Breast Cancer Without a Lump: Is It Possible?

It is possible to have breast cancer without a lump. About one in six people with breast cancer do not report having a lump when they’re diagnosed.

Breast cancer without a lump typically shows other symptoms. But it’s also possible to be diagnosed with asymptomatic breast cancer (without a lump or other symptoms) if your cancer is found during a breast cancer screening mammogram.

Some types of breast cancer, including lobular carcinoma and inflammatory breast cancers, are more likely to appear without a lump than with one. 

This article will explain the symptoms to watch out for if you’re worried about having breast cancer without a lump. It will also cover how long you could have breast cancer without knowing it or having symptoms. It will discuss what a delayed diagnosis means for you and what you need to know about annual screenings for breast cancer. 

Breast Cancers Without a Lump

Two types of breast cancer are more likely than other types to show up without a lump: lobular carcinoma and inflammatory breast cancer.

Lobular Carcinoma

Breast cancer is when the cells in the breast tissue start growing out of control. They can clump together, form a tumor, and start spreading from where they started. 

The most common place for these tumors to start is in the lining of the ducts that carry milk to the nipple. Called ductal carcinomas, these make up 70–80% of breast cancers. They are often found during a mammogram or when a person or their healthcare provider feels a lump in the breast.

The second most common type of breast cancer is lobular carcinoma. Lobular carcinoma makes up about 10% of breast cancers.

Lobular carcinoma starts in the milk glands and behaves differently than ductal carcinoma. It doesn’t form lumps but instead creates thickened breast tissue. This thickening makes the breast feel different but not like a lump. 

Inflammatory Breast Cancers 

Inflammatory breast cancers make up about 5% of breast cancers. They are a rare type of ductal carcinoma that can be aggressive. These cancers usually do not form a lump and may not be detected by a mammogram.

These cancers are called inflammatory because they cause symptoms like redness and swelling. This happens when cancer blocks the lymph vessels in the skin. These are tube-like structures that carry fluids back to the bloodstream.

Asymptomatic Breast Cancer Without a Lump 

As with many cancers, people often won’t know they have breast cancer until they find a lump or start having other symptoms. All cancers begin as asymptomatic, and all tumors start so small they are undetectable.

In many cases of breast cancer, the tumor grows, and the lump grows big enough for regular screening to pick up. Advanced screening technologies like mammograms, ultrasound, or magnetic resonance imaging (MRI) can find breast cancer before a lump or other symptoms develop.

You can have breast cancer without knowing it for several years, depending on how quickly it starts, grows, and spreads.

Annually, almost 288,000 new breast cancer cases are diagnosed in the United States. More than half of these cancers are found before they spread beyond the breast. More than 50,000 cases are found before they’re officially cancer, at the precancerous stage 0, ductal carcinoma in situ.

In some cases, breast cancer doesn’t form a lump you can feel. You may not know you have cancer until you start having other symptoms and report them to a healthcare provider. According to a 2017 study, about 17% of breast cancer cases are diagnosed without a lump. They may test for other health issues first, delaying your diagnosis.

Visible Breast Changes of Breast Cancer

Only about 83% of people with breast cancer have a lump when they first see a healthcare provider, according to a 2017 paper in the journal Cancer Epidemiology. The paper analyzed the symptoms of 2,300 women in the United Kingdom who were diagnosed with breast cancer.

The researchers found that around one in six women (17%) visited a healthcare provider asking about a symptom other than a lump. These symptoms are varied. About 11% were changes to the breast, while 5% were non-breast symptoms. Skin changes are common breast cancer symptoms.

These symptoms are most common:

• Changes to the nipple, including turning inward or leaking fluid other than milk
• Pain or itching in the breast or nipple
• Skin changes, including flaking, red spots, blotching, or skin that looks like an orange peel
• An open wound that develops on the breast
• Changes in the shape of the breast
• Changes in the size of the breast
• An infection in the breast or signs of inflammation—redness and warmth

Non-Breast Breast Cancer Symptoms

Symptoms that show up outside of the breast in people with breast cancer without a lump include:

• A lump in the armpit
• Pain in the armpit
• Swelling of the arm
• A lump in the neck or other signs of swollen lymph nodes
• Pain in the bones or muscles
• Fatigue or weakness
• Weight loss

Many of these are signs of advanced breast cancer that has spread to areas of the chest outside the breast or to organs and tissues farther away. If you have any of these symptoms and think you may have breast cancer, talk to a healthcare provider as soon as possible. 

