Breast Cancer Symptoms: Best To Know Your Breast
Medically reviewed by Carmen Fookes, BPharm. Last updated on Aug 5, 2020.
First Know What Is Normal For You
Everyone's breasts are different. This is why you need be be aware of how your breasts "normally" look and feel, so you can notice any changes.
The National Breast Cancer Foundation recommend you perform a self-examination of your breasts once a month. Over 40% of breast cancers that are diagnosed are self-detected. Always seek further investigation if you ever feel any sort of lump in your breast or breasts.
1. A New Lump Or Mass In Your Breast
The most common symptom of breast cancer for 90% of women is a new lump or mass in their breast. Lumps may feel hard or soft; tender, painful or painless; irregular or rounded. If you feel a lump of any sort, always get it checked by a health care professional experienced in the diagnosis of breast diseases.
Try not to panic too much. Eight out of ten lumps found turn out not to be cancerous. But it is still important to schedule an appointment with your doctor, just to be sure.
2. Skin Changes: Creasing, Puckering, Dimpling
In around 5% of women, breast cancer can cause changes in the skin of the breasts, such as creasing or puckering; dimpling; or a redness, scaliness, or thickening. Some rare breast cancers can give your breast skin an orange peel appearance.
Look at your breasts in a mirror with your arms raised and check for any dents or imperfections that are new. Check that the skin on one breast matches the skin on the other breast. If anything about the skin on your breasts has changed, see your doctor. Although not all breast skin changes indicate breast cancer (puckered breast skin is common after weight loss) it is important to follow up with a doctor.
3. Nipple Changes: Discharge, Inversion, Pain
For a very small percentage of women, a change in the appearance of one of their nipples may be their first sign of breast cancer.
Bleeding, or any kind of discharge from the nipple (other than breast milk) could suggest a type of breast cancer that lines the ducts behind the nipples. Other nipple changes include nipple inversion or retraction (turning inward); redness, scaliness or thickening of the skin around the nipple; or nipple pain.
If you develop any of these symptoms, report them to your doctor as soon as you can.
4. Other Changes: Swollen Lymph Nodes Or Breast Swelling
Sometimes breast cancer cells can collect in the lymph nodes and cause swelling in the more superficial nodes of the armpit or neck, long before a lump is large enough to be felt in the breast.
Report any sort of swelling - whether it is in your breast, in your armpit, or around your collar bone or neck, to your doctor for further investigation. Breast swelling caused by cancer can still occur even if no distinct lump can be felt.
Early Detection Means Earlier Treatment
In general, the earlier cancer cells are detected, the better the outcome. Very effective treatment is available for all stages of breast cancer; however, outcomes are usually more favorable when the cancer is found at stage 1 or stage 2.
Mammograms are a type of X-ray that are commonly used for screening.
The advantage of a mammogram is that it can detect tiny lumps, as small as 2 millimeters (mm) in size, which is about the size of a pencil tip. You would never be able to feel a lump this small. Most breast cancer tumors cannot be felt until they are at least 22 mm in size, or about the size of a small pea. But screening with mammograms isn't without controversy.
Mammograms: Are They Too Sensitive For Our Own Good?
There are undoubtedly pros and cons for screening mammograms. Although mammograms do save lives, for each breast cancer death prevented, 3 to 4 women are over-diagnosed and some, over-treated. A reasonably high percentage of breast cancers disappear of their own accord, and some are so slow-growing that they might not ever need treatment at all. Mammograms that show up suspicious but later turn out to be normal cause a lot of unnecessary anxiety and cost.
As a result, experts debate what age is best for screening. Guidelines published by the USPSTF recommend a screening mammography every 2 years for women aged 50 to 74 - the age range where most women of average risk develop breast cancer. For women aged under 50 or over 75, a decision should be made individually with her doctor. Women who have a mother, sister, or daughter with breast cancer may benefit from beginning screening in their 40s.
The American Cancer Society (ACS) recommends annual mammograms starting at age 45 years, and women may be given the choice of biennial or annual mammograms once they turn 55. Screening should continue indefinetely as long as a woman's overall health is good and she has a life expectancy of 10 years or longer. Women aged 40 to 44 should also be given the choice to begin annual mammograms.
To determine what's right for you, talk with your doctor.
Other Tests And Investigations: Ultrasounds, MRIs, And Biopsies
An ultrasound uses sound waves to produce an image of the breast and armpits. They are usually used in addition to a mammogram to help distinguish between cysts (fluid-filled sacs) and solid masses. MRI scans use radio waves, magnets and a contrast liquid to build up an image of the breast and any suspicious areas. MRIs are typically used in women at high risk of breast cancer.
Biopsies are usually done if a lump has been found. A sample is taken of the suspicious area which is then looked at under a microscope by an experienced doctor. Biopsies are the only way to tell if cancer is definitely present.
What Exactly Is Breast Cancer?
Cancer is the uncontrollable growth of cells. It occurs when a mutation, or abnormal change occurs that upsets how our cells multiply and divide. This allows the cell to keep dividing, out-of-control, instead of dying and being replaced by a new cell. Sometimes these out-of-control cells cluster together and form a lump called a tumor.
Breasts are made up of lobules that produce milk and ducts that carry the milk to the nipples. These lobules and ducts are surrounded by fatty tissue.
There are two types of breast cancer tumors: those that are called benign (noncancerous) and those that are malignant (cancerous). Benign tumors do not invade other tissues or spread to other parts of the body. They may be left alone or removed if they press on vital structures such as nerves or blood vessels.
Most types of breast cancer start off in the ducts of the breast. Ductal carcinoma in situ (DCIS) is the most common type of noninvasive breast cancer diagnosed, although some experts question whether DCIS should even be treated. Nearly all women diagnosed at this early stage can be cured.
Age And Family History Biggest Risk Factors
Approximately one in every eight women who live to the age of eighty will develop breast cancer. Your risk of developing breast cancer increases with:
- Age: only 1 in 1,732 women develop breast cancer in their 20s compared to 1 in 28 age 60 to 70.
- Specific genetic mutations: BRAC1 (55-65% of women with this mutation will develop breast cancer) and BRAC2 (45% will develop breast cancer).
A woman's lifetime risk of developing breast cancer is around 12%.
Alcohol, Weight, And Other Factors Also Increase Risk
Although you can't change your age or your genetics, there are several lifestyle choices you can make that reduce your risk of developing breast cancer, including:
- Limiting or avoiding alcohol - Breast cancer risk increases from 12% to 18% with more than 2 alcoholic drinks per day
- Maintaining a healthy body weight - Being overweight, especially after menopause, increases risk
- Stop smoking if you smoke
- Exercise regularly
- Know what your "normal" is and talk to your doctor if your breasts are different in any way
- Breastfeed for as long as possible
- Get a mammogram regularly from age 45 or 50, or whatever your doctor recommends.
Other factors that are associated with an increased risk of breast cancer include previous hormonal therapy; a family or personal history of breast or ovarian cancer; a history of radiation therapy to the chest area when young; and being of Caucasian descent. Diet, stress and anxiety may also play a role.
Breast Cancer Touches Everybody
Chances are you already know somebody affected by breast cancer. It might be your mom, daughter, sister, aunt, neighbor, or friend. On average, more than 900 women in the U.S. are diagnosed with breast cancer every day. Even the men we love can be affected as well. In 2020, more than 2,620 new cases of invasive breast cancer are expected to be diagnosed in American men.
The odds of beating breast cancer are so much better when it is detected and treated early. If you are a man, seek further investigation if you notice any skin or tissue changes around your nipples.
Finished: Breast Cancer Symptoms: Best To Know Your Breast
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Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.