Signs of Breast Cancer: What to Know

From lumps to nipple changes, these are common breast cancer signs and symptoms to know

If you’ve ever noticed a lump in your breast, you know how alarming it can be, considering that a breast lump is the best-known sign of breast cancer. But there are several other symptoms of breast cancer everyone should know—some of which, like skin or nipple dryness, can be easy to dismiss. Any changes to your breast should always be taken seriously, especially since some of the less common signs of breast cancer are associated with rare, aggressive subtypes of the disease.

That said, it’s important to keep in mind that most symptoms of breast cancer are also signs of far-less-serious conditions. Dry skin on the breast may be due to chafing or a skin condition, and only three to six percent of breast lumps are malignant (cancerous). So if you notice any of the symptoms discussed below, report them to your doctor as soon as possible—but try not to panic and assume you have breast cancer.

What are the signs of breast cancer?

Symptoms of breast cancer vary from person to person, but the most common sign is a new lump or mass. Lumps range in shape and texture, but malignant masses are more likely to be hard, painless, and irregularly shaped. But the disease can also be round, soft, tender, or painful, so it’s crucial to report any new sign of breast cancer—like a lump or mass—to your doctor, regardless of its characteristics.

According to one survey conducted on behalf of The Ohio State University Wexner Medical Center/OSUCCC, more than 90 percent of adults know that a lump is a sign of breast cancer. But concerningly, less than half of respondents know other signs of breast cancer.

These other less-common signs and symptoms of breast cancer in women include:

• Breast or nipple pain
• Skin dimpling, which can make skin on the breast resemble an orange peel
• Swelling of all or part of the breast
• Retracted (turned in) nipples
• Red, dry, flaking, or thickened nipple or breast skin
• Nipple discharge (other than breast milk)
• Swollen lymph nodes under the arm or near the collarbone

Many people with breast cancer don’t experience any symptoms, however. This is why getting regular breast cancer screenings is so important.

What are the most common first signs of breast cancer?

In its earliest stages, breast cancer may not cause symptoms. When it does, the most common signs of breast cancer are a lump, swelling, and/or pain.

How is breast cancer detected?

Many breast cancers are detected by routine breast cancer screening (via mammograms, ultrasounds, or MRI) before there’s any lump or other sign of breast cancer noted above. Ideally, breast cancer is detected before it presents with noticeable signs and symptoms, which can mean that the breast cancer is more advanced and aggressive. When breast cancer is diagnosed at its earliest stages or as non-invasive ductal carcinoma in situ (DCIS), it can be more easily treated.

Still, older studies have found that up to between 50 and 60 percent of women detect their breast cancers themselves. For women under 40, who aren’t routinely screened for breast cancer unless they’re high risk, that number has been found to be even higher: nearly 80 percent. These facts underscore the importance of knowing these signs of breast cancer and any changes in your breasts.

What are the signs and symptoms of rarer breast cancers?

Not all types of breast cancer cause the same symptoms. For example, a lump is usually not present in inflammatory breast cancer. More common symptoms of inflammatory breast cancer include redness and swelling of the breast, which are caused by cancer cells blocking lymph vessels in the skin.

Paget’s disease, another rare type of breast cancer, can cause a lump but is also associated with less commonly seen symptoms that may be mistaken for a skin condition such as eczema. That’s because Paget’s disease involves the skin of the nipple and the areola (the pigmented area around the nipple), causing redness and itching of the nipple and/or areola as well as flaky, crusty, or thickened skin on or around the nipple. Other signs of Paget’s disease include a flattened nipple and yellow or bloody nipple discharge.

A lump may also appear in patients with angiosarcoma, a very rare form of cancer that represents only 0.1% to 0.2% of all breast cancers. But its other symptoms—purple nodules and a discolored rash or bruised appearance on the breast or arm—are not frequently seen in other types.

What are the signs of breast cancer in men?

Signs of breast cancer in men are very similar to those in women. They include a painless lump or thickening in the breast tissue; changes to the skin covering the breast, such as dimpling, puckering, redness, or scaling; changes to the nipple, such as redness or scaling; a nipple that begins to turn inward; and discharge from the nipple.

Do these signs and symptoms always mean breast cancer?

No, because many symptoms of breast cancer are also associated with other medical conditions. In fact, most breast lumps indicate other, non-cancerous issues that typically aren’t serious, such as cysts, fibrocystic breast changes, fibroadenomas, and lipomas.

You may also notice a lump if you develop a collection of fluid in the breast called an abscess. And a mass can develop if you sustain an injury to the breast or experience a complication following breast cancer surgery (fat necrosis).

Clear or bloody fluid leaking from the nipple may also not be cause for alarm. It’s a common sign of intraductal papilloma, a benign, wart-like growth in a milk duct. Nipple discharge can also occur if you’re taking certain medications such as birth control pills or if you have a health condition such as hypothyroidism, mammary duct ectasia (widening milk ducts beneath the nipple), and a benign growth in the pituitary gland called prolactinoma.

In addition, most causes of dry, itchy, and sore nipples are harmless and temporary. These include chafing, yeast infections (thrush), contact dermatitis, eczema, and normal hormone fluctuations that occur during the menstrual cycle. Dry nipples can also be associated with pregnancy and breastfeeding.

Regardless, if you have any of the symptoms above, see your doctor to get the correct diagnosis. Some of these benign conditions such as complex fibroadenomas and multiple papillomas are considered uncontrollable risk factors for breast cancer in the future.

