Let's Talk About Breast Cancer Signs and Symptoms
Sometimes you have no clue there's a problem until your doctor says those words. But if you have a sense that something's not right, the symptoms here could be indications it's time to get things checked out.
Many breast cancers cause no noticeable symptoms. That’s why regular screening with mammography is so important. But if anyone’s going to catch it before a machine does, it’ll probably be you: Research shows that about 40 percent of women find their own cancers, either during self-examination or just by noticing something accidentally. If you're wondering what exactly to look for, the list below will help. Remember, having one or more of these symptoms doesn’t necessarily mean you have breast cancer!
Our Pro Panel
We went to some of the nation's top experts in breast cancer to bring you the most up-to-date information possible.
Joy'El Ballard, M.D.
OB-GYN and Author of "Loving Me, Myself and Her: Through Perimenopause & Beyond"
Jonathan Stegall, M.D.
The Center for Advanced Medicine
William Owens, M.D.
Aurora BayCare Medical Center Comprehensive Breast Care Center
Green Bay, WI
Typically, breast cancer tumors are hard with irregular edges while cysts and non-cancerous tumors called fibroadenomas are smooth. But it’s still important to get it checked since occasionally cancerous tumors can feel smooth as well.
It’s possible but not likely. The good news is that only 6% of women have metastatic, or stage IV, cancer when they are diagnosed because most begin to receive treatment before that point. See your doctor right away to be sure.
There are some things that you and your doctor can't detect with your own eyes. Mammograms can find tiny breast changes such as lesions called calcifications that you aren't able to see or feel from the outside. Breast cancer is most treatable when it’s found early.
It could indicate that the breast cancer cells have spread to nearby lymph nodes (this can also cause hard lumps or swelling near your breastbone or under your arms). Get it checked but don’t stress too much—if the cancer spreads to your lymph nodes it doesn’t necessarily mean it has spread to other organs.
The symptoms below are fairly common and do not necessarily mean you have breast cancer. In many cases, there are other benign explanations for what's going on. But because breast cancer is easiest to treat when found early, it’s always a good idea to bring any concerns to your M.D.’s attention. Here are five of the most common signs and symptoms of breast cancer to look out for.
1. Look for Lumps and Bumps
Many women have naturally lumpy breasts, or tissue that feels rope-like. That’s normal. But a new lump or one that feels different than the surrounding tissue needs to be checked. There are several different types of lumps you may find in your breast, most of which are benign (non-cancerous). More details:
These noncancerous tumors are not dangerous and don’t increase your risk of developing breast cancer in the future.They’re typically smooth-feeling and rubbery and move around in your breast if you press on them.
Fibroadenomas might get bigger during pregnancy or certain times of your monthly cycle and shrink after menopause. They are the most common type of noncancerous breast tumor and usually occur as a single lump, although it’s possible to develop multiple fibroadenomas.
Breast cysts are round or oval lumps filled with fluid. So-called “simple” cysts typically feel firm, round, and smooth and might come and go with your period. They can feel sore or tender. “Complex” or “complicated” cysts may be more irregularly shaped and look more suspicious on an ultrasound. A doctor may want to remove some cells or fluid from the cyst with a thin needle—technically called a needle biopsy—to positively rule out cancer.
Cysts are most frequent in women in their 40s, but they can happen at any age. About one-quarter of all breast lumps turn out to be cysts. They typically don’t need treatment, but a doctor may recommend draining the fluid to reduce swelling and tenderness, or in rare instances, surgical removal.
Your breasts are made up of fatty tissue, and sometimes, it can start to disintegrate and form painless, round, non-cancerous lumps filled with oily fluid. This condition is called fat necrosis, and is more likely to happen in women with large breasts or after a serious injury or breast surgery.
These lumps don’t usually hurt, but they can make the skin around the area look bruised, red, or thickened. Fat necrosis can also look like cancer on a mammogram, so a biopsy might be needed to rule it out. Usually no treatment is required. But, like a cyst, these lumps may be drained or surgically removed if they’re uncomfortable.
Cancerous lumps are often hard and painless, with irregular edges. Some cancers can feel smoother and round, however, so it’s important to get any new lump checked out by your doctor.
2. Watch for Swelling Near the Armpit or Collarbone
Lymph nodes, part of the body’s self-cleaning and infection-fighting system, can be found in your neck, under your arms, near the collarbone, and in many other places around your body. If breast cancer cells have spread to nearby lymph nodes, it may cause hard lumps or swelling near your breastbone, collar bone, or under your arms.
Any lump like this should be checked, especially if the swelling doesn’t go away, or isn’t associated with tenderness or pain. And don’t panic: If it is breast cancer and it has spread to nearby lymph nodes, that doesn’t necessarily mean the cancer is advanced or has reached other organs in the body.
3. Keep an Eye on Nipple Issues
Sometimes breast cancer can cause a nipple to invert or “sink” into the breast. A rare type called Paget disease also causes a rash on the nipple and areola.
