When you find a lump somewhere on your chest, your thoughts might immediately turn to cancer, particularly breast cancer. But there are actually many things other than cancer that can cause a chest lump.
The chest includes the breasts and skin. It also includes the chest cavity (thoracic cavity), which contains the spinal column, ribs, and breastbone (sternum). Behind the ribs and sternum are the heart, lungs, and esophagus.
The chest cavity also contains muscle, connective tissue, and membranes, as well as lymph nodes, arteries, and veins.
We look at some of the causes of chest lumps and what to expect when you see a doctor.
Even benign chest lumps can cause problems if they grow too large, so it’s important to get a diagnosis. The following are some types of lumps that might develop in the chest:
A cyst is a sac filled with fluid or other material. Breast cysts usually happen in women between 35 and 50 years old and are common with the approach of menopause.
You can also get a breast cyst from a blocked milk duct (galactocele).
Breast cysts may get bigger and more tender just before your period. When they develop just under the skin, they feel soft and smooth. When they develop deeper down, they can feel hard.
Breast cysts are usually painless, unless they grow particularly large. They’re rarely cancerous.
Among women, fibroadenomas are the most common benign breast lumps. The painless lump can happen at any age, but particularly in your 20s or 30s.
The lump is firm and smooth, and it moves freely when you touch it.
A lipoma is a clump of fatty tissue just underneath the skin. Lipomas are slow growing and painless, unless they press on a nerve or grow around blood vessels. They feel rubbery and move when you push on them.
Anyone can develop a lipoma, but they’re usually diagnosed in people between 40 and 60 years old.
Lipomas are usually harmless and almost always benign. However, there’s a very rare type of cancer called liposarcoma that grows in fatty tissues and can appear to be a deep lipoma.
Fat necrosis happens when fatty breast tissue is damaged from an injury to the breast or following lumpectomy or radiation treatment. This noncancerous lump is painless, round, and firm.
Sometimes, a breast lump turns out to be an abscess. That’s a build-up of pus that becomes inflamed.
Symptoms can include:
A hematoma is a blood-filled mass caused by a surgical procedure or injury to the breast. It should heal on its own.
This happens when there’s an overgrowth of tissues in breast lobules. It can cause lumps that look like calcifications on a mammogram.
Nodular fasciitis is a type of benign tumor that can occur anywhere in the body, including the chest wall, but rarely in the breasts.
The lump is fast growing, feels firm, and might have irregular margins. It may cause a certain amount of tenderness.
Injury to the chest
Sometimes, a superficial lump can form shortly after an injury to the chest. It may be painful, but pain and swelling are likely to improve when you apply ice.
Bone tuberculosis can cause lumps in the chest wall, ribs, spinal column, and sternum. Other symptoms include:
- weight loss
A lump in the breast can be a sign of breast cancer. Cancerous lumps are usually hard and have irregular edges, but lumps due to breast cancer can also be soft or round. They may or may not be painful.
Other signs of breast cancer include:
In addition to those listed above, there are some other reasons you can develop a lump in the middle of your chest.
A broken sternum is usually the result of blunt force trauma, like a car accident, sports injury, or fall from a great height. You might also have swelling, bruising, or hematoma.
Hodgkin’s lymphoma is a type of blood cancer that can also affect organs and lymph nodes. It’s not common, but it can sometimes affect bones, including the ribs, spine, and sternum.
Symptoms may include:
- chest pain
- weight loss
Xiphoid syndrome is a rare condition that causes inflammation of the lower tip of the sternum, which is called the xiphoid process.
In addition to the lump, it can cause pain in the sternum, chest, and back. It can be caused by blunt trauma or repetitive injury.
An epigastric hernia occurs just below the sternum and above the navel, usually in children. It can be present at birth or can develop later due to weak or strained abdominal muscles.
Other symptoms include swelling, discomfort, or pain that worsens during a sneeze or cough.
Benign lumps are usually soft and movable, while cancerous lumps tend to be hard and immovable.
If you have a new lump on your chest, it’s a good idea to see a doctor, especially if accompanied by:
- chest pain
- muscle atrophy
- chest expansion
- impaired movement
You should also see a doctor if you have a personal or family history of cancer or have experienced trauma to the chest.
A doctor will ask you questions about how long you’ve had the lump, how fast it’s growing, and any other symptoms.
In some cases, a physical examination will be enough to diagnosis the lump. This may be the case with cysts, fibroadenoma, and lipoma. Many times, other testing is necessary to make a diagnosis.
Imaging tests can help provide a detailed view of the chest to determine the lump’s exact location and size. It can also help determine if the lump is growing too close to blood vessels, bones, or internal organs.
These are some of the imaging tests you may need:
The only way to rule out or confirm cancer is with a biopsy. A biopsy involves taking a tissue sample for examination under a microscope.
Depending on the location of the lump, this can be accomplished by needle aspiration or surgical biopsy.
Treatment for chest lumps depends on the cause.
Watch and wait
Sometimes, a doctor may want to watch and monitor the lump to see if it goes away on its own before choosing a treatment. That may be the case with lipomas and some cysts.
Lumps due to chest injury can be treated with over-the-counter (OTC) pain relievers and anti-inflammatories.
Abscesses, extrapulmonary tuberculosis, and other infectious causes may be treated with antibiotics or other medications.
Noncancerous tumors may need to be surgically removed if they interfere with blood vessels, muscles, bones, or major organs.
Fibroadenomas, fat necrosis, and sclerosing adenosis are usually surgically removed. Because nodular fasciitis is difficult to differentiate from cancer, these lumps should also be removed.
Surgery may be an option for injuries to the bone.
Primary malignant tumors are typically surgically removed. In some cases, a chest tumor can be secondary, meaning it spread to the chest from another part of the body. When that’s the case, surgical options depend on the extent of the disease.
In addition to surgery, other treatments for cancer may include:
Chest lumps can be caused by a variety of factors. Most aren’t cancerous and many are easily treatable.
If you have a lump of unknown origin, ask a doctor if you should have it checked out. Whatever the cause, early diagnosis and treatment generally results in more options and a better outcome.