There may be few obvious signs of breast cancer.
Breast cancer is the most common cancer in women (besides skin cancer), affecting about 12%, or 1 in 8, women in her lifetime. The American Cancer Society (ACS) reports that nearly 317,000 women and 2,800 men are diagnosed with breast cancer each year.
Often there will be no warning signs of breast cancer. For many patients, a breast cancer diagnosis only comes about via a routine mammogram or ultrasound meant to screen for this common malignancy.
“This is why screening is so important,” says Dr. Melissa L. Pilewskie, a breast surgeon oncologist at Memorial Sloan Kettering Cancer Center in New York City.
Current screening guidelines from the ACS recommend that:
— Women between ages 40 and 44 have the option to start having annual mammograms.
— Women 45 to 54 should get an annual mammogram.
— Women age 55 and older can choose to either continue with an annual screening or switch to every other year. Screening should continue as long as the woman is in good health and is expected to live at least 10 more years.
Mammograms are low-dose X-rays of the breast that can pinpoint areas of concern long before they become palpable or cause other noticeable symptoms. Mammography is widely available and considered the gold standard in detecting breast cancer early when it’s more treatable. Talk with your health care provider about your risk factors and family history of breast cancer to establish the right screening protocol for your unique situation.
While most breast cancers show up on a mammogram before symptoms develop, in some cases, there are symptoms you may notice. Stay aware and visit your doctor if you develop any of the following five signs that you might have breast cancer.
1. A lump
The most recognizable sign of breast cancer is the development of a palpable lump in the breast, according to a survey commissioned by the Ohio State University Comprehensive Cancer Center — Arthur G. James Cancer Hospital and Richard J. Solove Research Institute. Some 93% of survey respondents recognized a lump as a sign of breast cancer, but less than half of respondents could identify other symptoms, such as puckering of the skin, an inverted nipple and discharge.
While a lump could be breast cancer, it’s not always. Breast lumps are very common, and the vast majority are not cancer. The National Breast Cancer Foundation Inc. reports that 60% to 80% of breast lumps are noncancerous and can be caused by a range of conditions, such as benign fibroadenomas and cysts, which may go away or their own or be treated depending on the type, size and whether they’re causing discomfort.
If a lump does turn out to be cancerous, it’s usually a fast-growing cancer that tends to be at a more advanced stage when it’s found.
Although cancerous lumps tend to be more irregular in shape, the only way to know whether any lump is dangerous or benign is by asking your doctor, who will typically order a mammogram or an ultrasound to get a closer look at the lump and then possibly a biopsy to check the tissue itself.
“It’s certainly important to have a general awareness of the breast, your breasts, and to seek evaluation for any abnormal lumps or bumps or painful areas,” says Dr. Harold Burstein, institute physician at Dana-Farber Cancer Institute in Boston and professor of medicine at Harvard Medical School.
It’s best to get any new lumps in the breast checked by a doctor as soon as possible.
2. Unexplained size changes
Women’s breasts can change in size and shape based on hormonal fluctuations that occur normally across the menstrual cycle. But any substantial changes to the size or shape of one or both breasts could be cause for concern, particularly if these breast shape changes produce differences between the breasts, says Dr. Michele Carpenter, breast program director at St. Joseph Hospital’s Center for Cancer Prevention and Treatment in Orange County, California.
For example, if one breast suddenly goes up a cup size while the other remains the same, that calls for a visit to the doctor to find out what’s going on. It’s also possible for some breast cancers to cause the breast to shrink in on itself, so that it looks smaller or indented. If one breast looks swollen or seems to suddenly shift from more oblong to very round or vice versa, that’s also worth checking out.
While it’s very common and completely normal for women to have one breast that’s larger than the other and for breasts to grow or shrink depending on hormonal fluctuations related to menstruation, menopause and pregnancy as well as weight gain or loss, any sudden, pronounced or persistent changes to the size or shape of the breast should be cause for concern.
3. Dimpling, puckering, redness, flaking, itching and other skin changes
An aggressive but rare form of breast cancer called inflammatory breast cancer can sometimes trigger changes to the skin of the breast, creating a dimpled or puckered effect. Often, these changes are described as making the skin look like the surface of an orange and may be described as “peau d’orange.”
Inflammatory breast cancer also sometimes causes pain, irritation, thickening of the skin, swelling and redness in the breast. While pain is typically not associated with most types of breast cancer, tenderness or discomfort in the breast is worth getting checked out, as it could signal other issues related to hormones or infection.
Skin changes can also be a sign of another rare form of breast cancer called Paget’s disease. But skin changes like a rash or bruise can also be caused by eczema or a trauma, such as being hit with a ball. If those explanations don’t match your experience, it’s best to get any redness or discoloration checked out by a doctor.
