Symptoms of breast cancer are by and large, pretty non-specific. The vagueness of these symptoms makes it very difficult to decide, if you do find a problem in your breast, whether or not you do actually have a serious problem.
The six most common symptoms of breast cancer, which are all explained below, are:
- A lump in the breast
- Bleeding from the nipple
- Dimpling or tethering of the skin of the breast
- Retraction of the nipple
- Alteration of the shape of the breast
- A rash on the nipple
The most common of these symptoms is a lump in the breast – and this is why this particular symptom is in the top position. But of course every lump in the breast is not malignant – far from it in reality – making a lump probably the most unhelpful and non-specific of all of the symptoms of breast cancer. Only about 10% of lumps in the breast actually turn out to be malignant.
There are only 3 commonly found lumps and so if you get a breast lump it is almost certainly going to be one of these: a Fibroadenoma, a cyst and of course a cancer in the breast.
The Triple Assessment is the routine your surgeon uses, in order to decide which one of these 3 lumps you actually have. The Triple Assessment has 3 parts as the name implies:
- An examination by the doctor
- Imaging – (mammography and breast ultrasound)
- A breast biopsy
The second of the symptoms of breast cancer is bleeding from the nipple. Bleeding from the nipple may be due to pre-invasive cancerous cells in the ducts or ‘pipes’ of the breast but actually this is one of the rarer symptoms and statistically only about 8% or less of women with bleeding from the nipple will actually have a breast cancer.
The next of the symptoms of breast cancer is dimpling or tethering of the skin. Of the 6 symptoms, this is actually one of the most accurate. If you are over 50 years of age and you notice that the skin is attached to a lump – you can pinch the skin over the lump and you will see that it does not move easily over it, or it dimples – then this is a worrying sign. Another way of showing that this IS one of the symptoms of a cancer in the breast, is to raise your arms above your head in front of a mirror and then slowly lower them. If you see that the skin gets caught, or tethered over or near the lump as you move your arms – remember to do this slowly – then this is one of the symptoms of a breast cancer.
The next symptom is retraction of the nipple. Simple nipple INVERSION is very common – this is where the nipple, instead of sticking outwards is folded inwards. You can tell that this is NOT one of the symptoms of breast cancer as benign (non-cancerous) nipple inversion is ‘slit-like’ in appearance. Nipple retraction, one of the more likely symptoms of breast cancer, is where the nipple and surrounding skin (the areola) is pulled backwards by the cancer. This is NOT slit-like in appearance.
The next of the symptoms is alteration of the shape of the breast. This again is fairly non-specific as many benign or non-cancerous lumps can also deform the shape of the breast. But if you see a COMBINATION of tethering, dimpling or nipple retraction with an alteration in the shape of the breast then you should be highly suspicious that you do indeed have a cancer in the breast.
The last of the six most common symptoms of a breast cancer is a rash on the nipple. This is a condition called Paget’s Disease. Paget’s Disease (named after Sir James Paget) is an ulcerating and destructive or erosive condition of the NIPPLE, although it may also extend onto the aureola – the darker skin around the nipple. Paget’s Disease of the Nipple is due to the presence of an underlying cancer in the breast and the diagnosis is confirmed by a biopsy of the ulcerated area. Paget’s is one of the most clear-cut symptoms of breast cancer.
Paget’s should not be confused with a scaly rash of the aureola where the nipple is normal – or ‘spared’. A scaly rash on the areola ONLY, with a normal nipple is usually eczema (dermatitis), a condition mostly treated by simple steroid creams.