Signs: Nipple discharge, breast skin dimpling, flaking skin. See your doctor immediately if you have any concerns.
Breast Cancer Symptoms
Breast Health Guide
Breast cancer is the second biggest cause of cancer death in women in America (lung cancer is the first). Fortunately since the 1990s the death rates have been declining with particularly large decreases noted in women younger than 50. This is believed to be connected to earlier rates of detection due to widespread screening as well as increased awareness of breast self-examination and improvements in medical treatments. Screenings such as mammograms tend to find breast cancer before it causes any symptoms. Breast cancers which are found by physical examination are usually much more advanced and are likely to have spread beyond the breast. The size of a lump and how far cancer has spread are important factors in determining the prognosis and breast cancer survival rates. For this reason, early detection is critical.
The most common physical sign of breast cancer is a lump or mass. A breast lump which is rock-hard, painless and has irregular sharp edges is likely to be cancerous. However breast cancer lumps can also be soft and rounded. For this reason it is important to have all lumps checked out by a doctor as soon as possible. Fortunately 9 out of 10 turn out to be benign (non-cancerous) after a biopsy. Most benign lumps are:
Cysts: Fluid filled sacs of tissue which are common and usually quite harmless.
Lymph Node Swelling
Occasionally breast cancer spreads to the underarm lymph nodes causing a lump or swelling in the armpit, even before the original tumor in the breast is large enough to be felt. Swollen lymph nodes may be one of the first things a doctor notices and this can lead to an early breast cancer diagnosis. A breast biopsy, taking a sample of axillary (underarm) lymph nodes, will be necessary.
Inflammatory breast cancer is a rare form of breast cancer (1-4 percent of cases) which causes the whole breast to look inflamed and sore. The breast can become swollen, increasing a full cup size within a few days. It looks red, firm and hot to touch. Other possible symptoms include pitted dimpled skin, thickening of the breast skin, a lump in the breast and a retracted nipple. Inflammatory breast cancer can appear quite suddenly which is why it may be mistaken for mastitis (an infection of the breast).
Breast pain (and nipple pain) is very common, particularly around a woman's period time and is not usually due to cancer. Pain which comes and goes is not something to worry about, but persistent pain should be checked, particularly if there is no obvious cause. If a women is taking estrogen replacement therapy or is still ovulating breast pain can occur as a normal cyclic change which brings fluid to the breasts, stretching and irritating nerve fibers. This sort of pain often only starts to appear when a woman is in her 30s or 40, when the balance of hormones begins to be slightly askew. Another common cause of breast pain is a cyst. Very rarely is breast pain a sign of cancer. However, it can be - which is why breast pain that continues for more than 6 weeks should be evaluated. The doctor may ask is pain present in both breasts or just one? Pain in both breasts is almost never cancer. Does the pain get worse before a period or is there a cyclical pattern? Is pain limited to one location (common to cysts) or does it radiate throughout the breast? Are there any other symptoms such as discharge, lumps or changes in the breast appearance? Very often pain disappears as mysteriously as it arrived.
Inverted nipples are nipples which appear indented into the breast, it is a condition some women are born with. It can be corrected with plastic surgery or some forms of stimulation. Retracted nipples on the other hand signify a change. When the nipples start as normal raised tissue but begin to pull inwards or change position, this is known as retracted nipples. Common causes include pregnancy, breastfeeding and breast infections like mammary duct ectasia or mastitis. It may also be an indication of breast cancer. If retraction has occurred ask your doctor to examine you, particularly if only one breast nipple is affected. An ultrasound or mammogram can help determine the cause of the change.
Discharge is noted in about 5 to 12 percent of breast cancer cases. Nipple discharge in a woman who is not pregnant is not necessarily abnormal. One or both breasts may produce a discharge either spontaneously or by squeezing the nipples. Discharge may look yellow, green, brown, clear or bloody. Any discharge not related to pregnancy should be investigated by a doctor.
Paget's disease is a rare form of breast cancer which normally affects the nipples first. Most cases are discovered in postmenopause women but can occur in women as early as 20. The nipples appear red, scaly and mildly irritated. Paget's disease is often mistaken initially for eczema. In an advanced stage the itchiness worsens, the nipples may tingle and become hyper sensitive. There may be nipple retraction and discharge. In breast cancer staging, discharges indicate a more advanced stage.
The breast starts to appear dimpled and uneven, rather like cellulite and the skin pores might be enlarged. This could be a sign of breast cancer, but other innocent causes can produce the same effect. To check your breast for dimpling, raise your arms as high as you can to stretch the skin. Any dimpling will become more apparent. Dimpling caused by cancer is usually a late sign, and suggests an inflammation or malignant mass below the skin. A doctor will check for any other signs such as nipple discharge or nipple retraction. Prominent visible veins on the surface of the breast should also not be ignored. This is also a common sign of breast cancer recurrence.
Where cancer has progressed from the breast to other parts of the body, is said to be 'metastatic' (stage 4). Metastatic breast cancer can cause:
• Bone pain throughout the body.
If a breast lump has been removed by surgery the woman will be closely monitored by doctors for subsequent years for signs of recurrence. Recurrence symptoms can show themselves locally, around the spot where the lump was removed or regionally, in the chest muscles, lymph nodes around the neck, collarbone and sternum. If cancer develops in the opposite breast from the one that was originally treated, it is probably not a recurrence. Cancers which develop on the other side usually represent a new cancer rather than a recurrence.
Local Recurrence Symptoms
Regional Recurrence Symptoms
If it becomes metastatic, symptoms can appear in other parts of the body (image), such as the bones, lung, brain, liver, or in lymph nodes far from the breast. If you would like more information there are lots of breast cancer books online to purchase.
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