7 Early Warning Signs of Breast Cancer

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If you do your breast exams regularly and get your mammograms every year or two, you probably think you're being proactive about breast cancer. The problem is, looking for lumps isn't as easy as it sounds. Studies show that breast lumps often aren't detectable by feel (they're not "palpable," in doctor-speak) until they're at least 10 to 15 millimeters -- the size of a dime -- and then only 48 percent of the time. It's really not until a lump is 20 mm or more that you're likely to feel it. Meanwhile, mammograms also miss approximately one in ten tumors, and they're less reliable in younger women and women with dense breast tissue.

So what works to catch breast cancer early? Science is hard at work on the problem: In spring 2012, researchers in Canada announced the invention of a sophisticated new computer software system capable of analyzing mammograms for "architectural distortion" -- subtle but specific patterns in breast tissue that can appear more than a year before the development of a lump. But that technology is years away from general use. In the meantime, top breast cancer experts say women should become as familiar with their own bodies as possible and be alert for any changes. Here are some of the earliest and most surprising signs and symptoms of breast cancer, as described by the women who know: breast cancer survivors themselves.

Breast cancer warning sign #1: Pain in the breast or chest

Whether it's an ache, throb, twinge, or sharp stab, pain or discomfort in the breast or chest area isn't a good sign.

How it feels: One breast cancer survivor describes the pain she brought to her doctor's attention as a "sharp pain that comes and goes." Another describes it as "a mild electric sensation that went from my left breast to my right nipple."

What causes it: Breast tumors can take many different forms; there can be a single lump, but there can also be an area of scattered seed-like tumors or an amorphous shape with multiple tentacles extending into the tissue. The tumor might also be directly behind the nipple or in one of the milk ducts. All of these growths cause different types of pain and discomfort.

Scary stat: As many as 30 percent of all breast cancer tumors aren't lumps, which makes them harder to detect.

What to do: Keep track of when, where, and how often the pain occurs. Tell your doctor, being as specific as possible. Make sure to be clear that this is a new symptom, different from any other sensation (such as the sore breasts of PMS) you've experienced before. If your doctor diagnoses mastitis and prescribes antibiotics (a typical response to breast pain), take the full cycle. But if the pain hasn't gone away, inform your doctor and ask for additional tests. Many women are told repeatedly that they have mastitis before they're able to make clear to the doctor that this isn't the case.

Breast cancer warning sign #2: Itchy breasts

This symptom, primarily associated with inflammatory breast cancer, is often missed. Some women may be sent home with topical medications for a rash by their doctor, when in fact they have inflammatory breast cancer.

How it feels: Extremely itchy -- the type of itch you might have with poison oak or ivy, which makes you feel like you absolutely have to scratch. Except scratching doesn't help, and neither do the creams nor ointments that typically relieve itchiness. Your breast may also feel irritated, or the skin may be scaly or dimpled like cellulite.

What causes it: Fast-growing cancer cells block blood and lymph vessels that feed the skin. The normal flow of lymph through breast tissues is impeded, and fluid builds up in and under the skin.

Scary stat: The median age of diagnosis for inflammatory breast cancer is 57 (54 among African-American women), and it's typically more aggressive than other types of breast cancer, with a five-year survival rate of 34 percent.

What to do: If the skin of your breast looks odd or your breasts feel different, see your doctor right away. If the doctor suggests a skin ailment or an infection and sends you home with a prescription, return immediately if your symptoms don't go away.

Breast cancer warning sign #3: Upper back, shoulder, and neck pain

In some women, breast cancer is felt in the back or shoulders rather than in the chest or breasts. For this reason, spine specialists routinely look for the presence of tumors when treating chronic back pain that's unrelieved by physical therapy.

How it feels: The pain, which is typically in the upper back or between the shoulder blades, is easily confused with sore muscles, a pulled tendon or ligament, or osteoarthritis of the spine. The difference is that it doesn't go away with stretching muscles or changing position. Bone pain feels like a deep ache or throbbing.

