The features that matter are how fast it appeared, whether it moves, and whether it hurts.
Assessed by a GMC-registered GP, not a symptom checker
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Arrange prompt assessment for a lump that is:
Go to A&E for a rapidly spreading, hot, red swelling with fever, or any swelling causing difficulty breathing or swallowing.
Sudden severe testicular pain needs A&E immediately — torsion is only salvageable within about six hours.
Finding a lump is frightening, and most lumps are harmless — cysts, lipomas, reactive lymph nodes after an infection.
The features that distinguish them are reasonably consistent. Reassuring: soft, mobile under the skin, appeared quickly, tender, and changing in size. Less reassuring: hard, fixed, painless, and slowly growing.
Those are guides, not guarantees, which is why a lump is assessed rather than watched from home.
Very common and benign
Site-specific
What matters clinically is not how big a lump is, but whether it is changing. That can only be judged against a starting point, and memory is unreliable.
These four things do most of the diagnostic work:
A lump that came up with a cold or sore throat and is shrinking after two or three weeks is behaving as it should. A lump that has not settled after three weeks, or that is growing at all, needs looking at rather than watching.
We will be direct about the limitation: a lump ultimately needs to be felt. A remote consultation cannot palpate it, and pretending otherwise would be unsafe.
What we can do is take a careful history — how long, how fast, whether it moves, whether it hurts, associated symptoms — look at clear photographs, and decide urgency and route quickly, which is often the thing that actually matters.
We arrange ultrasound, which is the usual first investigation for a soft-tissue, testicular or neck lump, alongside blood count and inflammatory markers where indicated, and provide an urgent referral letter the same day where the picture warrants it.
For breast lumps and any lump with concerning features, we will recommend your NHS GP, because the two-week-wait pathway is NHS only and is the right route.
Three weeks is the usual dividing line. A tender lump in the neck, armpit or groin that appeared alongside an infection and is getting smaller is behaving normally. Anything still present after three weeks, growing, hard, fixed in place, or painless, should be assessed rather than watched.
Two exceptions that should not wait three weeks at all: a lump in a testicle, and a new breast lump.
No — and this is the most common misunderstanding about lumps. Pain usually indicates infection or inflammation, both of which tend to be benign and self-limiting. The concerning pattern is the opposite: a painless, hard, gradually enlarging lump that is fixed to what lies beneath it. "It doesn't hurt, so I left it" is a familiar sentence in cancer clinics.
Watching is reasonable for a short defined period with a clear end date — not indefinitely, and not by repeatedly feeling it, which inflames the area and destroys your own comparison. Set a date three weeks out. If it has not gone by then, get it looked at rather than resetting the clock.
Very possibly. Sebaceous cysts (soft, mobile, often with a small central dot, sometimes discharging cheesy material) and lipomas (soft, rubbery, doughy fatty lumps that move easily) are extremely common and entirely benign. Both can be left alone or removed if they bother you. What distinguishes them is that they are soft and mobile — a hard, fixed lump is not one of these.
That is reactive lymph node enlargement, and it is exactly what lymph nodes are for. They swell during infection and shrink afterwards. The pattern that matters is a node that keeps growing, is rubbery-hard and painless, sits above the collarbone, or comes with night sweats, fever or weight loss.
Get it assessed this week — do not wait. Most testicular lumps are benign cysts, but testicular cancer is the commonest cancer in men aged 15–45 and it is highly curable when caught early. It is typically painless, which is exactly why it gets left. An ultrasound settles it quickly.
Common causes are enlarged lymph nodes and hernias. A groin lump that bulges when you cough or strain and disappears when you lie down is usually a hernia — which needs a surgical opinion, but not urgently. A groin lump that becomes hard, exquisitely painful and cannot be pushed back is an emergency, because a hernia can strangulate.
The consultation establishes the history — how long, whether it is changing, whether anything preceded it, and whether there are other symptoms — and the site and behaviour of the lump usually narrow it considerably. We can arrange blood tests and an ultrasound, which is the single most useful investigation for most lumps, and refer where needed.
What we cannot do is feel it, and for lumps that is a real limitation — the texture and mobility of a lump carry a lot of information. We will say so where examination is what decides it, rather than working around it.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 23, 2026
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It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
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If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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