Breast Cancer: Signs You Should Not Ignore

Finding a change in your breast can be frightening. But remember: most breast changes and most breast lumps are not cancer. At the same time, you should not ignore a new or unusual change. Breast cancer is generally easier to treat when detected early. 

What signs and symptoms should I look for?

1. A new lump in the breast

The most common symptom of breast cancer is a new lump or mass in the breast.

You may notice an area that feels different from the rest of your breast. Cancerous lumps are often described as hard or irregular, but this is not a rule. Breast cancer can sometimes feel soft, round, tender or even painful.

So please don't try to decide whether a lump is cancer simply by touching it. Any new breast lump deserves medical evaluation.

2. A lump or swelling in your armpit

When checking your breasts, don't forget your armpits.

A new lump or swelling under the arm can be an enlarged lymph node. Occasionally, breast cancer may cause enlarged lymph nodes in the armpit or near the collarbone. 

3. A change in the size or shape of your breast

It is completely normal for your two breasts to be slightly different.

What I want you to notice is a new change. One breast may suddenly look larger, swollen or different in shape compared with how it normally looks. 

4. Changes in the skin over your breast

Look at the skin as well as feeling the breast.

Please consult your doctor if you notice:

These changes do not automatically mean cancer, but they need examination. citeturn0search0turn0search1

5. Changes in your nipple

You know what your nipples normally look like.

Report a new nipple change, particularly if a nipple that previously pointed outward starts pulling inward.

Persistent scaling, crusting, redness or an eczema-like rash around the nipple should also be assessed. citeturn0search0

6. Discharge from the nipple

If you are not pregnant or breastfeeding and you develop new nipple discharge, especially spontaneous, one-sided, clear or blood-stained discharge, please get it checked.

There are several non-cancerous causes of nipple discharge, so discharge does not necessarily mean cancer. 

7. Breast pain

This is something many women worry about.

Breast pain alone is usually not a sign of breast cancer. Hormonal changes and many benign breast conditions can cause pain.

However, persistent pain in one particular area, especially when associated with a lump, nipple change, skin change or swelling, should be examined. citeturn0search0turn0search8

When should I consult a doctor?

Please make an appointment if you notice any new change that is not normal for your breasts, particularly a new breast or armpit lump, nipple retraction, unexplained nipple discharge, skin dimpling, persistent redness or swelling, or a noticeable change in breast shape.

Don't wait for the lump to become painful. Early breast cancers can be completely painless.

And don't postpone your appointment because you recently had a normal mammogram. No screening test detects every breast cancer. citeturn0search1turn0search8

What will my doctor do?

First, I will talk to you about the change you have noticed, how long it has been present, your menstrual and pregnancy history, previous breast problems and whether breast or ovarian cancer occurs in your family.

Then I will examine both breasts, your nipples and the lymph-node areas, particularly your armpits and the areas around your collarbones.

Depending on your age, symptoms and examination, I may then advise further tests.

Mammogram

A mammogram is a specialised low-dose X-ray of the breast. If you already have a symptom, your doctor may request a diagnostic mammogram, which focuses more closely on the suspicious area. 

Breast ultrasound

An ultrasound can help determine whether a lump is fluid-filled, such as a cyst, or solid. It is also commonly used to examine a suspicious area and to guide a needle during biopsy. 

Breast MRI

MRI is not required for every breast lump. Your doctor may recommend it in selected situations depending on your imaging findings, breast density, cancer risk or if cancer has already been diagnosed. 

Biopsy

If imaging shows a suspicious area, your doctor may advise a needle biopsy, commonly a core needle biopsy.

A biopsy removes a small amount of tissue so that a pathologist can examine it under a microscope.

This is important: a scan can suggest cancer, but a biopsy is what confirms whether an abnormal area is cancer. 

If cancer is confirmed, additional tests on the biopsy tissue and, when appropriate, further scans help your oncology team understand the type and extent of the cancer and choose the most appropriate treatment.

One message I want you to remember

Finding a breast lump does not mean you have cancer.

But neither you nor I should assume that a new lump is harmless without evaluating it.

Know what is normal for your breasts. If something changes, get it checked rather than waiting for it to disappear.

Early evaluation can provide reassurance when the change is benign—and when it is cancer, earlier detection can make treatment simpler and more successful. citeturn0search2