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Women's Health

Breast Cancer Doesn’t Always Start With a Lump — Insights From a Physician

It could be a benign cyst.


Our bodies are constantly changing in multiple ways — shape, size, texture, needs, and more. That’s why overnight appearances of things like pimples aren’t usually something to worry about. But when it comes to finding lumps in our breasts, we tend to jump to the worst possible scenario: Is it cancer? It’s important to take a breast lump seriously, because being proactive is key to fighting disease, but it might not always be as serious as you think. We talked to our expert to learn how you can tell the difference.

Meet our expert

Barbara DePree, MD, is a gynecologist in private practice and director of Women’s Midlife Services at Michigan’s Holland Hospital. A Certified Menopause Practitioner, she is the founder of, an educational resource for women’s sexual health in perimenopause and beyond. To ask her a question, send an email to

Q: I have a small lump just under the skin on my breast. It’s uncomfortable when I touch it, but I’ve always heard that lumps that hurt can’t be cancer. Is this true, or is it something to worry about?

A: It’s true that lumps that cause pain or discomfort are typically not cancer, but I always advise having your doctor check any breast lump. There are many benign breast conditions that are much more common than breast cancer that can cause pain, including cysts, fibroadenomas, and abscesses (a buildup of pus caused by an infection).

Sometimes we can tell if the lump is a cyst or abscess, in which case we drain it right in the office. However, most of the time, a mammogram and/or an ultrasound is needed to make a diagnosis. Also, be aware that breast cancer doesn’t always present as a lump: It can also appear as skin thickening in or around the breast, nipple changes or discharge, or swelling in or around the breast, collarbone, or armpit.

This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.

A version of this article originally appeared in our print magazine, First for Women.

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