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Breast Cancer Treatment Surgeon“I don’t have a lump, so there’s no way I can have breast cancer.” This statement reflects a widespread misperception, unfortunately. While a lump is the most common telltale symptom of breast cancer, the absence of a lump doesn’t mean that breast cancer can’t be present. There are other methods to detect breast cancer aside from feeling a lump, and screening is the key.

Nonpalpable Masses

Advances in mammography and ultrasound are allowing radiologists to detect a larger number of nonpalpable masses in breast tissue. Nonpalpable means the mass cannot be felt by hand. With cancer, nonpalpable growths are often too small to be felt, but can be detected on ultrasound, mammogram, or an MRI. Nonpalpable masses may be cancerous, or benign. A tissue sampling, called a core needle biopsy, will be necessary to rule out cancerous cells.


Like nonpalpable masses, calcifications, or calcium deposits, can’t be felt but can be detected in the breast tissue with a mammogram. Breast calcifications appear as white spots or flecks on a mammogram and are common, especially after menopause.

These calcifications can be macrocalcifications, which appear as large white spots or dashes, or microcalcifications, which appear as thin, white specks, much like grains of salt. Macrocalcifications are usually noncancerous. However, certain patterns of microcalcifications, such as tight clusters with irregular shapes, may indicate early stage breast cancer. Flecks of calcium caused by breast cancer tend to appear like crushed glass, as if you ground a drinking glass under your shoe.

Your doctor will order a secondary, or diagnostic, mammogram with additional magnification views to get a closer look at the calcifications. If the microcalcifications are still concerning, your doctor may recommend a core needle biopsy.

The Importance Of Screening

In the absence of a palpable lump, screening mammography, ultrasound, and MRI techniques have dramatically increased the number of breast cancers detected. As a result, many cases of breast cancer are being caught at earlier stages, which results in improved survival rates. More than ever, this underlines the importance of screening mammograms, Digital Breast Tomosynthesis (3D mammograms), ultrasound, and MRI’s for the detection of breast cancer.

The single best thing you can do is to maintain your regularly scheduled screening mammograms, and then follow your doctor’s advice if more diagnostic tests are warranted. Don’t make the mistake of assuming that just because you don’t feel a lump, there’s no way you could have breast cancer.

In addition, if you detect changes in your breast, or if you’d like to discuss the most successful surgical treatments for breast cancer, consult with Dr. Aaron Margulies. Dr. Margulies is committed to serving breast cancer patients through his solo practice in Breast Surgical Oncology and General Surgery, with offices at Tennova Turkey Creek Medical Center in West Knoxville, at Tennova North Knoxville Medical Center in Powell, at Jefferson Memorial Hospital, and in Newport. His extensive research and expertise have distinguished him as a leader in the field. To learn more about Dr. Margulies’ compassionate surgical care approach, visit or call (865) 692-1610.