Julie Reiland, MD, carries a green centimeter-sized stone in the pocket of her lab coat – not for luck or out of superstition, but to demonstrate, if asked, what breast cancer feels like to a patient or colleague.
Reiland, a breast surgeon with Avera Medical Group Comprehensive Breast Care, advocates for annual mammograms along with clinical breast exams. But she also advises patients to know the usual look and feel of their own breasts, so they can report anything that’s abnormal.
“The tissue of the breast underneath the skin is lumpy and bumpy stuff – like oatmeal or tapioca pudding,” Reiland said. A lump that feels like a pea, a grape, or a Hot Tamale candy and easily moves around is more likely to be a benign cyst. But a lump that feels like a hard rock that has irregular edges and doesn’t move is more likely to be cancer. “The stone I carry is about 1 cm in size – which is about the smallest tumor that can be felt in a self-breast exam.”
Imitate a mammogram
When women do a self-breast exam, they should try to imitate the mammogram experience as much as possible. “A mammogram squishes or flattens out the breast tissue. While a cyst will flatten, a tumor won’t,” Reiland said.
Once a month, she recommends that women lie flat with their arm over their head. “This gets the breast tissue to expand and flatten.” Then, using the middle portion of your fingers rather than the fingertips, push down on the skin, squishing the tissue between your fingers and chest wall.
“If you use the tips of your fingers, which are more sensitive, you’ll feel everything – even the normal lumps and bumps. Using the middle portion of your fingers helps you ignore the normal lumps and bumps, and feel anything that’s new or abnormal,” Reiland said.
Also, don’t be shy about standing in front of a mirror to look at your breasts. If the skin appears to dimple or pucker, that can be a sign of breast cancer as well.
Report anything new
Anything new or different should be reported to your doctor and checked out – whatever it feels like. But women who know they have cysts and what those cysts feel like don’t have to be hyper-vigilant every time they feel the cysts.
“Mammograms are a great screening tool, but they still miss 10 percent of the cancerous lumps you can feel. You should always report a new lump to your doctor. Don’t just assume the mammogram will find it,” Reiland said. Additional tests, like breast ultrasound and CESM (contrast-enhanced spectral mammography) might be needed to confirm that a felt lump is not suspicious.
“We need to use all tools at our disposal to find breast cancer early, when it’s most treatable, and this includes mammograms, exams in the clinic, and self-breast exams,” Reiland said.
To learn more about breast cancer care at Avera, go to www.Avera.org/mammo.