6 signs of breast cancer that aren't a lump

This page was reviewed under our medical and editorial policy by

Daniel Liu, MD, Plastic and Reconstructive Surgeon

This page was reviewed on March 31, 2023.

For decades, the medical community and the media have waged an effective awareness campaign about the signs and symptoms of breast cancer, educating the public about the importance of diligently monitoring their breasts for lumps.

That tactic has worked. Early detection of breast cancer has contributed to a 39 percent decline in breast cancer deaths in women from 1992 to 2020, according to the National Cancer Institute. While that’s an important step forward, many other abnormalities that may also indicate breast cancer are lesser known and discussed. Some, then, may be led to assume that no lump and no tumor mean no cancer, but that may be a dangerous conclusion to draw.

Visual breast cancer signs

When most people think about breast cancer symptoms, they think of breast lumps. But doctors say visual changes may be especially key in helping detect breast cancer early. Patients may notice some of these changes just by changing the way they look at their reflections in the mirror, says Cynthia Lynch, MD, Medical Oncologist at City of Hope Phoenix.

“You can see a lot of things just by looking at your breasts in the mirror. When your arms are by your side, you don't always see everything,” says Dr. Lynch, Breast Cancer Program Clinical Advisor for City of Hope. “Put your hands on your hips or raise them up. Having arms in two different positions while looking is also helpful.”

In this article, we’ll discuss the signs and symptoms of breast cancer, including:

If you believe you may be experiencing symptoms of breast cancer and want to schedule an appointment for diagnostic testing, or if you’re interested in a second opinion for breast cancer, call us or chat online with a member of our team.

1. Nipple changes

Changes in the nipple area may be a genetic malformation or alteration, but nipple retraction—when the nipple becomes inverted—may be a sign of cancer. If the nipple wasn’t inverted before and becomes inverted, consult with a doctor.

2. Bloody nipple discharge

Bleeding from the nipple may be limited and difficult to see, but if blood stains appear in a woman's bra, pay attention. Clear or milky secretions may result from normal physiologic changes during pre-pubertal stages. But if the secretions are unusual, bloody or continuous, speak to a health care provider.

3. Breast dimpling or thickening

Known in the medical community as peau d'orange (a French term meaning skin of an orange), any dimpling or thickening of breast skin that resembles an orange rind is a red flag. These symptoms are often associated with inflammatory breast cancer (IBC), a rare but aggressive disease that usually does not involve a lump and may not be detected by a mammogram. IBC symptoms are caused by cancer cells blocking lymph vessels in the skin.

Inflammatory breast cancer symptoms include:

  • Rash
  • Thickening of the skin
  • Shooting pain
  • Increased warmth in the breast
  • One breast appearing larger and feeling warmer and/or heavier than the other
  • Breast tenderness, pain or itching

Some changes are localized to the breast, upper abdomen or the rear part of the chest. Changes in color may be difficult to detect in African Americans and in obese patients with very large breasts. Patients may see changes in the breast from one day to the next, and skin changes may occur in less than six months.

Though IBC represents 1 percent to 5 percent of all breast cancers, it accounts for 10 percent to 15 percent of all breast cancer deaths.

4. A sore on the breast that's not healing

A red, scaly, flaky nipple, and any persistent skin change, including blood or fluid from the nipple, may be a sign of Paget’s disease of the breast, another rare form of breast cancer. This disease originates in the nipple. It’s not usually invasive and is most commonly diagnosed in patients in their 70s and 80s.

5. Swollen lymph nodes in the armpit

Some patients with breast cancer that has spread to the lymph nodes may have no symptoms in the breast or changes in the structure of the breast, but they feel something unusual under their arm. This may mean that cancer from the breast has traveled to the axillary lymph nodes, which are in the armpit. Affected nodes may also be in the lower part of the neck if the cancer is a little more advanced. Cancer cells often use the lymphatic system to invade distant organs.

It’s important to also remember that not all breast lumps are signs of cancer, a fact that underscores why it’s important for women to be familiar with the look and feel of their breasts. “Have an awareness of your breasts,” Dr. Lynch says. “You need to touch them to be aware. Breast self-awareness is the terminology now used instead of a self-breast exam.”

6. Breast pain with no lump

Breast pain when there’s no visible or physical lump may still cause concerns about breast cancer. Breast pain, also known as mastalgia, can be associated with many conditions, including:

  • Hormonal changes during menstrual cycle
  • Water retention, which may also occur during menstruation
  • Breast injury
  • Breast infection
  • Pregnancy
  • Breastfeeding
  • Medication side effect
  • Breast cancer

Breast soreness may be chronic in some women, but it typically resolves on its own.

While breast pain can occur with breast cancer, it’s often not a symptom. According to the American Academy of Family Physicians, the risk of breast cancer in patients with breast pain and normal breast exam and mammography results is about 0.5 percent.

IBC can cause pain and typically has no lump, but still only accounts for 1 percent to 5 percent of breast cancer cases in the United States, according to the National Cancer Institute.

Breast pain and the menstrual cycle also have a close relationship, with premenopausal women experiencing breast pain more than postmenopausal women.

If patients are experiencing pain in the left breast, since it’s situated slightly above the heart, it could indicate a potential heart problem. Chest pain related to a heart attack may occur in the middle of the chest beneath the sternum, and it can be mild or burning and sharp.

Gastrointestinal or musculoskeletal conditions may also lead to breast pain.

Breast cancer treatment options

Each breast cancer patient’s care team is led by a medical oncologist and may also include a breast surgeon, radiation oncologist, radiologist, pathologist and a plastic/reconstructive surgeon. Pathologists and oncologists are experienced and trained in tools designed to diagnose, stage and treat the many types of breast cancer, from early-stage ductal carcinoma in situ to complex diseases such as triple-negative breast cancer and IBC. Genetic counseling and genetic testing may also be available for qualifying patients.

A patient-centered care model is designed to help patients remain strong during breast cancer treatment. The multidisciplinary care team may recommend various evidence-informed supportive care services, including:

The entire team works together with a whole-person focus to personalized and comprehensive care.

If you believe you may be experiencing symptoms of breast cancer and want to schedule an appointment for diagnostic testing, or if you’re interested in a second opinion for breast cancer, call us or chat online with a member of our team.

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Show references
  • American Academy of Family Physicians (2019, December 18). Breast Pain in Women.
  • Salzman B, Collins E, Hersh L (2019, April 15). Common Breast Problems. Am Fam Physician. 99(8):505-514.
  • American Heart Association (2020, October 9). Symptoms of Heart Attack in Women and Men.
  • American Cancer Society (2021, January 12). Inflammatory Breast Cancer.
  • National Cancer Institute (2016, January 6). Inflammatory Breast Cancer.
  • U.S. National Library of Medicine (2020, December 7). Warning Signs and Symptoms of Heart Disease.
  • U.S. National Library of Medicine (2020, October 16). Breast Pain.