How to support your breast health

Several breast cancer risk factors cannot be controlled, such as genetics and age. But there are many steps you can take to lower your likelihood of developing the disease and, if it does happen to you, improve the odds that it’s caught early.

• Learn your family history and share it with your doctor. If you have a family history of breast or other cancers, your doctor may advise you to follow screening recommendations for women at high risk of the disease. These can include starting screening before age 40, getting a mammogram and an MRI every year, and undergoing genetic testing. Women with an average breast cancer risk should ask their doctors what screening schedule is right for them.
• Get familiar with how your breasts look and feel. While studies have failed to show meaningful benefits of conducting breast self-exams on a large population level, it’s still important to practice breast self-awareness and know the normal characteristics of your breasts so you can spot potentially concerning changes more easily.
• Follow a healthy diet. Eating nutrient-rich foods—think fruits, vegetables, fatty fish, beans, whole grains, and nuts—may reduce your risk of breast cancer. It can also help you lose and maintain weight, which is important since being overweight or obese is a risk factor for breast cancer.
• Exercise regularly. Women who exercise for at least 30 minutes, five days a week, are less likely to get breast cancer. In addition to helping manage weight, exercise may help reduce the risk of breast cancer by supporting a healthy immune system, reducing inflammation and, in women who have been through menopause, lowering estrogen levels.
• Limit or stop drinking alcohol. According to the World Health Organization, alcohol consumption is one of the biggest risk factors for breast cancer. Follow current dietary guidelines, which recommend adults not drink or drink in moderation (one or fewer drinks in a day for women, two or fewer drinks for men).
• Quit smoking. The habit is associated with increased risk of breast cancer and is more significant in certain women. These include those who started smoking as teens, women who have smoked for at least 10 years, and those who smoke more than  five cigarettes a day.
• Breastfeed your babies, if possible. Nursing has been shown to have a protective effect against breast cancer, particularly in people who have the BRCA1 gene mutation.

References

Angiosarcoma. (2019, February 27). Cancer.gov. https://www.cancer.gov/pediatric-adult-rare-tumor/rare-tumors/rare-vascular-tumors/angiosarcoma

Angiosarcoma of the breast. (2021, October 15). Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/breast-cancer/angiosarcoma-of-the-breast

Ärzteblatt, D. Ä. G. R. D. (n.d.). Benign breast disease in women (19.08.2019). Deutsches �Rzteblatt. https://www.aerzteblatt.de/int/archive/article/209397

Inflammatory breast cancer. (2016, January 6). Cancer.gov. https://www.cancer.gov/types/breast/ibc-fact-sheet

Jernström, H., Lubiński, J., Lynch, H. T., Ghadirian, P., Neuhausen, S. L., Isaacs, C., Weber, B., Horsman, D., Rosen, B. P., Foulkes, W. D., Friedman, E., Gershoni‐Baruch, R., Ainsworth, P., Daly, M. B., Garber, J. E., Olsson, H., Sun, P., & Narod, S. (2004). Breast-feeding and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers. Journal of the National Cancer Institute, 96(14), 1094–1098. https://doi.org/10.1093/jnci/djh211

Male breast cancer – Symptoms and causes – Mayo Clinic. (2024, March 13). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/male-breast-cancer/symptoms-causes/syc-20374740

Most breast cancers don’t start with a noticeable lump – here is what you need to know about subtle symptoms. (n.d.). The James – OSUCCC. https://cancer.osu.edu/news/most-breast-cancers-dont-start-with-a-noticeable-lump

NCI Dictionary of Cancer Terms. (n.d.). Cancer.gov. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/intraductal-breast-papilloma

Newcomer, L. M., Newcomb, P. A., Trentham‐Dietz, A., Storer, B. E., Yasui, Y., Daling, J. R., & Potter, J. D. (2002). Detection method and breast carcinoma histology. Cancer, 95(3), 470–477. https://doi.org/10.1002/cncr.10695

Nipple discharge. (2024, January 20). Mayo Clinic. https://www.mayoclinic.org/symptoms/nipple-discharge/basics/causes/sym-20050946

Paget disease of the breast. (2012, April 10). Cancer.gov. https://www.cancer.gov/types/breast/paget-breast-fact-sheet

Ruddy, K. J., Gelber, S., Tamimi, R. M., Schapira, L., Come, S. E., Kereakoglow, S., Lin, N., Winer, E. P., & Partridge, A. H. (2009). Presentation of breast cancer in young women. Journal of Clinical Oncology, 27(15_suppl), 6608. https://doi.org/10.1200/jco.2009.27.15_suppl.6608

Suspicious breast lumps – Symptoms and causes – Mayo Clinic. (2024, February 8). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/suspicious-breast-lumps/symptoms-causes/syc-20352786

Thind, A., Diamant, A., Hoq, L., & Maly, R. C. (2009). Method of detection of breast Cancer in Low-Income Women. Journal of Women’s Health, 18(11), 1807–1811. https://doi.org/10.1089/jwh.2008.1224

U.S. Department of Health & Human Services, National Institutes of Health. (n.d.). Understanding breast changes and conditions. In A Health Guide [Health guide]. https://www.cancer.gov/types/breast/breast-changes/understanding-breast-changes.pdf

What are the symptoms of breast cancer? (2023, July 27). Centers for Disease Control and Prevention. https://www.cdc.gov/cancer/breast/basic_info/symptoms.htm