A lump on your sternum can be unsettling, but it is important to understand that a significant number of sternum lumps are benign, meaning they are not harmful. This article aims to provide general information about various potential causes, offering clarity and helping to alleviate some of the initial anxiety you might feel.
Common Explanations for Sternum Lumps
One frequent cause of sternum discomfort and sometimes a perceived lump is costochondritis, an inflammation of the cartilage that connects your ribs to your breastbone. This condition causes sharp, aching, or pressure-like pain, often on the left side of the sternum, and can worsen with deep breaths, coughing, or movement. While swelling is not a feature of costochondritis, the inflammation itself can feel like a tender area or even a subtle lump.
Tietze’s syndrome is a related condition that involves inflammation of the costal cartilages and includes visible swelling. This firm swelling usually occurs at one or two specific rib-to-sternum junctions. It often presents with localized swelling, warmth, and tenderness, sometimes causing the skin to appear red. It is relatively rare and often affects individuals under 40.
Fatty tumors, known as lipomas, are common and harmless. These soft, movable lumps form just beneath the skin. They grow slowly, are painless, and vary in size. Lipomas can occur anywhere on the body where there is fat, including the chest, and typically appear in adults aged 40-60.
Cysts, such as sebaceous cysts, can manifest as lumps on the sternum. These fluid-filled sacs form when oil glands become blocked. While benign and slow-growing, they can become uncomfortable or inflamed if infected. Sebaceous cysts are soft and movable, and may have a small dark dot in the center.
Past injuries can lead to a lump on the sternum. A sternum fracture can heal but leave a permanent lump and tenderness at the fracture site, sometimes feeling like a “step” or deformity. Even without a full fracture, trauma can cause a hematoma, a painful blood collection under the skin.
A lump near the sternum can be a prominent xiphoid process, the small cartilage or bone at the sternum’s bottom. This structure can become more prominent due to trauma or inflammation. Pain in this area (xiphoidalgia) can result from injury, straining, or acid reflux, making it tender. The xiphoid process typically ossifies around age 40.
Other Potential Causes
Infections, such as osteomyelitis (a bone infection) or localized abscesses, can cause swelling, pain, and a noticeable lump. These infections may develop quickly and be accompanied by fever.
A sternum lump may be related to bone or cartilage tumors. While most chest wall tumors are benign, such as osteochondromas, some can be malignant. Rare malignant bone tumors like chondrosarcoma or osteosarcoma can manifest as a lump on the sternum, often presenting with pain and swelling.
In rare cases, a lump on the sternum could be a sign of metastasis, the spread of cancer from another part of the body. This is an uncommon cause of a sternum lump and is usually accompanied by other systemic symptoms, such as unexplained weight loss or fatigue.
Recognizing When to See a Doctor
Certain characteristics and accompanying symptoms of a sternum lump warrant medical evaluation. Seek professional attention if the lump rapidly changes in size or shape, or suddenly appears much larger. Any lump that becomes increasingly painful, tender to the touch, or shows signs of redness or warmth around the area should also be assessed. A lump that feels hard, is fixed in place, or has an irregular shape, rather than being soft and movable, is another indicator for a doctor’s visit. Additionally, if the lump is accompanied by systemic symptoms such as unexplained weight loss, persistent fever, night sweats, or unusual fatigue, medical consultation is important. If the lump appeared after a significant injury, or if it causes you any personal concern or anxiety, seeking medical advice can provide reassurance and appropriate guidance.
What to Expect During Diagnosis and Care
Initial Evaluation
When you see a healthcare professional for a sternum lump, the process begins with a thorough medical history and physical examination. The doctor will ask about when you first noticed the lump, its characteristics, any associated pain or symptoms, and your overall health history. During the physical exam, the doctor will feel the lump, assessing its size, texture, mobility, and tenderness.
Diagnostic Tests
Depending on the initial findings, your doctor may recommend imaging tests. An X-ray may be used to examine the bones and cartilage. An ultrasound provides detailed images of soft tissues, distinguishing between fluid-filled cysts and solid masses. More advanced imaging, such as a CT scan or MRI, may be used for a comprehensive view of the chest structures, to determine the lump’s exact location, size, and composition.
Biopsy and Treatment
In some cases, if the nature of the lump remains unclear or if there is any suspicion of a more concerning condition, a biopsy may be necessary. A biopsy involves taking a small sample of tissue from the lump, which is then examined under a microscope by a pathologist. This procedure can definitively determine whether the lump is benign or malignant. Treatment for a sternum lump depends entirely on the diagnosis, ranging from simple observation for harmless conditions to medication for inflammation or infection, or surgical removal if deemed necessary. Many benign lumps do not require specific treatment beyond monitoring.