Breast cancer may not show any abnormalities in its early stages, making it difficult to detect, and it may be overlooked even at advanced stages. However, most breast cancers are associated with more or less abnormal changes. The most important thing is to be aware of the signs and symptoms of breast cancer and to learn how to check yourself to be aware of the “distress signals” from your breasts.
Breast swelling
A swollen breast is the most common symptom of breast cancer, and most breast cancer patients usually have a swelling in their breast sooner or later. However, the presence of a lump in the breast does not necessarily mean it is cancer. Most lumps that appear in the breast are benign. Most swellings in breast cancer have the following characteristics:
- Occurring unilaterally in the breast, mostly in the upper outer part of the breast;
- Often appearing singly and less often with multiple swellings at the same time;
- Firm to the touch with indistinct borders;
- Feels adherent to surrounding tissues and is not easily pushed;
- There is usually no obvious pain.
Confined glandular thickening in the breast
Sometimes, tissue that is slightly thicker than the surrounding tissue is palpated in the breast, and if there are no other manifestations, it is a breast enlargement in most cases. However, if the boundaries of the thickened tissue are unclear and the size cannot be measured, there is also the possibility of breast cancer. For breast tissue thickening that persists for a long time, is not related to the menstrual cycle, or continues to thicken and increase in extent with time involvement, it should be taken seriously.
Breast skin changes
An “orange peel change” in the skin of the breast can be very suggestive of breast cancer. This is often seen when the lesion is superficial or invades surrounding tissues, and as a result of the pulling of the lesion and the resulting edema, the skin of the breast appears to have many small indentations, like an orange peel.
Breast pain or local discomfort
Pain is not a characteristic sign of breast cancer. Breast pain can have many causes, such as painful swelling of the breast during the menstrual cycle, and can also be caused by infection, trauma, and cysts. Therefore, it is not possible to determine whether cancer is present based on pain or not.
In the early stages of breast cancer, there is usually no significant pain. As the disease progresses and the lump increases in size, the breast may become painful to varying degrees. There is also a manifestation similar to mastitis, where breast pain is accompanied by swelling, redness, and fever, at which point it is important to be alert to the possibility of inflammatory breast cancer.
Some women do not feel a breast swelling and do not have significant pain, but always feel localized discomfort in the breast, especially in postmenopausal women who sometimes feel mild pain and discomfort in one breast, or a sinking, aching discomfort in the back of one shoulder, even affecting the upper arm. This condition also requires vigilance and may indicate breast cancer.
Changes in the nipple
The nipples are often pulled by the breast cancer lesion, so the nipples may look high on one side and low on the other. Sometimes the nipples can also be pulled downward and appear sunken, and it can be difficult to pull the sunken nipples out. Of course, many women can have nipple invagination themselves, so it is important to distinguish whether it is a recent change or has always been present.
Eczema-like changes in the nipple and areola
Eczema-like changes in the skin of one nipple and areola, such as redness, itching, and rash, may be due to eczema-like breast cancer, also known medically as Paget’s disease. This is a rare malignant tumor of the nipple and areola area. This breast cancer may also be followed by rough, thickened, flaky skin of the nipple and areola area with fluid exudation, followed by gradual erosion, repeated crusting and skin peeling after erosion, and slowly flattening and disappearing nipples.
Of course, the nipple and areola area is one of the areas that are prone to eczema. However, if eczema on the nipple or areola is not effective after more than 2 weeks of symptomatic treatment, or if it recurs repeatedly, it should be taken seriously and the possibility of breast cancer should be considered.
Papillary overflow
Most nipple discharge is normal. Normal nipple discharge is more often bilateral and may occur during pregnancy, some time after stopping breastfeeding, when the breast is irritated by friction, etc., or when it is squeezed. Of course, nipple discharge can also be caused by benign conditions such as cysts, infections, and ductal dilation of the breast.
However, nipple discharge can sometimes be a symptom of breast cancer. The color of the discharge is generally not helpful in determining whether it is normal. Both abnormal and normal nipple discharge may be clear, yellow, white, or green, but bloody discharge must be abnormal. If nipple discharge is accompanied by a lump in the breast, or if the breast s x-ray is abnormal, breast cancer is more likely.
Lumps in the armpit
A swelling in the armpit may be inflammation, paronychia, etc., or it may be a benign tumor, a malignant tumor, or a lymph node metastasis from a malignant tumor.
Tumors account for a large proportion of axillary swellings, including some benign tumors such as lipomas, nerve sheath tumors, and parametrial fibroadenomas, and malignant tumors such as malignant lymphomas and liposarcomas, which are less common but more alarming. Lymph node metastasis from some cancers may also lead to palpable swelling in the armpit.
The most likely and first lymph node metastasis in breast cancer is axillary lymph node metastasis. Even if no definite lesion is felt in the breast but an axillary mass is found, it should be seen immediately for further investigation. The lymph nodes that are enlarged, hard, scattered and pushable in the armpit may be metastases from breast cancer, and as the disease progresses, the lymph nodes may gradually fuse and adhere to and fix the skin and surrounding tissues, and metastatic lymph nodes may be felt on the clavicle and in the contralateral armpit.
In summary, breast cancer has a variety of presentations and no fixed characteristic presentation, making early detection difficult. The first thing you need to do is to make sure that you have a good idea of what you are doing.