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Breast cancer

Breast cancer symptoms

Perhaps the most recognized symptom of breast cancer is a lump or mass in the breast tissue. While many women go to the doctor after finding a lump, every woman should also be aware of other changes to the breast or nipple.

With the different types of breast cancer come a variety of related symptoms. For example, invasive ductal carcinoma (IDC), which forms in the milk ducts, may cause a distinct breast lump that you can feel. Invasive lobular carcinoma (ILC), which forms in milk-producing glands, may cause a thickening in the breast.

Early warning signs of breast cancer

Symptoms of breast tumors vary from person to person. Some common, early warning signs of breast cancer include:

  • Skin changes, such as swelling, redness, or other visible differences in one or both breasts
  • An increase in size or change in shape of the breast(s)
  • Changes in the appearance of one or both nipples
  • Nipple discharge other than breast milk
  • General pain in/on any part of the breast
  • Lumps or nodes felt on or inside of the breast

Symptoms more specific to invasive breast cancer are:

  • Irritated or itchy breasts
  • Change in breast color
  • Increase in breast size or shape (over a short period of time)
  • Changes in touch (may feel hard, tender or warm)
  • Peeling or flaking of the nipple skin
  • A breast lump or thickening
  • Redness or pitting of the breast skin (like the skin of an orange) 

It's important to remember that other, benign conditions may have caused these changes. For example, changes to the skin texture on the breast may be caused by a skin condition like eczema, and swollen lymph nodes may be caused by an infection in the breast or another, unrelated illness. Seeing a doctor for an evaluation will help you determine whether something you notice is cause for concern.

Invasive breast cancer symptoms

Invasive breast cancer symptoms may include:

  • A lump or mass in the breast
  • Swelling of all or part of the breast, even if no lump is felt
  • Skin irritation or dimpling
  • Breast or nipple pain
  • Nipple retraction (turning inward)
  • The nipple or breast skin appears red, scaly, or thickened
  • Nipple discharge
  • A lump or swelling in the underarm lymph nodes

Ductal carcinoma symptoms

Ductal carcinoma in situ (DCIS) does not cause any symptoms. Rarely, a woman may feel a lump in the breast or have nipple discharge. However, most cases of DCIS are detected with a mammogram.

Lobular carcinoma symptoms

Lobular carcinoma in situ (LCIS) does not cause symptoms and cannot be seen with a mammogram. This condition is usually found when a doctor is doing a breast biopsy for another reason, such as to investigate an unrelated breast lump. If a person has LCIS, the breast cells will appear abnormal under a microscope.

Inflammatory breast cancer symptoms

Unlike other breast cancers, inflammatory breast cancer (IBC) rarely causes breast lumps and may not appear on a mammogram. Inflammatory breast cancer symptoms include:

  • Red, swollen, itchy breast that is tender to the touch
  • The surface of the breast may take on a ridged or pitted appearance, similar to an orange peel (often called peau d’orange)
  • Heaviness, burning, or aching in one breast
  • One breast is visibly larger than the other
  • Inverted nipple (facing inward)
  • No mass is felt with a breast self-exam
  • Swollen lymph nodes under the arm and/or above the collarbone
  • Symptoms unresolved after a course of antibiotics

Unlike other breast cancers, inflammatory breast cancer usually does not cause a distinct lump in the breast. Therefore, a breast self-exam, clinical breast exam, or even a mammogram may not detect inflammatory breast cancer. Ultrasounds may also miss inflammatory breast cancer. However, the changes to the surface of the breast caused by inflammatory breast cancer can be seen with the naked eye.

Symptoms of inflammatory breast cancer can develop rapidly, and the disease can progress quickly. Any sudden changes in the texture or appearance of the breast should be reported to your doctor immediately.

For women who are pregnant or breast-feeding, redness, swelling, itchiness and soreness are often signs of a breast infection such as mastitis, which is treatable with antibiotics. If you are not pregnant or nursing and you develop these symptoms, your doctor should test for inflammatory breast cancer.

Male breast cancer symptoms

Male breast cancer symptoms can be similar to those experienced by women and may include:

  • Lumps in the breast, usually painless
  • Thickening of the breast
  • Changes to the nipple or breast skin, such as dimpling, puckering or redness
  • Discharge of fluid from the nipples

Metastatic breast cancer symptoms

Metastatic breast cancer symptoms depend on the part of the body to which the cancer has spread and its stage. Sometimes, metastatic disease may not cause any symptoms.

  • If the breast or chest wall is affected, symptoms may include pain, nipple discharge, or a lump or thickening in the breast or underarm.
  • If the bones are affected, symptoms may include pain, fractures, constipation or decreased alertness due to high calcium levels.
  • If tumors form in the lungs, symptoms may include shortness of breath or difficulty breathing, coughing, chest wall pain or extreme fatigue.
  • If the liver is affected, symptoms may include nausea, extreme fatigue, increased abdominal girth, swelling of the feet and hands due to fluid collection and yellowing or itchy skin.
  • If breast cancer spreads to the brain or spinal cord and forms tumors, symptoms may include pain, confusion, memory loss, headache, blurred or double vision, difficulty with speech, difficulty with movement or seizures.

Papillary carcinoma symptoms

Although papillary carcinoma may not be present, a routine mammogram may detect its development. For those who do experience symptoms related to this type of cancer, the following may be common:

Mass: Papillary carcinoma is most often detected as a cyst or lump of about 2 cm to 3 cm in size that may be felt with the hand during a breast self-exam.

Nipple discharge: About 50 percent of papillary carcinomas occur beneath the nipple, resulting in bloody nipple discharge.

Triple-negative breast cancer symptoms

Although triple-negative breast cancer does not look different from other breast cancer, it has several unique characteristics, including:

Receptor status: Tests that detect receptors for estrogen, progesterone and HER2 will be negative, which means hormone therapy, a traditional breast cancer treatment, is not effective. Instead, triple-negative breast cancer treatment options will include chemotherapy, targeted therapy and radiation.

More aggressive: A greater tendency to spread and recur after treatment compared to other breast cancer types. This risk decreases after the first few years following therapy.

Cell type and grade: Triple-negative breast cancer cells tend to be “basal-like,” meaning that they resemble the basal cells lining the breast ducts. The cells may also be higher grade, which means that they no longer resemble normal, healthy cells.

Next topic: What are the types of breast cancer?

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