
Breast cancer is the second most common cancer affecting women in the United States (next to some types of skin cancer that are most common). Screening tests can help you identify if you have the condition. However, it is also important to check if your breasts are normal and have no new changes that you find abnormal. These new changes may be the warning signs that may be suggestive of breast cancer.
Early signs and symptoms of breast cancer differ among patients. The most common sign and symptom is a new painless, hard lump or mass with irregular edges. Not all patients with breast cancer will develop the lump. Some patients may experience any of the early signs and symptoms that include:
- Swelling of the whole breast or some of its area
- Dimpling of the breast skin
- Nipple retraction (turning inward)
- Nipple or breast skin that is red, dry, flaking, thickened, or itchy
- Unusual discharge (other than breast milk) from the nipple
- Pain in the nipple or breast
- Swelling of the lymph nodes in the armpit (even without feeling a lump in the breast)
Although all these signs and symptoms may be caused by conditions other than breast cancer, it is recommended to schedule an appointment with your doctor. Your doctor will examine your breast and ask you to undergo tests to check if the signs and symptoms are due to breast cancer or other conditions.
Can breast cancer be detected early?
Some women with breast cancer may not develop signs and symptoms in the earliest stages of the disease. However, breast cancer can be detected early even before any symptoms appear. This is possible by screening tests. Screening tests means checking for the presence of cancer even if there are no symptoms of cancer. Screening tests can help find breast cancer early so that treatment can be initiated at the earliest.
It is easier to treat breast cancer successfully when it has been found early and is small. This is why taking a regular breast cancer screening test is so crucial.
The American Cancer Society recommends women with average risk to undergo a basic cancer screening test that includes a mammogram (an X-ray picture of the breast). The recommendations depend on their ages.
- Between 40 and 44 years: Women have the option of whether to go for a mammogram every year.
- Between 45 to 54 years: Women should get mammograms every year.
- 55 years and older: Women can consider a mammogram every alternate year, or they can choose to continue yearly mammograms. They should continue doing the screening as long as they are healthy and are expected to live for at least 10 more years.
Average risk women include women with
- No personal history of breast cancer.
- A strong family history of breast cancer or a genetic change related to an increased risk of breast cancer.
- No history of chest radiation therapy before the age of 30 years.

QUESTION
A lump in the breast is almost always cancer. See AnswerWhat are mammograms?
Mammograms are low-dose X-rays of the breast. A mammogram can often find breast changes before breast cancer develops enough to cause any symptoms.
To take a mammogram of your breast, your breasts will be placed on the flat surface of a mammogram machine and will be pressed by another flat surface of the same machine from above. This step is repeated to take side views of your breast. You may feel slight pain or discomfort that lasts for only a few moments during the procedure.
You can expect to get the results of your mammogram in a few weeks. Results will be reported by the radiologist to you and your doctor.
Mammograms are not perfect at diagnosing breast cancer. If there is some suspicious region in the breast, you will be asked to undergo a few more tests to confirm or rule out breast cancer. These tests include:
- Breast ultrasound (sonogram)
- Magnetic resonance imaging (MRI)
- Biopsy (removal of a piece of the breast tissue to check the presence of cancerous cells)
Before undergoing the screening test, make sure you discuss with your doctor its risks and benefits.
Leis HP. Early signs and symptoms of breast cancer. West J Med. 1980;133(3):225.
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What you should know about breast cancer
- Breast cancer is the most common cancer among American women.
- One in every eight women in the United States develops breast cancer.
- There are many types of breast cancer that differ in their capability of spreading (metastasize) to other body tissues.
- The causes of breast cancer are unknown, although medical professionals have identified a number of risk factors.
- There are 11 common types of breast cancer and 4 uncommon types of breast cancer.
- Breast cancer early signs and symptoms include
- a lump in the breast or armpit,
- bloody nipple discharge,
- inverted nipple,
- orange-peel texture or dimpling of the breast's skin (peau d'orange),
- breast pain or sore nipple,
- swollen lymph nodes in the neck or armpit, and
- a change in the size or shape of the breast or nipple.
- Breast cancer can also be symptom free, which makes following national screening recommendations an important practice.
- Breast cancer is diagnosed during a physical exam, by a self-exam of the breasts, mammography, ultrasound testing, and biopsy.
- Treatment of breast cancer depends on the type of cancer and its stage (0-IV) and may involve surgery, radiation, or chemotherapy.
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