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How can I tell if I have breast cancer?

In the majority of women, breast cancer is first noticed as a painless lump in the breast. 

There are however other signs (Please click here to see more illustrations in Breast Cancer Signs – A Pictorial Essay) to be aware of:

Notice the right breast (the breast to your left in the photo) is larger than the left, of a different shape and there is a subtle lump projecting from the upper part of the right breast. The right nipple is pointing downwards when compared to the left.

Breast

• Change in size or shape

• Dimpling of the skin

• Lump or thickening 

The breast on the left (the breast to your right in the photo) shows the nipple being “drawn in” compared to the normal right nipple. There is some reddening of the skin to the side of the nipple in the left breast.

Nipple

• Blood-stained discharge (very rare)

• Rash on nipple and surrounding skin (also very rare)

• Nipple becoming inverted (turned inwards)

• Lump or thickening, especially if associated with nipple discharge 

• Nipple discharge is very common and is normally due to benign breast conditions. It is when there is a blood stained or bloody discharge, which should be a cause for concern. 

• In Paget’s disease of the nipple, there is an association with breast cancer. However, rashes on the nipple or around the nipple (areola region) may also be due to eczema. See your doctor to find out exactly what is the diagnosis. 

• Nipple inversion may be “normal” in some women and they may be born that way. However, if there is recent nipple inversion for no apparent reason, you should see your doctor immediately. 

Arm 

• Lump or swelling in the armpit

Pain

Pain in the breast or mastalgia deserves a special mention because this is one of the most common reasons causing a woman to start to feel her breast, become anxious and bring her to the doctor. 

However, pain in the breast is not usually a symptom of breast cancer.  In fact, many healthy women find their breasts lumpy and tender before menstruation and some types of benign breast lumps are painful. Pain is usually due to fibrocystic changes in the breast. 
 

Aberrations of Normal Development and Involution of the breast

This section on the symptoms and signs of breast cancer would be incomplete without a brief mention of the more common but benign conditions of the breast. In the course of investigation for breast cancer, these would be diagnosed.  

Over her lifetime, a woman can encounter a broad variety of breast conditions. These include normal changes that occur during the menstrual cycle as well as several types of benign lumps. It is only when the aberrations of normal development and involution (aging) are more pronounced that a “disease” state is reached and you complain of symptoms. What they have in common is that they are not cancer. Even for breast lumps that require a biopsy, some 80-90% prove to be benign. 

In the early reproductive period (about 15-25 years), owing to the changes in the different tissues of the breast, one may develop discrete lumps such as fibroadenoma. This condition may be multiple or a single lump can grow to a very large size. The breast may also “enlarge” more than normal (juvenile hypertrophy).

In the mature reproductive period (about 25-40 years), there may be exaggerated hormonal effects resulting in cyclical breast pain, lumpiness of the breast which may be localised and discrete.

In the involution period (about 35–55 years), depending again on which tissues are affected, cysts (fluid filled sacs) may develop, duct dilatation, periductal fibrosis and inflammation may occur. There may also be changes at the cellular level either with increased proliferation or atypical looking cells.

Know your breast cancer facts!

In many women, breast cancer is first noticed as a PAINLESS lump in the breast.