Essential new healthwisdom about what’s

normal, what’s not–andhow to stay cancer-free

Finding a lump in your breast is, no doubt about it, scary. Coldsweat scary. Call your mom scary. M. Night Shymalan scary. Itis also perfectly normal. “Research has shown that at least halfof all women experience some kind of noncancerous breastlump, bump or other symtom that strikes them as abnormalbefore they reach menopause,” says Freya Schnabel, M.D.,chief of breast surgery at Columbia University Medical Centerin New York City. The operative word there is noncancerous-the vast majority of breast lumps pose no risk. Still, thatprobably won’t be at the top of your mind if you find one. JillHerzig was 34 and pregnant when she felt a lump. “I wastrying to fit my newly big breasts in my not-yet maternity bra,and felt this bump that felt like an olive,” she says. “I wasshaken, and immediately went to my ob-gyn. She sent me foea biopsy to be sure, but said, ‘I’ve felt a lot of cancer in mylife, and this isn’t cancer.’ She was right-it was was somethingcalled a lactating adenoma caused by my pregnancy.”

Sarah G. was 22 when she felt her forst bump while in theshower. It was about the size of a peanut, but not as hard, andit terrified her right into her doctor’s office. “My ob-gynreassured methat the lump was anormal part of fibrocysticbreast changes, which she told me are common, and she nixed

further tests,” she says. “Every once in a while my breasts feellumpier or more tender, but now I don’t think twice about it.Those symptoms are simply part of having fibrocystic breasts-or just having breasts at all!”

How can you know which of your breasts’ inevitable quirksare worth worrying about and which aren’t? First arm yourselfwith the reassuring info that often gets brushed aside in favorof dire warnings in the media. Then read up on the latestresearch on how to keep your risk minuscule. It’s all here, andit’s all meant to put you at ease.

When to worry, when to relaxThough all bumps deserve your attention, any lump a youngwoman finds is very unlikely to be a cancer-breast canceraffects only about one one hundredth of one percent ot womenunder 40. And even in breast lumps that require a biopsy, some80 percent prove to be benign, according to the NationalCancer Institute in Bethesda, Maryland.”Breasts are usuallyuneven in texture, with small bumps that feel granular,” saysEva Singetary, M.D., professor of surgical oncology attheUniversity of Texas M.D. Anderson Cancer Center inHouston. “Lumpiness is not a disease.”

Experts recommend that you always bring any breat changesto your doctor’s attention, particulaly a lump that doesn’t goaway after a menstrual cycle or two. “Even if you find one likethat, it’s unlikely you have cancer,” says D. David Dershaw,M.D., director of breast imaging at Memorial Sloan-Kettering

The Lumps & BumpsGuide to Your Breasts

Experts agree: Get an annual breast exam from your doctor.

Cancer Center in New York City.Here’s a quick guide to what alump might really be:

If it feels like a small waterballoon, it’s probably a cyst.This fluid-filleed sac, similar to ablister, most often forms in theducts of the breast. Cyststypically occur in women over 30and are harmless, but they can bepainful. A breast sugeon can draina cyst with a fine needle if itbothers you.

If it feels like a rubber ball, itsprobably a fibroadenoma. Thistype of harmless growth can bethe size of a pea or a lemon, it’susually smooth, firm or rubberyand movess when you push it.These bumps are most commonin women in their twenties and

thirties, but may appear at any age.Hormones from pregnancyof breast-feeding can prompt grows known as lactatingadenomas. “It’s usually best to remove fibroadenomas, notbecause they’re dangerous, but because they may grow,” saysDr. Dershaw. “It’s easier to remove them when they’re small,and the proceedure is less likely to deform the breast.”

If your breasts feel lumpy all over (like a bowl of chile),you probably have fibrocystic changes. At least half of allwomen have breasts that feel uneven in texture, sometimeswith bumps, like soft cooked beans. Fibrocystic breasts oftenswell in response to your monthly hormones, and can beespecially painful the week before you period. “These changesare harmless but can make breast exams difficult. It’s harder tofeel a dominant lump when breasts are lumpy overall,’” saysVicki Seltzer M.D., vice president for Women’s HealthServices at North Shore-Long Island Jewish Health SysteminNew York. Fibrocystic changes include any one of about 15variations; only one type(atypical hyperplasia) may increasethe risk of breast cancer if you have family historyof thedisease. In most cases, the changes are harmless. Andonce you reach menopause, the problem usuallydisappears.

If it feels like a sponge, it couldbe a pseudolump. Apseudolump oftendoesn’t have adistinct

shape, and you can’t feel a real edge; it’s simply a dense orthick area in your breasts thathas no known cause. Truepseudolumps are benign, but because they are the nost difficultlump to diagnos, your doctor will often order more tests to ruleout cancer says Susan Love, M.D., a breast surgeon and chairof the Dr. Susan Love Research foundation in PacificPalisades, California.

If it feels like a piece of coral, it could be cancer. A lumpthat is hard, irregular and doesn’t budge when you push it withyour finger tips should set of an alarm.See you doctor as soonas possible. Of course, no matter how it looks or feels you should point outto your doctor any breast lump, bump, nipple discharge or skinchanges such as scaliness or dimpling. She may recommend adiagnostic mammogram or ultrasound which provide detailedpictures of just one area of your breasts rather than scannigboth breasts for possible problems. If those test are clear; thenit’s safe not to worry. “But if a lump or symptom persists-evenif a mammogram or ultrasound doesn’t show canser-considerasking for a biopsy anyway, “ says Dr. Dershaw.(continued on page 123)