Juliann Reiland, MD, FACS, a breast surgeon for the past two decades, has felt her fair share of breast cancers. To show women who ask what breast cancer feels like, Dr. Reiland, YRMC PhysicianCare Breast Surgery, carries a small, jagged, gravel rock in her pocket.
While Dr. Reiland recommends annual screening mammograms and yearly clinical breast exams, she also advises patients to understand the usual look and feel of their own breasts, so they can report anything that feels abnormal.
“The breast tissue under the skin is lumpy-bumpy stuff, similar to oatmeal or tapioca pudding,” Dr. Reiland explained.
A lump that moves easily and feels smooth and round, like a pea, a grape, or even a Hot Tamale candy, is more likely to be a non-cancerous cyst or fibroadenoma. But a lump that feels like a hard rock, with jagged, irregular edges, and doesn’t move easily is more likely to be a cancer.
“The stone I carry is one centimeter, smaller than the length of a dime. One centimeter is about the smallest cancer that can be felt with a breast exam.”
Imitate a Mammogram
Dr. Reiland advises that when women do a self-breast exam, they should try to imitate a mammogram as much as possible.
“A mammogram compresses or flattens out the breast tissue. Normal breast tissue, like oatmeal or tapioca, will flatten, but a cancer, like that rock, won’t flatten,” she said.
Once a month, she recommends women lie flat on their back with their arm over their head, elbow close to their ear.
“This allows the breast tissue to spread out and flatten. Then, keeping the fingers of the opposite hand close together to form a paddle, press down on the breast skin, trying to flatten the breast against the chest wall,” Dr. Reiland explained. “Your fingertips are more sensitive, and will feel all the normal lumps and bumps. It’s the action of trying to flatten out the breast tissue that helps abnormal lumps stand out.”
The last part of your monthly self-breast exam, is to stand in front of a mirror to look at your breasts. Raise your arms over your head. (It’s normal to have one breast larger than the other). You are looking for dimples or puckering of the skin.
Report any Changes
Anything you believe is new or different should be reported to your healthcare provider. If you haven’t had a mammogram in a year, a diagnostic mammogram will be ordered. Often, ultrasound is used to look in the area of the lump you can feel.
There are many tools used to identify breast cancer. Mammograms, the first tool, are excellent at seeing cancers too small to feel. This is why they are so important as a yearly screening. But even mammograms aren’t perfect, missing about eight to 15 percent of the breast cancer we can feel. So, even if your mammogram is normal and you feel a lump, you need to report it. There are other tests to look at breasts in different ways than mammograms. These are ultrasounds, MRI and contrast mammograms (CESM).
“It’s important to use these tools when we are concerned a breast cancer is present,” Dr. Reiland said. “However, if a screening mammogram is normal, an exam in the clinic is normal, and a self-breast exam is normal, you most likely don’t have a breast cancer that has been missed.”
For information about Dr. Reiland, please visit YRMC PhysicianCare Breast Surgery or contact us at (928) 442-8740. Screening mammography is available through the BreastCare Center at YRMC or Prescott Medical Imaging. Assistance is available for women unable to afford screening mammography through the Community BreastCare Fund.