How Do I Know If My Breast Lump Is Cancer? Warning Signs

According to the American Cancer Society, warning signs of breast cancer include:

• Painless and hard lump in the breast or armpit 
• Watery or bloody nipple discharge 
• Red crusted area over breast or nipples
• Constant pain or discomfort in the breast
• Dimpling over breast skin or a rash that does not subside
• Changes in the shape or size of the breast
• Sinking in or inversion of the nipple or upward-facing nipple
• Unexplained weight loss

Breast cancer is one of the most diagnosed cancers in women and accounts for about 30% of all cancers in women. Breast cancer can start in any part of the breast and may affect either the ductal or lobular cells or even the connective tissue in between.

Common types of breast cancer include:

• Ductal carcinoma: Most common type of breast cancer that occurs in the epithelial cells lining the milk ducts
• Lobular carcinoma or adenocarcinoma: Develops in the lobules or ducts (milk glands) of the breast
• Invasive breast cancer: Breast cancer that has spread to surrounding breast tissues.
  • Triple-negative breast cancer: Aggressive type of invasive breast cancer in which cancer cells lack estrogen or progesterone receptors and produce little to no HER2 protein
  • Inflammatory breast cancer: Aggressive invasive breast cancer in which cancer cells obstruct lymph arteries in the skin, giving the breast an inflamed appearance

Less common types of breast cancer include:

• Paget’s disease: Starts in the ducts and spreads to the skin of the nipple and areola
• Angiosarcoma: Starts in cells that line blood vessels or lymph vessels
• Phyllodes tumor: Develops in the connective tissue (stroma) of the breast

Nonmodifiable risk factors

• Advancing age 
  • Women aged 30 to 40 years: 0.49%-1.55%
  • Women aged 50 to 60 years: 2.40%-3.54%
  • Women older than 70 years: 4.09%
• Genetic mutations
• Increased breast density
• Family history of breast cancer
• Personal history of breast or ovarian cancer
• Precancerous breast conditions, such as duct ectasia or Paget’s disease
• Ethnicity (Caucasian women are more likely than African American women to develop breast cancer)
• Early start of menstruation
• Late menopause
• Radiation to the thoracic area

Modifiable risk factors

• Alcohol
• Smoking
• Lack of physical activity
• Obesity (especially after menopause)
• Having your first child after the age of 30
• Abstaining from breastfeeding
• Hormone replacement therapy
• Prolonged oral contraceptive pill use
• Stress or anxiety
• Exposure to certain carcinogens

Breast cancer survival rates are highest when detected at an early stage. Prognosis depends on the stage of cancer, response to treatment, and whether the cancer is HER2 positive or negative:

• Stage 0 or stage I: 99%
• Stage II: 93%
• Stage III: 72%
• Metastatic or stage IV: 27%

Breast tumors that have spread to other regions of the body are difficult to cure.

Regular self-examinations for lumps can help with early detection. Other screening options for breast cancer include the following:

• Mammograms: An X-ray examination that exposes the breasts to a low dose of ionizing radiation to capture images of the inside of the breasts
• Ultrasound: Creates images of the inside of the breasts using sound waves that help determine if a breast lump is solid or cystic
• MRI scan: Assesses breast tumors that are not visible on mammography or ultrasound, especially in women with thick breast tissue
• Positron-emission tomography (PET) or CT scan: Nuclear imaging technique that combines PET and CT scans to highlight the anatomic site of abnormal metabolic activity inside the breasts
• Scintimammography: Examines a breast abnormality using small quantities of radioactive material, a special camera, and a computer
• Biopsy: Involves removing cells or tissues to check for signs of malignancy

In order to detect breast cancer early, it is critical to examine your breasts regularly. This is the best way to spot symptoms early when they are most treatable.

Things to look for when conducting a self-examination of your breasts include:

• Painless lump or mass with irregular edges
• Redness or swelling
• Dimpling or puckering of the skin
• Changes to the nipple
• Pain in breast

Treatment of breast cancer is determined by the size, stage, and spread of the tumor.

• Surgical treatment
  • Lumpectomy: Removal of the cancerous breast tissue and a margin of tissue around it
  • Mastectomy: Removal of the entire breast
  • Sentinel node biopsy: Removal of lymph nodes that are the first to get lymph drainage from the tumor
  • Axillary lymph node dissection: Removal of more lymph nodes if cancer cells are detected in the sentinel lymph nodes
  • Contralateral prophylactic mastectomy: Removal of healthy breast tissue to reduce the risk of recurrence
  • Breast reconstruction: Done after breast removal for aesthetic purposes
• Radiation therapy: Intense bursts of radiation are used to eliminate cancer cells.
• Chemotherapy: Medications are used to destroy cancer cells following surgery if there is a high chance of recurrence.
• Hormone therapy: Synthesis of estrogen and progesterone hormones is inhibited as these can drive tumor development.
• Complementary and alternative medicines: Supplementary therapies can help minimize side effects, relieve pain, and boost the immune system through:
  • Acupuncture
  • Homeopathic medicine
  • Dietary supplements
  • Probiotic therapy
  • Massages or yoga