Breast Cancer - Signs & Symptoms

Breast cancer symptoms

This page tells you about the symptoms of breast cancer.  There are sections
on

• Breast lumps in general    
• What to look out for    
• If you spot a lump    
• Breast pain    
• More information

Breast lumps in general

The first symptom of breast cancer for many women is a lump in their breast. 
But 9 out of 10 breast lumps (90%) are benign.  That means they are not cancers.
Most benign breast lumps are

• Areas of benign breast change, causing lumpiness that is more obvious just
  before a period, particularly in women over 35    
• Cysts - sacs of fluid in the breast tissue.  These are quite common    
• Fibroadenoma - a collection of fibrous glandular tissue.  These are more
  common in younger women

What to look out for

Changes that could be due to a breast cancer are

• A lump or thickening in an area of the breast  
• A change in the size or shape of a breast    
• Dimpling of the skin    
• A change in the shape of your nipple, particularly if it turns in, sinks
  into the breast or becomes irregular in shape    
• A blood-stained discharge from the nipple    
• A rash on a nipple or surrounding area    
• A swelling or lump in your armpit

Like breast lumps, these signs don't necessarily mean cancer.  Inverted
nipples, blood stained nipple discharge or a rash can all be due to other
medical conditions.  But if any of these things happen to you, you should get it
checked out.  It may be nothing and seeing the GP will put your mind at rest. 
It may be a benign condition that can easily be treated.  Or at the very worst,
if you have a cancer you give yourself the best chance of successful treatment
by going to the doctor early on.

There is a rare type of breast cancer called inflammatory breast cancer which
can have different symptoms.  The whole breast can look red and inflamed and can
be very sore.  The breast may feel hard.  The skin sometimes looks like orange
peel because the pores stand out in the inflamed area.

Another rare type of breast cancer shows up as a rash on and around the
nipple.  It is called Paget's disease.  The red, scaly rash can be itchy.  It
looks a bit like eczema and is sometimes mistaken for that at first.

If you spot a lump

See your doctor straight away.  If you notice anything unusual about your
breast, have it examined.  Even though most breast lumps are benign, they need
to be checked to rule out cancer.

Your doctor will examine you and if necessary, send you to a specialist
breast clinic for further checks.  At the clinic, they will be able to see on
your mammogram or ultrasound if the lump is a fluid-filled cyst or a solid lump. 

If it is a cyst, they may get rid of it by draining the fluid out through a
fine needle.  If it is a solid lump, they will stick a very fine needle into it
and take a tissue sample to test for cancer cells.

Some women prefer to have benign lumps removed to relieve their worry.  They
may be concerned that they will confuse them with any other lumps they may get
in the future.  But if you and your doctor are confident that the lump is
benign, you do not have to have it removed if you do not want to.  Benign lumps
don't turn into cancer.

If your lump is a cancer, the earlier you have breast cancer treatment, the
better your chance of cure.

Breast pain

Pain doesn't usually mean cancer.  Many healthy women find that their breasts
feel lumpy and tender before a period.  And some benign breast lumps are
painful.  Many women get pain in their breasts for a while, which goes after a
time.  There may be no obvious reason for the pain, even with lots of tests. 
Most breast pain is not caused by cancer, but some breast cancers do cause pain,
so if you are worried, see your GP.

Some Symptoms of Advanced (Metastatic) Breast
Cancer

Stage 4, or metastatic breast cancer is the most advanced
stage of this disease. Metastatic breast cancer is defined as having spread
beyond the breast and underarm lymph nodes into other parts of the body.

• bone pain (bone metastases) 
• shortness of breath (lung metastases) 
• drop in appetite (liver metastases) 
• unintentional weight loss (liver metastases) 
• headaches, neurological pain or weakness (could be brain metastases) 

Inflammatory Breast Cancer (IBC) – Aggressive and
Unusual Symptoms

One type of breast cancer that does not appear in
lumps is called inflammatory breast cancer (IBC). This aggressive cancer grows
in sheets instead of lumps, and it invades nearby skin, resembling a rash. It
will not respond to topical creams or antibiotics, and should be treated very
promptly. Symptoms:

• a sudden increase in mature breast size (as much as a cup size in a few
  days) 
• itching in the skin of the breast that is continuous and not relieved by
  pills or creams 
• a change in the breast skin color, resulting in pink, red, or dark-colored
  areas 
• breast is excessively warm to the touch, or harder or firmer than usual 
• unusual pain, which occurs out of the regular cycle 
• sometimes a change in skin texture, similar to the skin of an orange 
• breast skin ulcers (later stage IBC)

Symptoms of Breast Cancer
Recurrence

Recurrence of breast cancer is classified as local,
regional, and distant. A distant recurrence is the same as advanced (metastatic)
breast cancer. A local recurrence is breast cancer that has returned after
treatment, in or close to the original tumor location. It can often be
effectively treated. Regional recurrence may be in the chest wall muscles, or in
lymph nodes located beneath your sternum, just above your collarbones, and
around your neck.

Local Recurrence Symptoms:

• a small lump or rash in the excision scar, on or under the skin

Regional Recurrence Symptoms:

• swollen lymph node in the same armpit where cancer was previously removed 
• swollen lymph nodes above collarbones or sides of neck

A New Tumor Is Not a Recurrence

If a new tumor appears and has a different pathology than the original breast
cancer, it is not considered a recurrence. It is called a new primary, and can
occur in a different area of the breast that was originally affected, or in the
opposite breast. A new cancer is diagnosed and treated independently from the
original tumor.