid masses. In some cases, a Magnetic Resonance Imaging (MRI) scan may be used, especially if other imaging tests are inconclusive or if there is dense breast tissue.
If imaging tests suggest a suspicious area, a biopsy may be performed to obtain a tissue sample for analysis. A core needle biopsy, often guided by ultrasound or mammography, involves using a needle to remove tissue samples from the lump. A pathologist then examines the samples to determine if the cells are benign or malignant. This approach helps ensure an accurate diagnosis and appropriate management plan.