No Lump, But Pain in the Breast 

Having a strange pain in your breast can be disconcerting. Pain in the breast with no lump is a health issue called mastalgia. It is a sign of many different things. These can include:

• Hormonal changes
• Water retention
• Breast injury
• Breast infection, including mastitis (clogged ducts)
• Pregnancy
• Breastfeeding

It can also be a side effect of a new medication. In the Cancer Epidemiology study, breast pain is a symptom in about 6% of breast cancer cases.

And according to the American Academy of Family Physicians, only about 0.5% of people (one in 200) with breast pain have breast cancer that shows up on a regular breast screening.

Armpit Pain

Aside from changes to the breast, symptoms of breast cancer can crop up in other areas of the body. Specifically, cancer can spread to the lymph nodes in the underarm or the chest. 

The lymph nodes in the armpit are called the axillary lymph nodes. When breast cancer has spread, it can cause the lymph nodes to swell, become tender, or cause pain. You should be able to feel cancerous or swollen lymph nodes if they’re present in the armpit.

Armpit pain is a symptom of breast cancer in about 0.2% of the people in the Cancer Epidemiology study. A lump in the underarm was found in about 1.2% of people in the study.

Consequences of Delayed Diagnosis

When breast cancer presents without a lump, people take longer to report their symptoms to a healthcare provider. This can cause a delayed diagnosis. Some signs, especially in younger people or those breastfeeding, can lead to a misdiagnosis. 

According to the Cancer Epidemiology study, about 15% of people with breast cancer symptoms without a lump waited more than 90 days before seeking help—twice as many as those with a lump.

People who can take longer to get a correct breast cancer diagnosis can hurt their prognosis. A missed or delayed breast cancer diagnosis may lead to a need for more aggressive treatment and a worse outlook.

Breast cancer is much easier to treat and has much higher survival rates when diagnosed early. The five-year survival rate for breast cancer that hasn’t spread to other tissues is 99.1%. This drops to 86.1% if it has spread to other nearby tissues (or the lymph nodes). If it has spread to other organs, the five-year survival rate for breast cancer is 30%.

If you’ve been misdiagnosed or had a delayed breast cancer diagnosis, talk to your oncologist (cancer specialist) as soon as possible to see how this may impact treatment. If breast cancer is more advanced because of the diagnosis delay, treatment will likely be more aggressive. 

Annual Screening Recommendations 

Following screening guidelines, most cancers can be caught early before they develop into a lump or show other symptoms. The United States Preventive Services Task Force recommends screening mammograms for women ages 50–74 who are at average risk every two years. 

Women ages 40–49 years old should talk to their healthcare providers about when to start and how often to get a mammogram. Breast cancer screening is not typically recommended for people assigned male at birth who are at average risk. People who are transgender should talk to a healthcare provider about whether they recommend a screening.

Even when you get your annual screening on time, mammograms aren’t 100% accurate in showing if a person has breast cancer. They can miss about one in eight breast cancers.

The reliability of screening mammograms is a bigger problem for people with dense breast tissue. If your radiologist or healthcare provider says you have dense breasts, find a radiologist who specializes in dense breast tissues—they can get better imaging results than others.

It’s also vital to monitor your breast health at home. Self-exams are not the be-all and end-all of watching for signs of cancer, but they help you become familiar with your breasts. This will make it easier to notice if there are changes. Keep an eye out for other symptoms, as well. 

It may help you see changes if you look at your reflection in the mirror, especially while holding your arms in different positions, like above your head. Common lymph nodes that show signs of cancer are in your armpit and chest, so watch those areas for changes.

Summary

It is possible to have breast cancer without a lump. About one in six breast cancer patients do not report having a lump when diagnosed. Breast cancer without a lump typically shows other symptoms, including breast pain, breast skin changes, a lump in the armpit, a breast wound that won’t heal, or back pain.

Breast cancer without a lump is more common in inflammatory breast cancer and lobular carcinoma. Breast cancers that present without a lump are more likely to be diagnosed late or misdiagnosed as another health issue. This can lead to delays in treatment, worsening the prognosis. 

But it’s also possible to be diagnosed with asymptomatic breast cancer without a lump or other symptoms if your cancer is found during a breast cancer screening mammogram. Following annual screening recommendations can find breast cancer early before it forms a lump or causes other symptoms. 

A Word From Verywell 

Trying to figure out if your unusual symptoms are breast cancer without a lump can leave you feeling anxious. But know that many of the non-breast or non-lump symptoms listed here are rare, happening in less than 5% of people with breast cancer who report their symptoms to a healthcare provider.

If you’re worried about a symptom, ask a healthcare provider. They’ll have a better idea of your risk factors and the likelihood that the odd pain or symptom might be cancer. They can send you for some diagnosing testing to determine what’s causing your symptoms.