Finding a new lump or bump on your body can be concerning. However, not all lumps and bumps are harmful. In fact, many are benign (non-cancerous) and do not require any treatment. This article will provide an overview of painless lumps, discuss possible causes, and give guidance on when medical evaluation is recommended.
What is a painless lump?
A painless lump is an abnormal mass or swelling that develops under the skin and does not cause pain or discomfort. The lump may be firm, soft, or rubbery. It can range in size from very small to several centimeters across. Painless lumps are often discovered incidentally by the person themselves or by a doctor during a routine physical exam. They may occur anywhere on the body, but are commonly found on the neck, armpit, breast, abdomen, groin, or back.
What are some possible causes of painless lumps?
There are many possible causes of benign (non-cancerous) painless lumps. Some common examples include:
- Lipomas – Benign fatty tumors that form lump under the skin, usually on the trunk, neck, or limbs.
- Sebaceous cysts – Lumps filled with keratin material and sebum from clogged hair follicles or oil glands.
- Ganglion cysts – Gel-filled cysts that develop near joints or tendons, often on the wrists or hands.
- Fibroadenomas – Benign breast tumors composed of glandular and fibrous tissue, common in younger women.
- Epidermoid cysts – Slow-growing lumps containing dead skin cells and keratin, found anywhere on the skin.
- Lymph nodes – Can become enlarged due to inflammation or infection.
Less commonly, painless lumps can potentially be a sign of cancer. Examples include:
- Lipoma-like liposarcomas – Rare fat cell cancers that resemble benign lipomas.
- Dermatofibrosarcoma protuberans – A slow growing form of skin cancer that forms a hard painless lump.
- Breast cancer – Most breast cancers are painless at first. Male breast cancer is also possible.
- Melanoma – Lumps caused by advanced skin cancer deposits under the skin.
- Lymphoma – Hard, rubbery lymph node swelling that persists longer than 3-4 weeks should be evaluated for possible lymphoma.
When should a painless lump be evaluated?
While most painless lumps are benign, it is still a good idea to have them evaluated professionally. See your doctor promptly if you notice any of the following:
- The lump seems to be growing rapidly over weeks to months
- The lump is very large, over 5 cm (2 inches) across
- The lump is hard, fixed, or immobile when you press on it
- The lump does not go away on its own after 4-6 weeks
- The lump recurs in the same spot after being removed
- You have other worrisome symptoms like unexplained weight loss, fever, night sweats
- You have a family history of cancer or breast cancer gene mutations
Screening mammograms can detect suspicious breast lumps, though they may still be painless. Any new breast lump in men should be promptly medically evaluated as well.
What happens during evaluation of a painless lump?
If you visit your doctor about a painless lump, the evaluation will likely include:
- Medical history – Your doctor will ask about risk factors, other symptoms, the lump’s onset, growth, etc.
- Physical exam – The doctor will examine the lump’s size, texture, mobility, and look for other abnormalities.
- Imaging tests – An ultrasound, mammogram, MRI, or CT scan can help characterize the lump.
- Biopsy – A small sample of cells from the lump taken via needle or surgery to determine if cancerous.
- Blood tests – Bloodwork may be done to look for indicators of cancer or infection.
Based on the results of the evaluation, your doctor can then determine if the lump is benign or malignant. Benign lumps may simply be monitored or removed if bothersome. Cancerous lumps require appropriate treatment like surgery, radiation therapy, chemotherapy, or immunotherapy.
Can painless lumps turn out to be cancer?
Yes, some types of cancers can present initially as painless lumps under the skin. However, the vast majority of painless lumps turn out to be benign. According to one study, only about 4% of painless superficial masses turn out to be malignant based on biopsy results.
Some features make a painless lump more worrisome for cancer:
- Lump is large, over 2 cm (0.8 inches)
- Lump is fixed/immobile rather than moveable under skin
- Lump is firm, hard, or rock-hard feeling
- Lump is growing rapidly over weeks to months
- Lump recurs after attempted removal
- Lump bleeds or ulcerates
However, a benign-appearing lump can still rarely turn out to be cancer, so biopsy is important for accurate diagnosis in uncertain cases.
How are painless cancerous lumps treated?
Treatment for a cancerous lump depends on the type of cancer and stage. Common treatments include:
- Surgery – Operations to remove malignant lumps and surrounding tissue margins.
- Radiation – High energy x-rays targeted at cancer cells to destroy their DNA.
- Chemotherapy – Cytotoxic medicine cocktails infused through the bloodstream to kill rapidly dividing cancer cells.
- Immunotherapy – Medications that help boost the immune system to attack cancer.
- Targeted therapy – Drugs that specifically block growth mechanisms of cancer cells.
Treatment also often involves imaging tests like CT scans, MRIs, and PET scans to detect the extent of disease spread. Cancer staging helps determine the optimal combination of treatments to implement.
What is the outlook for benign vs malignant painless lumps?
The outlook heavily depends on whether a painless lump is benign or malignant:
- Benign lumps – Have an excellent outlook overall. Most remain asymptomatic or are simply cosmetic issues. Some benign lumps like lipomas can recur after removal but are not dangerous.
- Malignant lumps – Outlook varies greatly depending on cancer type and stage. Early stage malignant lumps controlled by surgery alone have a good prognosis. Advanced widespread cancers are more difficult to treat.
In general, benign lumps should not be cause for concern, but need monitoring. Malignant lumps require prompt treatment but are uncommon overall. Stay vigilant about any new skin lumps and see your doctor if you have any concerns.
In summary, the discovery of a new painless lump is a common occurrence and only rarely a sign of cancer. Having the lump properly evaluated by a medical professional is important, especially if the lump has worrisome features like rapid growth, large size, or hard immobile feel. With appropriate workup and biopsy, the vast majority of painless lumps can be correctly diagnosed as benign or malignant. Benign lumps can be left alone or removed, while cancerous lumps require specific oncology treatments. Being aware of any new skin lumps and getting prompt medical care remains key to ensuring an optimal outcome.