What causes it: Most breast tumors develop in the glandular tissue of the breast, which extends deep into the chest, close to the chest wall. If tumor growth pushes backward toward the ribs and spine, the resulting pain may be felt in the back rather than in the breast. A common place breast cancer metastasizes, or spreads, is to the spine or ribs, becoming secondary bone cancer.

Scary stat: According to one study, the five-year survival rate for breast cancer patients whose cancer has spread to the bone is only 8.3 percent, compared with an overall survival rate of 75 percent.

What to do: Pay close attention to how back pain feels. If it doesn't go away with rest, stretching, or physical therapy, see your doctor. Keep the doctor informed if back pain continues despite treatment, and request a bone scan.

Breast cancer warning sign #4: Changes in breast shape, size, or appearance

Contrary to popular belief, not all breast tumors cause a hard lump close enough to the surface to be noticeable. "Instead of feeling a lump, I noticed that one of my breasts was more oval than the other, hanging down lower and sort of sticking out to one side," says a California woman who discovered she had breast cancer at the age of 42.

How it feels: Because this change is one of appearance more than feel, your partner may notice it before you do. Or you might become aware of it as you put on your bra or look at yourself in the mirror at the gym.

What causes it: Tissue growth that's deeper in the breast or masked by dense breast tissue may push out the shape or size of the breast without causing a noticeable lump. If you've been told you have dense breast tissue, be particularly alert for this sign.

Scary stat: Mammograms miss up to 50 percent of tumors in women with dense breasts.

What to do: Study the size and shape of your breasts in a mirror. Sit facing the mirror and look at both breasts dead-on, then raise your arms, turn sideways, and look from each side. If there's a difference in size or shape you haven't noticed before, bring it to your doctor's attention.

Breast cancer warning sign #5: A change in nipple appearance or sensitivity

One of the most common locations for a breast tumor is just beneath the nipple, which can cause changes in the appearance and feel of the nipple itself. In particular, nipple changes are often the giveaway for men with breast cancer.

How it feels: You may notice that one of your nipples sticks up less than it used to, or it might have become inverted, flattened, or indented. Women with breast cancer often recall that they noticed a decrease in nipple sensitivity, which is most likely to come to your attention -- or your partner's attention -- during sex. Another nipple change to take seriously is discharge when you're not breastfeeding, whether it's bloody, milky, or watery. The skin of the nipple may become crusty, scaly, or inflamed.

What causes it: Many breast cancers start in the milk ducts just under and around the nipple, affecting the nipple's appearance or causing pain or discharge. There's also a rare cancer, Paget's disease of the breast, that specifically strikes the nipple. A tumor in the milk ducts, just behind or to one side of the nipple, pushes the skin up around the nipple or pushes the nipple aside. As tumors grow, they may attach to -- and thus retract -- the skin or the nipple itself. The tumor might also cause irritation and infection, leading to discharge.

Scary stat: The American Society of Breast Surgeons recently released research that male breast cancer is typically identified later and is deadlier than breast cancer in women.

What to do: Because some women have naturally inverted nipples or have discharge during and post-pregnancy, a doctor won't necessarily notice this symptom. Since you're the one who knows best what your nipples look like, pay close attention to any changes and discuss them with your doctor. Mastitis is a common conclusion for doctors presented with nipple changes, in which case you'll be sent home with antibiotics. If they haven't cleared up the symptoms within ten days, go back and request further evaluation.

Breast cancer warning sign #6: Swelling or lump in your armpit

You know how the lymph nodes in your neck and throat can feel sore when you have the flu? Any pain in the armpit is a sign to check the area carefully with your fingers. A lump under the armpit is likely to be hard and attached to surrounding tissues, so it doesn't move when you touch it. Or tissue may feel thickened and dense compared with the armpit on the other side.

How it feels: Like a sore or tender spot under the arm. You may also feel a lump, though not necessarily. Affected lymph nodes may feel swollen or tender or develop a lump before a tumor is big enough to be felt in the breast itself. In some women, the swelling is more prominent under the arm or up under the collarbone.

What causes it: The lymph nodes in your armpit are where breast cancer spreads first, by way of lymphatic fluid that drains from the breast. Since the lymph nodes are the first place it's likely to metastasize, breast cancer is staged according to whether it's lymph-node positive or negative.

