Which palpation features are most characteristic of breast cancer?

• A. Soft, mobile, well-delimited
• B. Round, mobile, and tender
• C. Firm or hard, irregular, poorly delineated, possibly fixed, and non-tender
• D. Pulsatile and warm

Answer: (C)

Palpation findings that raise concern for breast cancer include a mass that is firm or hard, with an irregular shape and poorly delineated margins, often fixed to surrounding tissues, and typically non-tender. This combination reflects malignant invasion and a desmoplastic reaction that makes the lump feel stony, irregular, and tethered to the chest wall or skin. The non-tender nature is common in cancer unless there is secondary inflammation.

In contrast, a soft, mobile, well-delimited lump is more characteristic of benign lesions like a fibroadenoma or a simple cyst. A round, mobile, and tender lump can accompany benign inflammatory or cystic processes. A pulsatile and warm lesion points toward a vascular issue or infection/inflammation, not cancer.