4. Nipple discharge
If you’re not breastfeeding but you develop spontaneous discharge from the breast — whether it’s watery or thick, clear or bloody — “it’s important to seek evaluation,” Burstein says.
Such abnormal, spontaneous nipple discharge has a “low chance” of being cancerous, Carpenter says, but it should still be checked out because it could signal a hormonal problem or thyroid disease.
Galactorrhea, the medical term for spontaneous lactation that’s not connected to childbirth or nursing, can also be a sign of an infection or a side effect of certain medications, such as birth control pills and certain antipsychotic medications. In all cases, talk to your doctor.
5. Changes to the nipple
If the nipple becomes painful, retracts, flattens or inverts, so it looks like it’s turned in toward the breast, those changes can all be signs of breast cancer.
The skin around the nipple or areola — the darker pigmented skin surrounding the nipple — becoming scaly or dry like it’s been sunburned can also be a sign of trouble.
Be aware of your breasts and what’s normal for you.
The Centers for Disease Control and Prevention no longer recommends regular self-exams, but it’s still a good idea to get familiar with how your breasts look and feel so you’ll be able to notice symptoms such as pain, lumps and changes in size that could signal something’s wrong.
Breast tissue can naturally feel lumpy, bumpy and uneven, and there’s wide variation in what’s normal from one person to another. Here’s what you need to know about your breasts.
Breasts are comprised of:
— Fat
— Fibrous connective tissue
— Glandular tissue
— Nerves
— Blood vessels
— A complex network of milk-producing lobules and ducts
Flag anything that feels off, including persistent or unexplained breast pain.
Your health care provider will also conduct clinical breast exams to help spot palpable changes to the breast. For many women, a clinical breast exam is a standard feature of their annual physical or gynecological visit.
Know your breast cancer risk factors.
Gene mutations are a major risk factor for breast cancer that’s beyond your control. You’ll want to let your doctor know if you have a family history of breast cancer (especially in a first-degree relative, such as your mother or a sister) and if you are of Ashkenazi Jewish heritage, in which case you should consider getting genetic testing to check for mutations that increase your risk.
Other breast cancer risk factors you have no control over include having dense breasts and starting menstruation at a younger age. The longer you’ve had your period, the more exposure you’ve had to hormones that can trigger certain types of breast cancer.
But there are some lifestyle changes that may lower your risk of developing the disease:
— Avoid or limit alcohol consumption. Alcohol consumption has been linked to several types of cancer, including breast cancer, according to the National Cancer Institute. If you are going to imbibe, the ACS recommends that women have no more than one drink per day and men have no more than two drinks per day.
— Eat a healthy diet. Diets that are high in ultra-processed foods can increase inflammation in the body, which can contribute to the development of several types of cancer, including breast cancer. Focus on developing healthy eating patterns that include nutrient-dense whole foods, plenty of colorful fruits and vegetables, lean proteins and whole grains.
— Exercise enough. The ACS recommends adults get 150 to 200 minutes of moderate intensity or 75 to 150 minutes of vigorous intensity activity each week to lower cancer risk.
— Lose excess body weight. Obesity has been clearly linked with increased risk of several types of cancer, including breast cancer, the CDC reports. Shedding excess weight may lower risk. Surgical or pharmaceutical interventions may also be warranted for some individuals. If you’re struggling with excess weight, talk with your doctor about your risks and best options.
What to do if you find any signs of breast cancer
First, don’t panic. As noted, many of these changes to the shape, size or appearance of the breast may be caused by benign conditions or normal hormonal fluctuations.
Either way, if you’re concerned, call your doctor and set up an appointment to get it checked out. In many cases, it will be a false alarm.
Even if it’s not, breast cancer is a highly curable disease.
“There are more breast cancer survivors in the U.S. than survivors of any other cancer except skin cancer,” Carpenter explains.
Even after the symptoms have been investigated and treated, it’s best to keep up with routine breast screenings (unless you’ve had a mastectomy). Breast cancers caught earlier are much more treatable and have a higher survival rate. Make sure you’re up to date on your mammogram.
“If you’re young and don’t get regular breast imaging, see your doctor so they can start the process of imaging and referral if needed,” Carpenter says.
5 signs you might have breast cancer
1. A lump
2. Unexplained size changes
3. Dimpling, puckering, redness, flaking, itching and other skin changes
4. Nipple discharge
5. Changes to the nipple
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Breast Cancer Symptoms originally appeared on usnews.com
Update 05/28/25: This story was previously published at an earlier date and has been updated with new information.
