lumps: could we actually define the word "MOVABLE"

blah333 · January 2020

Just curious, I have combed endless posts on this site regarding suspicious lumps and people always talk about whether they are movable or not. I am talking more about "pea" type, pebble, marble lumps. Aren't they always movable to some degree? It seems like they can usually be pushed slightly in all directions, or is that just an illusion - where really just the top of the skin is moving, making it appear that the lump is movable? This may sound like a stupid/simple question but to be clear: what does it really mean for a lump to be movable or fixed? I know that larger, thickened areas can move less or be stable. But don't all "pea" lumps move a little?

Bonus question: I could not find this anywhere, but is it even possible to have still develop cysts after mastectomy? I see many women have recurrence scares and it turns out to be a cyst, but those women had lumpectomy. I'm still posting this in the "Not Diagnosed but Worried" area because that is where the most "worried about a lump" posts appear.

WC3 · January 2020

During the examination that lead to my diagnosis, the doctor felt my lump twice. The first time he felt it from the top, and remarked that it felt normal. I think this was because the skin over it was loose and moved, giving the impression that the lump was moveable. He then felt it from the underside of my breast and his opinion changed. So yes, I think loose skin can give the impression that a lump is moveable.

djmammo · January 2020

Do breast cancer lumps move?

"Breast lumps typically do not "move" around the breast. However, sometimes a breast lump will be fixed, or stuck, to the chest wall. Most lumps will be movable within the breast tissue on examination."

(from Dana-Farber.org click link above for more info)

blah333 · January 2020

of course lumps don't just move on their own around the breast, to me "movable" meant "able to move" -- when pressed or touched (or examined). People generally regard a movable lump as a good sign, however it seems that most are movable. But then I thought maybe they just have the illusion of being moved. Lol this stuff sure can make one neurotic. I have just seen too many posts where "it's movable" "it doesn't move" but most people don't go into details about what they mean.

MelissaDallas · January 2020

blah, stop worrying about the posts, because most of the people I see on "not diagnosed but worried" who think they have "fixed" lumps that don't move are incorrect according to their doctors.

djmammo · January 2020

TO ALL

Just to clarify the quote I included from the article from Dana Farber:

Fixed means fixed to the chest wall, not to the tissue around it. An invasive cancer early on can be moved side to side in relation to the chest wall and still be invading the surrounding breast tissue which will move with it. Conversely there could be a small benign mass in extremely dense tissue which may restrict its movement when a breast exam is performed. Even if the mass is "freely movable" or fully "mobile" it is not a guarantee that its benign. An ultrasound would still be required.

It is not a reliable sign of benign or malignant on physical exam and I believe checking for mobility is absent from the current recommendations for self breast exam for this reason.

Beesie · January 2020

Thanks for that clarification, djmammo. That's really helpful to know.

blah, I will second what MelissaDallas said, I've had lots of palpable lumps (fibroadenomas and cysts) over the years and while some were clearly moveable, some that I thought were "fixed" my doctor said were moveable. In the end, to djmammo's point, it doesn't matter anyway.

blah333 · January 2020

Thanks, sorry I didn't initially click on the link you posted, djmammo. But it's good, because now that text is posted here for anyone like me in the future that might be reading through old posts on this board or search "movable lump" or "fixed lump."

I appreciate that you mention "It is not a reliable sign of benign or malignant on physical exam" because that is the impression I got from reading the "worried" posts and the ways women described their lumps. Then I wondered maybe people just have different definitions of what movable and fixed lumps feel like? This should also be reiterated because women seem to put a lot of stock in the idea of movable = good, fixed = bad.

I am not trying to gauge my own outlook on this characteristic, at all. I was first told to get a mammogram in 2017 after a doctor gave me a breast exam and found a lump. It moved.. though one report I read indicated that lump was probably benign. For awhile I thought the DCIS presented itself in the form of a lump, but it may have been investigating a benign lump that revealed DCIS during my mammogram. I'm not sure anymore.

The only thing I'm sure of is getting information from imaging and biopsies. And lump = make a doctor's appointment.

B-A-P · January 2020

My Cancercous area .. you couldn't feel much of a lump. My breasts were dense. When I got my Diagnosis, my radiation Onco did an exam while I was sitting up vs the laying down method. The underside of my breast was hard and dense like nothing I had ever felt. It was quite obvious. When the chemo was shrinking everything, you could feel everything softening up. Regular breast exams while laying down caught nothing which is interesting. You couldn't feel any abnormality at all and I had many doctors at it.

Conversely, I also had a Fibroadenoma and I could literally pick it up with two of my fingers and feel every edge, and move it every which way. They call it a breast mouse for a reason. It moves right under your fingers. Also felt very rubbery. I was never worried about that one based on characteristics ( But had multiple USs to verify and check stability)

That being said, as DJmammo has commented, movability shouldn't be a determining factor in whether or not it's looked into

djmammo · January 2020

blah333

"Then I wondered maybe people just have different definitions of what movable and fixed lumps feel like?"

There is only one definition really, the one from the textbook that is taught in medical schools and residency.

A mass fixed to the chest wall has a much higher probability of being malignant than one that is freely mobile BUT what feels fixed to the patient may not feel fixed to me and vice versa but after examining a few hundred more patients with lumps, y'all should begin to get the hang of it .

AliceBastable · January 2020

I never felt a lump, nor did my PCP who examined me just a few days prior to the (procrastinated) routine mammogram that did find it. Surprise!

blah333 · January 2020

so, I am still waiting for a scan on my nodule/lump and I occasionally touch it to see if it has changed. I was pushing on it with my finger and remembered that usually they tell women to examine their breast with their arm in the air. It is almost situated on top of a rib. When I lift my arm above my head, it moves to in between my ribs. Does this mean it is movable, or just having the illusion of having moved? It almost seems like it shape-shifts.

djmammo · January 2020

blah333

Is it sliding across the muscle when you raise your arm, or is it moving with the muscle when you raise your arm? A rhetorical question really as you will be having an MRI which will answer your question. Also masses don't change in size day to day so feeling it often will provide no additional information.

Article on the clinical breast exam

PS: Remind me if you had an ultrasound and what the report said.

blah333 · January 2020

it's hard to say.. it's on top of my rib, but when I raise my arm it kind of disappears in between two ribs. It does seem to slide, but I can't exactly tell. I WISH I was having an MRI. I have a CT scan on Sunday. Hopefully by this time next week I'll have some more information. Unfortunately I did not have an ultrasound yet, but my 6month appointment for that is the first week of Feb. This was not present at my last ultrasound, and they never even bother with the front of my chest. Trying to move my US appointment up sooner and I called today to see if I could already get a biopsy scheduled. The delay and uncertainty is so brutal to me. Not sure that this actually changes in size, but the way in which it is palpable on the surface does seem to change slightly from day to day or a few days later.

Left side with small 0.5 cm nodule felt 2-3 cm below her mastectomy scar on medial aspect (is in same location as where pt felt), mildly prominent ribs noted on L side compared to right, no other palpable chest wall masses, no axillary LAD, no erythema or skin changes noted.

I may be overreacting with worry but this is my first lump on my chest post-mastectomy. I ask some of these questions to also help me with any future lumps or nodules I might have. I wish I could adopt an "innocent until proven guilty" stance but it is a challenge!

lumps: could we actually define the word "MOVABLE"

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