Scary stat: If breast cancer has spread to the lymph nodes, the five-year survival rate declines to 84 percent, as compared with 98 percent for node-negative breast cancer.

What to do: Colds, flu, and infection can also cause swollen lymph nodes, so if you're sick or have an infection, wait for it to clear up before you worry. But if a lump or tender spot in the underarm area persists for a week with no apparent cause, see your doctor.

Breast cancer warning sign #7: Red, swollen breasts

When your breasts hurt, it's easy to conclude that it's the typical soreness of PMS. And if your breasts feel hot or look reddened, you might suspect an infection such as mastitis. But these are also signs of inflammatory breast cancer.

How it feels: It's as if your breasts have a fever. They may feel swollen and sore, or the skin and underlying tissue may feel hot or look red or even purple.

What causes it: Inflammatory breast cancer is the most likely cause of this symptom. But breast tumors can also push on tissues, causing breasts to feel swollen and sore. In this case, you may also see, upon checking, that your breast is distended.

Scary stat: Once breast cancer has spread beyond the breast (stage IV), the average survival is less than four years. So it's extremely important to detect breast cancer as early as possible.

What to do: Call your doctor right away about any symptom that could be inflammatory breast cancer. If the pain is diagnosed as mastitis and you're prescribed antibiotics, you should feel better within a week to ten days. If you don't, call your doctor and request further evaluation.

Medically reviewed by Dr. Farrokh Sohrabi

Melanie Haiken

Melanie Haiken discovered how important it is to provide accurate, targeted, usable health information to people facing difficult decisions when she was health editor of Parenting magazine. See full bio

2 months, said...

So I’m 18, and about a year or so ago I found a lump in my left breast and it was diagnosed as a cyst, And I’m not noticing that brown like discharge has been coming out of my nipples, could this be a mos diagnosis?

2 months, said...

I'm 53, have no breast cancer in my immediate family and am not on HRTs. I had silicone breast implants nearly 17 years ago and had a yearly mammogram in May 2017. Nodules were noted on both nipples as well as a small cyst was noted in the left 3'oclock measuring 4.5mm. The nodules had benign imaging appearance. There was no evidence of ductal ectasia and no suspicious axillary lymph node. For the last month I've been experiencing periodic sharp, shooting pains both at night and during the day which are on the far left handside of my breast area which seem to be behind my breast area and difficult to point out exactly.

3 months, said...

I've been having severe pain behind my right nipple lately and my breast/nipple just dont feel right..different texture..sometimes the nipple inverts..just different, I will be 60 in august..my mother had breast cancer as did my aunt on my father's side. I'm faithful about my mammograms but not due for one til October. Should I go to my gyn?

5 months, said...

I’m 38 and last week developed an excruciating amount of pain in my left breast. Also, what looks like a pimple on my nipple that won’t pop. I went to my doctor and he has ordered a ultrasound and mammogram next week. I am scared to death! Tell me if this is normal! My doctor said he did not think it was anything to worry about but I am so scared. I have read so many articles about being misdiagnosed and then having inoperable cancer years later that I don’t know what to believe. Help me! And please keep me in ur prayers!

8 months, said...

I should start off by stating I'm 26 years old and have noticed a few "spots" for about 3 years or more.I have had a couple "dense" spots that are tender sometimes painful. They are in the left breast and the ultrasound today showed the non painful lumps around the armpit area was a cluster of cyst. But the part that worried me was the "dense tissue" on the 8 quadrant (middle of beast about an inch from nipple to chest area) it tender and painful. When I took my towel off and laid down with my arm above my head the tech was in shock because the lump was visible where my breast had fallen to the side. When she hit the camera on it she said she has never seen tissue dense as this before. This coming from a mammogram office examine breast everyday. It was awkward. She said at the end of the visit that I didn't have anything to worry about. Now being as young as I am and have already had surgery on my gallbladder and carpel tunnel and also having 5 polyps removed from my colon before I was 22. I feel I'm too young for the dense tissue in this state. My left breast is obviously different then my right. Being much denser and slightly smaller and little off shaped. But my grandmother was the same way so as I developed I kinda knew I would be....uneven. has anyone else hard of someone having an extremely dense area on one breast. My doctor said pain is nothing to worry about. But I been on the mirena for almost 5 years and haven't had a period in 4 years so I don't see how menstrual breast pain or cyst can relate. I have recently had pregnancy symptoms. light headed over heated feeling faint nausea throwing up breakfast almost every day for months. But all pregnancy test came out negative. I just got my bc switched back to the pill. 3 days ago. We are trying to see if that subsides my symptoms. There is definitely something wrong with my body the doctors are about to sweep it because of my insurance

