Breast cancer symptoms

Many of the breast cancers are diagnosed much earlier than they can produce any symptoms. Routine use of mammogram helps women to identify the breast cancer long before it can cause any symptoms. In the early stages breast cancer may be asymptomatic and women may notice only a breast lump. As the breast cancer progresses the cancer cells can invade in to the surrounding normal structures and other distant organs and this may lead to development of symptoms. Any one or more of the following may occur during various stages of progression of breast cancer.

• A lump (mass) in the breast, these lumps are most commonly painless
• Swelling or thickness of the breast
• Redness, swelling and or pain in the breast
• Lump in the arm pit area due to the spread of breast cancer to the lymph nodes in that area
• Areas of warmth or redness in the breast
• Development of asymmetry of the breast
• Inversion or changes in the appearance of the nipple
• Flattening or indentation on the skin of the breast. This may indicate a change in the underlying structures.
• Scaling or redness of the skin on the breast
• Unusual dimpling in the breast which may indicate adhesion to underlying structures
• Discharge from the breast or nipple. This can be clear, dark or bloody in nature.
• Burning, itching or scaling of nipples.
• Pain or tenderness in the breast or underarm area. If this does not relive overtime possibility of breast cancer should be considered
• Infection or inflammation of breast
• Development of breast abscess
• Bone pain may occur during the late stages of breast cancer due to involvement of bone
• Change in the mental status, seizure, and neurological events can occur in the late stage of the disease due to involvement of brain or spinal cord
• Jaundice may occur in the later stages of breast cancer due to the involvmenent of liver or surrounding structures.
• Chest pain and difficulty in breathing may occur in the late stages of the disease due to involvement of lung and surrounding structures.

Early breast cancer symptoms

Most common symptoms of breast cancer are explained in detail in the following section.

Abnormal mammogram

      With the increasing number of women receiving annual screening mammograms, more and more patients are diagnosed with breast cancer through screening mammograms. These women typically have no symptoms. Some of them may be getting a mammogram because of some suspicious symptoms.

Breast lump

     This is the commonest presenting problem in a patient with breast cancer. Patient or physician may feel a lump in the breast and majority of patient will not having any symptoms. About 70 percent of breast cancers are diagnosed this way. It is to be remembered that all breast lumps are not breast cancer. It is impossible for a woman or a physician to know for certain whether a breast lump indicates breast cancer until further investigations like a mammogram, ultrasound or biopsy is performed. Breast biopsy involves taking a small sample of breast tissue and examining it under a microscope to determine whether it contains cancer cells. However, There are certain features of the lump that may suggest that the lump is cancerous or benign before definitive diagnostic procedures like a biopsy is performed. The following findings may suggest the lump to be breast cancer and in the absence of these finding a benign breast lesion is more likely.

• The lump is firm and hard on examination
• Margins of the lump are not clearly identifiable
• Lump does not move freely and is fixed to the chest or breast tissues
• Skin over the lump is showing a dimple or attached to the deeper tissues
• Skin Lump is associated with a bloody nipple discharge
• Multiple lumps are not felt
• No similar lump in the opposite breast

The following findings on the other hand would suggest a lump to be non-cancerous

• Lump is soft to feel and yielding to mild pressure
• The lump is discrete and is easily distinguishable
• The lump moves freely within the breast tissue
• There are multiple breast lumps
• There is a similar lump on the other breast
• Lump disappears completely during some phase of menstrual cycle

Eczema like lesion near the nipple

     Eczema like lesion near the nipple may be a presentation of breast cancer called Paget's disease. Nienty percent of women who develop Paget's disease have an underlying breast cancer. Half of all women who have Paget's disease will have a breast lump that can be felt. Paget's disease first appears as a scaly red rash affecting the nipple and sometimes the dark area of skin surrounding the nipple (called the areola). The rash always affects the nipple first and may then spread to the surrounding areola. The area may start to bleed slightly. From the eczema-like rash the disease may progress to redness and inflammation of the breast crusting, ulceration or bleeding can develop. Some women may develop itching and or burning sensation. The inflamed tissue may start leaking serous fluid. The nipple may turn inwards (called inverted) and there may be a discharge, which may be clear, yellow or red in color. A breast lump may or may not be felt.

Inflammatory breast cancer

     Breast cancer may present as redness and swelling of the whole breast. This is a particularly aggressive form of breast cancer called inflammatory breast cancer and is usually associated with poor prognosis. Inflammatory breast cancer causes the breast to appear swollen red and inflamed. This appearance is often but not always caused by the blockage of cancer cells in the lymphatic vessels in the skin of the breast, preventing the normal flow of lymph fluid and leading to red, swollen breast which may resemble and acute infection or inflammation. Symptoms associated with breast cancer include redness, swelling, warmth causing the appearance of inflammation. The breast may have a changed appearance or shape and the skin of the breast may become thick, pitted or ridged causing peau d'orange appearance d'orange (resembling an orange peel). Breast may show a lump or a lump may be felt in the arm pit . Sometimes the skin develops ridges and small bumps that resemble hives.

Other breast cancer symptoms

     Breast cancer may also present as pain in the breast, breast enlargement, nipple inversion, skin inversion, erosion or other changes in the area of nipple.

Late breast cancer symptoms

     Advanced breast cancer symptoms may vary depending upon many factors. In the later stages of breast cancer it may spread to distant organs, by a process called metastatic spread. Advanced breast cancer symptoms will usually depend upon the organs involved with advanced breast cancer and also upon the degree of involvement of the distant organs. In this process the cancer cells will travel from the primary breast cancer site through blood or lymphatic system to organs like bone, liver, lungs, chest wall and brain. Once the cancer cells reach these organs, they will start growing in these tissues. Advanced breast cancer may cause variety of symptoms depending upon the tissue and the surrounding structures. Metastatic growth inside the chest may cause pain in the chest and breathing difficulties. Involvement of the chest wall may lead to pain and development of fluid within the chest cavity. Involvement of liver or surrounding tissues may lead to development of jaundice and liver failure. Development of metastasis in the bone may lead to bone pain and fractures. Involvement of the vertebral bones may cause pressure on the spinal cord and this may in turn lead to development of weakness, bladder dysfunction and paralysis. Involvement of brain by metastatic breast cancer may lead to altered mental state, seizures, head aches, and neurological events like weakness or stroke. Involvement of the skin may cause development of skin lesions usually as small lumps in the skin.

Other breast cancer information

Please visit our main breast cancer page or Breast cancer blog for more breast cancer information, chemotherapy information, information on breast cancer treatment and breast cancer news updates.

Did you know?
In the early stages breast cancer may be asymptomatic and women may notice only a breast lump. As the breast cancer progresses the cancer cells can invade in to the surrounding normal structures and other distant organs and this may lead to development of symptoms. Any one or more of the following may occur during various stages of progression of breast cancer.