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6 Warning Signs of Breast Cancer

Even if you get regular mammograms, knowing possible cancer signs is important

Early breast cancer detection is key to saving lives.

In a perfect world, no one would ever get breast cancer. In the next best world, all breast cancer would be caught at the earliest, most treatable stage — a point at which most people have no symptoms and cancers in women are typically found by screening mammograms. But even among women who carefully follow screening guidelines, the first sign of breast cancer can be a lump or other change in the breast.

That’s why it’s so important, cancer experts say, for women to know their breasts, notice changes and get them checked out promptly.

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“You don’t want to get to the point where there are changes in the breast, if that’s possible,” says Karen Knudsen, chief executive officer of the American Cancer Society.

When women skip screenings, or cancers are missed or develop between mammograms, a quick reaction to possible symptoms can make a big difference in treatment outcomes, says Ethan Cohen, M.D., an associate professor of breast imaging at the University of Texas MD Anderson Cancer Center.

“We do see quite a few people who say something like, ‘Yeah, I felt this lump six months ago, and it just kept growing and growing,’ ” Cohen says. “Please don’t do that.”

These are among the changes that should trigger a call to your health care provider:

1. A new lump in your breast

That’s, by far, the most common sign of breast cancer, Knudsen and Cohen say. A painless, hard mass with irregular edges is most worrisome, but a soft, round or tender mass can sometimes be cancer as well, according to the cancer society.

Important to know: Most lumps are not cancer. They can be benign cysts or normal breast tissue that feels lumpy. Monthly hormonal cycles and the approach of menopause can create lumpiness as well.

2. Thickening or swelling of the breast

Even if you don’t feel a lump, if your breasts are normally the same size and one suddenly looks larger, you should get it checked out.

3. Swollen lymph nodes under the arm or near the collarbone

This can precede breast changes due to cancer in some women. Swollen lymph nodes are part of the body’s response to infection or injury — or even the COVID-19 vaccine — so they often are a sign of another condition, but still worth a visit to your doctor.

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4. Skin changes on the breast

The skin may be itchy, red, scaled, dimpled or puckered. In some cases, it might resemble an orange peel.

5. Changes in nipple appearance

The nipple may retract inward or seem pulled to the side.

6. Nipple discharge

Any discharge that isn’t breast milk is a cause for concern. The discharge could include bleeding.

Should you do self-exams?

About 65 percent of breast cancers in the United States are diagnosed in early stages, while still confined to the breast, Knudsen says. Such early breast cancers are unlikely to have outward signs or symptoms, she says.

But the fact that one-third of breast cancers are diagnosed later, when signs and symptoms are more likely, raises a question: Should you do regular breast self-exams to detect those changes as soon as possible?

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Although monthly self-exams were once widely recommended, studies found that they did not increase the early detection of breast cancer or lower death rates for women at average risk for breast cancer.

Today, many doctors recommend that women simply pay attention to how their breasts normally look and feel and how they change, during monthly menstrual cycles and through life changes such as pregnancy, breastfeeding, menopause and aging.

“It’s important for each woman to know what her normal is,” Cohen says. In general, he says, women should seek medical attention for “anything that they’re pretty sure wasn’t there before and persists over the course of a week or so.”

He adds that some women at high risk, such as those who have previously had breast cancer or have a strong family history or known genetic risks, might also have regular breast exams by a doctor to try to catch changes as quickly as possible.

Women who get regular mammograms, as 65 percent to 76 percent of women in the United States do, should be just as vigilant as those who’ve missed some screenings — as many U.S. women did during the early days of the COVID-19 crisis, Knudsen says.

If a woman finds a lump or other change, she says, “it’s the right time to go to their provider, even if they’ve had a mammogram only three months before … timing is irrelevant.”

How often do you need a mammogram?

Guidelines on how often women should get screening mammograms vary. Expert groups call for women to get them as early as age 40 or as late as 50, then to repeat them every year or every two years up to at least age 74. Knudsen says it’s important for every woman to talk to her doctor about the best screening plan for her, considering her health history, family history and other factors.

What happens if you find something?

Most women who show up at a doctor’s office with a breast lump or other worrisome change will get a diagnostic mammogram, Cohen says. That’s a more thorough and focused version of the familiar test used for screening. In addition, women with symptoms should expect an ultrasound exam of the affected breast, he says. 

Most often, the testing does not turn up breast cancer. When it does, women and their doctors can start to work on a treatment plan.

What about men?

Yes, men can get breast cancer. Though men account for less than 1 percent of breast cancer cases in the United States, risk rises with age, just as it does in women. In 2022, about 2,710 men will be diagnosed with the disease and about 530 will die from it, according to the American Cancer Society.

There’s no breast cancer screening program for men, so paying attention to possible symptoms is especially important for them, Cohen says.

The symptoms are the same as in women, and lumps are, by far, the most common, he says. Because men have less breast tissue, the usual first symptom is “kind of like a little rock on the chest wall” that may not be visible but is easy to feel, he says.

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