Breast cancer can also sometimes cause fluid to leak from the nipples. This is not the same as the milky discharge from both breasts that’s common if you’re pregnant and for up to a year after you’ve stopped breastfeeding. Thyroid problems, pituitary tumors, and some medications can also cause nipple discharge.
What you’re looking for here is clear or bloody fluid that may come from just one breast instead of both or is associated with a lump. If that’s you, get yourself checked out ASAP.
4. Be Aware of Changes in the Shape of Your Breast
If one of your breasts looks different than normal, or different than your other breast, pay attention. Tumors can make your breast look bigger or take on a new shape. Breast cancer can also cause the skin on the breast to pucker or dimple.
One type of breast cancer, known as inflammatory breast cancer (IBC), can make your breasts sore, hard, inflamed, and red—and can cause the skin to look rough like an orange peel. IBC is rare (only 1 to 5% of all breast cancer cases in the United States), but it’s aggressive. Younger women are more likely to be diagnosed with IBC than older women, and black women are more likely to have IBC than white women.
5. Don't Ignore Breast Pain
Most breast cancers do not cause pain, but there are some exceptions to this rule. If you have any soreness or tenderness that doesn’t go away and doesn’t seem to be linked with your menstrual cycle, especially if it’s only in one breast, talk to your doctor.
What Are the Symptoms of Advanced Breast Cancer?
When cancer cells spread to other parts of your body, that’s known as stage IV, or metastatic, breast cancer. The most common places for metastatic breast cancer to spread to are the lungs, bones, liver, and brain.
The vast majority of breast cancers are found before this point—only 6% of women have metastatic cancer when they are diagnosed. Also important: Having any of these symptoms does not mean you have stage IV cancer, either. It’s important to talk with your doctor to figure out what’s going on. Here are some of the basic symptoms.
Symptoms of spreading to your lungs:
chronic chest infection
coughing up blood
shortness of breath
Symptoms of spreading to your bones:
severe back pain with numbness in legs and/or incontinence
Symptoms of spreading to your liver:
pain on right side of abdomen
lack of appetite
Symptoms of spreading to your brain:
weak or numb limbs
memory problems and/or unusual behavior
When Should I Call My Doctor?
If you notice something is “off,” it’s better to be safe than sorry. Definitely get any new or unexplained changes in your breasts checked out by a doctor. Most insurance plans—including high-deductible and government-subsidized policies—offer yearly “well-woman visits” at no charge. If you’re uninsured, consider a free or low-cost checkup from a county health clinic or Planned Parenthood, or a low-cost video visit through Doctors on Demand, Zoomcare, PlushCare, or similar services.
What to Expect at the Doctor’s Office
Your doctor will use a couple of different methods to check for breast cancer, including a clinical exam to feel for lumps or other concerning changes. If necessary, the next step will be an imaging test and then, if needed, a biopsy.
Mammogram. Most likely, you’ll start getting regular screening mammograms in your 40s, although if you are at increased risk for breast cancer, you may need to start earlier. These imaging tests looks for masses or small white dots known as calcifications. If a doctor suspects breast cancer, they will order a diagnostic mammogram to further explore any changes in the breast.
Ultrasound or MRI. Sometimes, the doctor will want to get a more-detailed picture of your breast and will order an ultrasound or magnetic resonance imaging (MRI) to get more information about a suspicious lump or spot.
During a biopsy, the doctor will take a bit of fluid or tissue from the breast—either through a needle or sometimes a scalpel—and test it for cancer.
Take a deep breath—all of these signs and symptoms probably feel scary, but remember, they might not be breast cancer at all. Try not to stress too much until you've talked to your doctor. And if it does turn out that you have breast cancer, know that there are tons of treatments available to you. Read more on that here.
- Fibroadenomas are not dangerous: Breastcancer.org. (2018). “Fibroadenoma.” breastcancer.org/symptoms/benign/fibroadenoma
- Fat necrosis characteristics: American Cancer Society. (2019). “Fat Necrosis and Oil Cysts in the Breast.” cancer.org/cancer/breast-cancer/non-cancerous-breast-conditions/fat-necrosis-and-oil-cysts-in-the-breast.html
- Characteristics of cancerous breast lumps: Mayo Clinic. (2018). “Suspicious Breast Lumps.” mayoclinic.org/diseases-conditions/suspicious-breast-lumps/symptoms-causes/syc-20352786
- Swelling near armpit or collarbone: Cancer Research UK. (2017). “Symptoms of Advanced Breast Cancer.” cancerresearchuk.org/about-cancer/breast-cancer/advanced/symptoms
- Changes in the size, shape, or feel: American Cancer Society. (2019). “Breast Cancer Signs and Symptoms.” cancer.org/cancer/breast-cancer/about/breast-cancer-signs-and-symptoms.html
- Symptoms of metastatic breast cancer: Cleveland Clinic. (n.d.). “Metastatic Cancer.” my.clevelandclinic.org/health/diseases/17224-metastatic-cancer
- Inflammatory breast cancer information: National Cancer Institute. (2016). “Inflammatory Breast Cancer.” cancer.gov/types/breast/ibc-fact-sheet