'I've never really done breast self-exams. Then one day in the shower, I felt a hard lump.'

I’d heard mammograms were painful, so when I found a breast lump a month ago I got nervous. Somewhere I’d also heard, or read maybe, having your breasts squished between the mammogram plates was even worse if your breasts are small, which mine are.

At 44, I’m under the age of regular mammogram screening for women (from age 50 in Australia, although if you want to be screened earlier, it is free over 40).

But the thought of breast cancer was scarier than the mammogram, so I braced myself and went to the doctor.

I wasn’t someone who regularly did breast self-exams. They’d always confused me.

Watch: A quick how-to check your breasts - what to do, and what you're looking for. Story continues after video.

Women’s breasts are not just smooth fat. They’re made up of fibrous connective tissue and fat, milk ducts, and 15-20 sections called lobes filled with milk-producing glands (alveoli).

Depending on what your hormones are doing, it’s completely normal for breasts to be lumpy, painful, or change in size slightly. With all the normal lumps and bumps, I wondered how I would even notice a lump that wasn’t meant to be there. 

But in the shower one day, my hand brushed over my breast and I knew instantly the hard lump I could feel wasn’t normal. It was like a small, heavy marble had slipped under my skin. 

When the doctor examined me a week later, he found the lump quickly too. The fact that it was small, not painful, and had appeared fairly recently made him less concerned it was cancer, but to be sure he booked me in for a mammogram.

According to the doctor, many younger women end up having unnecessary biopsies done on breast lumps, as only 20-40 per cent of all breast lumps are actually cancer and 80 per cent of new breast cancers are in women 50 and over.

I was keen to avoid a biopsy too. Still, because breast cancer is the most common cancer for women, it’s better to be safe and get it checked.

At the mammogram clinic, a radiographer checked my notes and asked me to remove my top and bra (In Australia, all BreastScreen radiographers are women). I stood half-naked next to the large X-ray machine as she positioned me between two flat pads, explaining the procedure as she went.

“If it hurts let me know,” she said, punching instructions into the machine. “It’s uncomfortable, but it’s not meant to hurt at all.”

Yeah, right, I thought and, ignoring her reassurance, expected the worst as the X-ray pads closed in on my left breast. I stood awkwardly with my arm up, holding my breath and anticipating the painful part. The machine held in place for a few seconds, clicked a few images, and then released.

“Is that it?” I laughed out loud in relief. It wasn’t comfortable – which is what you’d expect from a breast clamp – but it definitely wasn’t painful.

The radiographer switched the machine to the other side and repositioned me. Again, it wasn’t comfortable, but there was no pain.

Usually results from a screening exam take a week or two, but as I live in a place with a small hospital and this was a diagnostic mammogram, they processed the X-rays while I sat in the waiting room.

A single breast lump showed up on the mammogram, the one I’d found, and they led me to another room for an ultrasound to get a better picture of what type of lump it was.

The junior doctor doing the ultrasound reassured me it didn’t look like the nasty kind, and then asked me to wait while he checked with the specialist on duty. 

A few minutes later I was led back to the mammogram room for more pictures of my left breast from slightly different angles. (This time I wasn’t at all worried about it being painful) 

The specialist repeated the ultrasound and came to the same conclusion. It wasn’t a lump I needed to worry about. 

The whole process took longer than I was expecting. I was double and triple-checked, but the fact they were so thorough felt reassuring. And, bonus, I wouldn’t need a biopsy! 

The specialist handed me an information sheet and explained the type of lump. “You have a breast cyst which is pretty common in women your age. Hopefully, it will go away on its own in the next few weeks, but if it gets painful come back and it can be drained to relieve the pressure.”

Two weeks later, the lump vanished on its own.

What are breast cysts?

What I experienced is incredibly common. Many of us will develop breast cysts in our 30s and 40s because of normal hormonal changes like before your period, or during perimenopause and menopause, but they can happen at any age.

Doctors call it fibrocystic breast changes or fibrocystic breast disease - which sounds far more serious than it is. You can get one or more and they might appear (and disappear) overnight. They can feel hard or soft, painful or painless, and can even be there without you noticing.

The cysts are fluid-filled lumps, kind of like blisters, inside your breast tissue. Quite often you won’t even need a mammogram to diagnose a breast cyst. A physical examination and ultrasound can be enough.

Your doctor might drain the cyst with a small needle if it’s large or painful, or making you feel really worried. Draining a cyst is a really quick procedure with a tinier needle than one used to take blood. The cyst shrinks away after it’s been drained and if it refills, you can just go back and have it drained again. It’s not a sign of something more sinister.

It can feel a bit scary finding a cyst in your breast, but cysts are no more likely to become cancerous than any other part of your breast. Most of us will get one at some stage in our lives.

If you’ve had a breast cyst though, don’t assume every lump is a cyst. It’s always good to get lumps and unusual changes checked out.

Signs to watch out for. 

It’s important to know what’s normal for you. Women’s breasts change a lot over our lives. They respond to the hormonal changes each month and those that happen over our lifetime. They also change with weight loss and gain, pregnancy, and aging.

It’s far less common, but men very occasionally get breast cancer too; around 160 men were diagnosed with breast cancer in 2021 in Australia.

Also, if you are a transgender woman taking medication to lower male hormones and boost female hormones, you may have an increased risk of developing breast cancer.

We all need to know and regularly look at our bodies so we’ll notice something out of the ordinary for us.

Australia has a 91-96 per cent survival rate of breast cancer, and a lot of this is thanks to early detection.

Listen to The Quicky and know how often you need to be checking your breasts. Story continues after podcast.

According to the Australian Cancer Council, we need to look for:

• New lumps or thickened skin, particularly changes in just one breast. 
• Nipple discharge and changes, such as changing shape or turning inverted. 
• Unusual soreness in your breast or nipples. (Not related to your usual menstrual cycle breast pain).
• Skin dimpling, rash, or redness. 
• Swelling, lumps, or pain in your armpit.

Feature Image: Supplied.