A sharp shooting pain in the breast - is it cancer? A watery discharge from both nipples - is it serious? An itchy patch near your armpit, or an itchy nipple - can breast cancer start with a simple itch?
The following quick guide to breast symptoms will help you determine whether it’s best to call the doctor now, or wait and watch awhile.
You’re in the shower, and while soaping up you feel a breast lump. What do you do?
First step: don’t panic
The vast majority of the time a woman discovers a lump in her breast, it’s not cancer. Many women have naturally lumpy breasts; when you run your hands gently along your breasts, they may feel gravelly; or like you have marbles or other "growths" under your skin. So long as that’s how they always feel, it’s fine. When one lump SUDDENLY stands out from the rest, and becomes dominant, then you need to pay attention.
So, what to do if you feel one of these suddenly dominant breast lumps?
Second step: don’t panic!
According to Dr. Susan Love, the well-respected author of Dr. Susan Love’s Breast Book, only 1 in 12 dominant lumps found in premenopausal women is cancerous.
If the lump you feel is soft and squishy, and you can move it around a bit, it’s probably a cyst.
If the lump feels firm, and you can move it around a bit, it might be a fibroadenoma, a benign (non-cancerous) lump.
If it feels firm, and you can’t easily move it around, it might be a cyst or fibroadenoma that’s deep inside your breast; or (least likely), it might be cancer.
So, when to call the doctor?
If you’re premenopausal, it probably makes sense to wait through one menstrual cycle; if the lump diminishes in size or disappears, it’s probably responding to hormonal changes in your body, which points to it being a cyst or fibroadenoma.
If, after one cycle, the lump is still there, it’s worth a call to the doctor. You’ll want to find out exactly what the lump is, even if there’s no need to treat it.
If you’re postmenopausal and not taking hormones, any new lump wouldn’t be hormone-related. And, new breast lumps in postmenopausal women have a 50/50 chance of being cancerous; so it’s best to call the doctor as soon as possible.
What if you feel a lump in your armpit?
A new lump in your armpit is almost always a swollen lymph node. Lymph nodes are your body’s ER; they take care of medical emergencies (infections) by filtering bacteria and other foreign substances out of your blood. And in the course of doing this, they can become infected themselves, and swell up.
Have you been sick recently? Had an infection of some kind? That lump in your armpit may be part of your illness, and it should gradually fade away as you start to feel better.
However, since breast tissue can extend up into your armpit, an armpit lump could actually be breast cancer - especially if it’s closer rather than farther from your breast. So treat an armpit lump the same as you would a breast lump (above), waiting to call the doctor if you’re premenopausal; or calling right away if you’re postmenopausal, or haven’t been sick lately.
A rash on your breast, itchy or not, is almost always a skin problem of some kind - especially if it’s on both breasts. Maybe you changed your shower gel or laundry detergent; perhaps you’ve been swimming a lot more than usual.
If you can’t think of anything obvious that might have caused a rash, keep your eye on it; if it disappears, fine. If it doesn’t disappear over the course of several weeks, or if it gets worse (especially if it gets worse suddenly), call the doctor. In very rare cases, a breast rash can be a symptom of inflammatory breast cancer.
If you experience an itchy breast, and it feels like a surface itch, check out the information on breast rash above. Even when no rash is visible, itching can be caused by the same factors that cause a rash.
If the itching feels more internal - you definitely don’t feel like you can scratch it - you might try waiting it out. Sometimes it’s a temporary nerve issue; or it might be hormonal, related to your menstrual cycle.
If the itching gets worse, however, and your breast shows outward signs of change - swelling, rash, redness, or dimpling of the skin - then it’s time to call the doctor. You might have mastitis (a breast infection), or inflammatory breast cancer.
You might occasionally notice discharge from one or both nipples. If the discharge happens only when you squeeze your nipples; and if it’s milky, or perhaps light green or light yellow, it’s most likely hormonal. Stop squeezing your nipples, and see if there’s any spontaneous discharge; if not, and if there are no other breast changes, it’s probably fine to just wait for it to go away.
If the discharge is in one nipple; if it happens without squeezing (spontaneously); and if it’s sticky and clear, or brown/red, then you should get it checked by a doctor.
Your nipples are very sensitive; and the same conditions that might cause breast rash and itching (above) could affect your nipples the same way. Unless you see an outward change in your nipple or areola (the colored part around the nipple), it’s probably OK to just wait it out.
Nipple pain, redness, scaliness, oozing
If both nipples are irritated - they might be red, oozing, and scaly, usually with accompanying itching and pain - you probably have a skin condition, like eczema. Your doctor can prescribe something to help treat it.
If the symptoms are in just one nipple, and the problem doesn’t go away with treatment, then you might have a rare type of breast cancer, Paget’s Disease of the Breast. Don’t let your doctor ignore this possibility; if your "eczema" doesn’t respond to treatment, then ask for further tests (a nipple biopsy) to rule out cancer.
Are you experiencing breast pain? If so, would you characterize the pain as soreness, sharp pain, achiness"… Or all three?
Whatever your answer to the questions above, your pain is almost certainly unrelated to breast cancer. If the pain comes and goes throughout the course of your menstrual cycle, it’s called cyclical pain, and is due to hormonal changes.
If the pain is steadier, or comes and goes randomly without any pattern, it’s probably related to some other issue. Costochondritis, arthritis where your breastbone and ribs meet, can feel like pain in your breast. Large cysts can also be painful; an ultrasound can determine if your pain is cyst-related. And phlebitis, a painful blood vessel infection, can happen in your breast as easily as it can elsewhere in your body.
If the pain is accompanied by obvious breast changes - swelling, redness, heat, and/or itching - then you’d want to see the doctor as soon as possible. You’re probably dealing with mastitis, a painful breast infection; but you could also be seeing symptoms of inflammatory breast cancer.
Finally, if the pain is in your left breast, consider the possibility you might be dealing with a heart issue. Any pain on the left side - chest, breast, shoulder, arm, or neck - should be taken seriously.
So, when should you contact a doctor about breast pain?
Unless it’s accompanied by signs of infection, that’s totally up to you.
Clearly, if the pain is severe, see a doctor ASAP; severe pain can signal something serious. You can approach milder pain as you would any other minor ache. If you’re fortunate, painful breasts will respond to Tylenol, or an anti-inflammatory medication like Motrin. If OTC medications don’t help, then you’d probably want to see the doctor to find out what else might be done.
One of the oddest sensations women feel in their breast is an elusive vibrating or tingling. Many women describe it as feeling like the "silent ring" (vibration) of a cell phone. Some say it feels like when an arm or leg "goes to sleep."
The good news is, this symptom is almost never associated with breast cancer. The not-so-good-news? No doctor has been able to identify for sure what causes this uncomfortable sensation, or what to do about it.
When you see a change in your breast, it can be difficult trying to separate normal concern for your health from unwarranted panic about cancer.
But remember - your risk of getting breast cancer is always very low. Breast cancer fear is real, but it can be broken down and dealt with. Knowledge is power; once you know your breasts and understand changes you might see, you’ll be well on the way to conquering cancer fear.
PJ Hamel is senior digital content editor and food writer at King Arthur Flour, and a James Beard award-winning author. A 16-year breast cancer survivor, her passion is helping women through this devastating disease. She manages a large and active online survivor support network based at her local hospital and shares her wisdom and experience with the greater community via HealthCentral.com.