a Hard Lump in the Upper Inner Right Chest: Fat or Something More?

Hard mass in the upper inner right chest?

I have a hard lump on the upper inner side of my right breast, measuring 170 cm and weighing 76 kg.
It looks normal, but it hurts only when pressed lightly.
I visited a family medicine clinic for an examination, and the doctor said it was just fat.
However, when I returned for a follow-up three days later, the skin over that area was bruised, and the doctor said it was nothing to worry about.
I feel that the doctor might not have taken the lump seriously due to my gender and age, so I didn’t ask further questions.

I would like to know if it is normal for fat to cause bruising on the skin.
What other symptoms might occur with fat deposits? How can I differentiate between this and a tumor or malignant tumor? I’m not sure if I can share a picture, but here is what the bruise looks like: https://i.imgur.com/LiF6I03.jpg.

Bi, 10~19 year old female. Ask Date: 2019/07/20

Dr. Chen Sirong reply Oncology

A 17-year-old male with a specialization in radiation therapy for malignant tumors, please forward your questions to a general surgeon.
Thank you.

Reply Date: 2019/07/20

More Info

When it comes to a hard lump in the upper inner right chest, it is understandable to have concerns, especially regarding the possibility of it being something serious like a tumor or malignancy. Based on your description, it seems that you have already consulted a physician who suggested that the lump is likely a lipoma, which is a benign tumor made up of fat tissue.
Lipomas are generally soft, movable, and painless lumps that can occur anywhere in the body where fat cells are present. They are usually not a cause for concern unless they grow large or become painful. The fact that you experienced some bruising around the area could be due to a few reasons. It might be a result of minor trauma or pressure applied to the area, which can happen even if you are not consciously aware of it. Bruising can occur when small blood vessels break under the skin, leading to discoloration.
In terms of symptoms associated with lipomas, they typically do not cause any symptoms unless they press on nearby structures or nerves. If a lipoma becomes large enough, it may cause discomfort or pain, especially if it is located in a sensitive area. Other symptoms that might arise from a lipoma could include a noticeable change in size or shape, tenderness, or changes in skin color over the lump.
Differentiating between a lipoma and a malignant tumor is crucial. Malignant tumors often present with additional symptoms such as rapid growth, hardness, irregular borders, and associated symptoms like weight loss, fever, or night sweats. Unlike lipomas, malignant tumors may be fixed to the underlying tissue and can be painful.
If you have concerns about the lump or if it changes in size, shape, or symptoms, it is advisable to seek further evaluation. Imaging studies such as ultrasound or MRI can help in assessing the characteristics of the lump more accurately. In some cases, a biopsy may be warranted to definitively rule out malignancy.

In summary, while a hard lump in the chest can be concerning, the likelihood of it being a benign lipoma is high, especially given your physician's assessment. Bruising could be a normal response to minor trauma, but if you notice any changes or have ongoing concerns, do not hesitate to follow up with your healthcare provider for further evaluation. Regular monitoring and open communication with your doctor are key to ensuring your health and peace of mind.

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