In 2022, there were 2.3 million women diagnosed with breast cancer and 685 000 deaths globally. Breast cancer is a disease in which abnormal breast cells grow out of control and form tumours. If left unchecked, the tumours can spread throughout the body and become fatal.
Early on, a person may notice a change in their breast when they perform a monthly breast exam or when minor abnormal pain doesn’t seem to go away.
Visual breast cancer signs
When most people think about breast cancer symptoms, they think of breast lumps. But doctors say visual changes may be especially key in helping detect breast cancer early. Patients may notice some of these changes just by changing the way they look at their reflections in the mirror.
You can see a lot of things just by looking at your breasts in the mirror. When your arms are by your side, you don't always see everything. Put your hands on your hips or raise them up. Having arms in two different positions while looking is also helpful.
In this article, we’ll discuss the signs and symptoms of breast cancer, including:
- Nipple changes
- Bloody nipple discharge
- Breast dimpling or thickening
- A sore on the breast that's not healing
- Swollen lymph nodes in the armpit
- Breast pain
1. Nipple changes
Changes in the nipple area may be a genetic malformation or alteration, but nipple retraction—when the nipple becomes inverted—may be a sign of cancer. If the nipple wasn’t inverted before and becomes inverted, consult with a doctor.
2. Bloody nipple discharge
Bleeding from the nipple may be limited and difficult to see, but if blood stains appear in a woman's bra, pay attention. Clear or milky secretions may result from normal physiologic changes during pre-pubertal stages. But if the secretions are unusual, bloody or continuous, speak to a health care provider.
3. Breast dimpling or thickening
Known in the medical community as peau d'orange (a French term meaning skin of an orange), any dimpling or thickening of breast skin that resembles an orange rind is a red flag. These symptoms are often associated with inflammatory breast cancer (IBC), a rare but aggressive disease that usually does not involve a lump and may not be detected by a mammogram. IBC symptoms are caused by cancer cells blocking lymph vessels in the skin.
Inflammatory breast cancer symptoms include:
- Rash
- Thickening of the skin
- Shooting pain
- Increased warmth in the breast
- One breast appearing larger and feeling warmer and/or heavier than the other
- Breast tenderness, pain or itching
Some changes are localized to the breast, upper abdomen or the rear part of the chest. Patients may see changes in the breast from one day to the next, and skin changes may occur in less than six months.
Though IBC represents 1 percent to 5 percent of all breast cancers, it accounts for 10 percent to 15 percent of all breast cancer deaths.
Having one or more of these symptoms doesn’t necessarily mean you have breast cancer. Nipple discharge, for example, can also be caused by an infection.
4. A sore breast that is not healing
A red, scaly, flaky nipple, and any persistent skin change, including blood or fluid from the nipple, may be a sign of Paget’s disease of the breast, another rare form of breast cancer. This disease originates in the nipple. It’s not usually invasive and is most commonly diagnosed in patients in their 70s and 80s.
5. Swollen lymph nodes in the armpit
Some patients with breast cancer that has spread to the lymph nodes may have no symptoms in the breast or changes in the structure of the breast, but they feel something unusual under their arm. This may mean that cancer from the breast has traveled to the axillary lymph nodes, which are in the armpit. Affected nodes may also be in the lower part of the neck if the cancer is a little more advanced. Cancer cells often use the lymphatic system to invade distant organs.
It’s important to also remember that not all breast lumps are signs of cancer, a fact that underscores why it’s important for women to be familiar with the look and feel of their breasts. Have an awareness of your breasts. You need to touch them to be aware. Breast self-awareness is the terminology now used instead of a self-breast exam.
6. Breast pain with no lump
Breast pain when there’s no visible or physical lump may still cause concerns about breast cancer. Breast pain, also known as mastalgia, can be associated with many conditions, including:
- Hormonal changes during menstrual cycle
- Water retention, which may also occur during menstruation
- Breast injury
- Breast infection
- Pregnancy
- Breastfeeding
- Medication side effect
- Breast cancer
Breast soreness may be chronic in some women, but it typically resolves on its own.
While breast pain can occur with breast cancer, it’s often not a symptom. According to the American Academy of Family Physicians, the risk of breast cancer in patients with breast pain and normal breast exam and mammography results is about 0.5 percent.
IBC can cause pain and typically has no lump, but still only accounts for 1 percent to 5 percent of breast cancer cases in the United States, according to the National Cancer Institute.
Breast pain and the menstrual cycle also have a close relationship, with premenopausal women experiencing breast pain more than postmenopausal women.
If patients are experiencing pain in the left breast, since it’s situated slightly above the heart, it could indicate a potential heart problem. Chest pain related to a heart attack may occur in the middle of the chest beneath the sternum, and it can be mild or burning and sharp.