10 months, said...

2 weeks ago I noticed a longish lump in my right armpit. It doesn't hurt, but it's hard. I'm not freaking out ;just curious if anyone else had this and what was the outcome. Cancer does run on my father's side. Grandfather died of pancreatic cancer , and my father has been battling colon cancer.

10 months, said...

I have been experiencing breast pain in my upper right breast for the last few months. I had a total hysterectomy 11 yrs ago and have not been on HRT in almost 7 yrs. my last breast exam showed mild calcium deposits. Very low grade and of no concern. I also have very dense breast tissue. I am 45 yrs old. The breast pain I experience in my right breast is in the upper breast area. If I bend over, sleep on my stomach, or on my left side where the breast would lay to the side, or on my back, it rends me to not be able to move. I have to literally roll out of bed just to get out of bed. If I touch the top of my right breast it is excruciating pain. It sometimes radiates to my shoulder blade or back. I do not feel any lumps or masses of dense tissue in the painful area either. Has anyone experienced this?

11 months, said...

Thanks for such a useful information. It is very necessary to identify the early symptoms of cancer. Cancer symptoms are often ignored by the womens. My mother-in-law is diagnosed with level3 beast cancer, her treatment is currently going on at breast cancer radiation Bronx(She is responding to the treatment very nicely. Hopefully she will get cured soon.

about 1 year, said...

Hi I'm 31 years old and yesterday I started having servere pain in my chest like a pulled muscle then I started checking my breast and my right breast feels like a lump near nipple and looks like its sunk in some can anyone give me advice I had a breast exam a few months back but plan on going to doctor monday

about 1 year, said...

Hi, I am a 50 yr old female, I have had a swollen lymph node under my right arm pit for 4 weeks approximately with no flu/cold symptoms or infections. The last week it has become very painful also my upper back and neck aches. I have also noticed the gland under my jaw has been enlarged for a few weeks. I've had lots of blood tests and I get results back in 2 days time. Does anyone have any ideas?

about 1 year, said...

hey im 25 and i am experiencing frequent pain that comes and goes inside my breast, for the past few days i was experiencing it just below my left breast next to the heart, but now is directly in the breast, could this be breast cancer??

over 1 year, said...

Hi my name is Diane and I am 58. My Mom died from breast cancer at 46. My last mammograms have been fine but I am divorced and recently got a guy friend, I am very dry down there so my Gynecologist ordered me progesterone cream that I have been using for 2 months now. (Nomore) all the sudden I hogtie this sharp pain under my left breast, now it seems like it is directly in my left breast. When I move quickly it's stabbing and burning sensation! What do you think?

over 1 year, said...

Hello, I am a 42yr old. I have been experiencing sharp pain in one of my breast, I went to my Gyne after my self exam and realizing that I have a large area with nothing there, like, NO TISSUE! The Gyne began the exam and got to that portion of my breast and snatched his hand back, saying he hadn't seen this before... He said that it appears that my breast tissue really is gone... Has anyone ever heard of this happening? I have never had any cysts or anything in that particular breast. I have not had periods in over 3 years now. I did nurse my daughter (17) for 3 years when she was born. Mammogram is over the wknd. Thanks for anyone words you can offer.

over 1 year, said...

Hello. Ian 23yrs old...frm 3days iam having pain in my breast n frm tdy even I am having upper back pain...n I haven't got my periods.last period was on sep 12