”Breast cancer” is a terrible name! Do you know anything about such a terrible word? In early 2019, the National Cancer Center released data showing that the top incidence of malignant tumors in women is breast cancer, with an annual incidence of about 304,000. In the last decade, the mortality rate of breast cancer in our cities has increased by about 39%. And there is one characteristic of breast cancer among women in China: low age of incidence, with the peak age being only 35-49 years old! What are the early symptoms of a disease with such a high incidence and mortality rate? 1. Lumps 95% of breast cancer patients will have breast lumps. It can be one or multiple lumps; it can grow in any part of the breast; and the lump may be round, oval or even without boundary and irregular in shape; the texture is usually harder than normal glands, occasionally when the pathology belongs to a special type, the lump can be about the same texture as normal glands; the lump activity is sometimes good and sometimes poor. 2. Skin changes The ligaments under the skin of the breast are pulled during the growth of the mass, which can cause the skin on the surface of the mass to sink, forming a small “dimple”. Sometimes the growth of the lump affects the subcutaneous lymphatic vessels of the breast skin, causing blockage of the subcutaneous lymphatic vessels, resulting in thickening of the skin, similar to “orange peel”-like changes. Sometimes the lump grows and spreads to form new nodules under the skin, which appear as small, hard nodules with a reddish color around the lump, like small “satellites” around the lump. Sometimes the lump grows outward, gradually growing and breaking through the skin to form a “cauliflower”-like rupture, occasionally with blood and water flowing from the surface, or even pus and blood flowing out, sometimes with a foul odor. 3, nipple areola changes Deep nipple masses, along with the growth process, the milk ducts below the nipple invasion caused by the nipple flattening, depression, retraction, and even the nipple into the areola, resulting in areola deformation. There is a type of breast cancer that occurs specifically on the nipple, called nipple Paget’s disease, which is characterized by eczema-like changes on the surface of the nipple, repeated erosion, crusting, erosion and crusting again, sometimes accompanied by nipple itching or pain, and over time, the nipple will gradually become flatter and flatter, or even the nipple will disappear, and the entire areola will be a kind of “eczema”-like change. The entire areola is a kind of “eczema”-like change. Some women have sunken nipples since childhood, called “congenital sunken nipples”, which is different from the sunken nipples caused by breast cancer. 4. Nipple overflow Some breast cancers will cause nipple overflow (1.3-7% of all breast cancers), especially bloody overflow should be highly alert! When the amount of overflow is large, it will come out directly from the nipple without external force, but when the amount is small, it will be discovered only after squeezing the nipple or unintentionally finding blood or liquid stains in the underwear. Of course, breast cancer with nipple overflow as the only symptom is very rare, and most of them are accompanied by breast lumps. 5. Pain Most of the early stage of breast cancer is not accompanied by pain, which is why many people are diagnosed with breast cancer when the size of the lump is already not small. When the lump grows and affects the nerves, it will cause pain in the chest wall or armpit, or even pain in the back of the shoulder, and usually when breast cancer causes pain, the disease is not too early. Of course, breast pain caused by breast enlargement can be accompanied by any disease of the breast, so when breast pain occurs, the cause of the pain should be clarified. Breast cancer is scary because it can metastasize, especially to important organs, such as brain, liver, lungs and bones, which can affect the quality of life and even affect the life. When the cancer cells reach the lymph nodes in the armpit, the lymph nodes will swell and the structure will be destroyed, and the lymph nodes will move from one station to the next. So when lymph node metastasis occurs in breast cancer, it means that the disease is not early. There is a rare but serious type of breast cancer called “occult breast cancer”, which is a type of breast cancer with axillary lymph node metastasis as the main symptom, and patients usually find painless lumps in the axilla unintentionally, and only a few patients have local pain due to lumps involving the nerves. Axillary lumps may be single or multiple, or multiple lumps may be separated or adherent to each other and hard, and if the lump compresses the axillary vein, it may cause edema in the affected upper limb. In a small number of patients, distant metastases are already present at the time of consultation. According to the data of the 2019 Chinese Society of Clinical Oncology (CSCO) Annual Meeting on Breast Cancer, the 5-year survival rate of breast cancer patients in China has reached 83.2%, which has increased by 7.3% in the past 10 years, and the progress of breast screening and adjuvant therapy has made breast cancer no longer a “death sentence”. Special note: 1. The early stage of breast cancer is related to the size of the lump, the presence or absence of axillary lymph node metastasis and the presence or absence of other organ metastasis, while the malignancy is related to the pathological type of breast cancer; 2. There is no evidence to prove that the larger the breast is, the more likely it is to develop cancer or which side has a higher chance of developing cancer; 4, it is true that the non-breastfeeding breast has a higher chance of developing cancer than the breast after breastfeeding, so new mothers are advised to breastfeed as much as possible; 5, mammary gland hyperplasia is not cancerous, and “atypical hyperplasia” with a tendency to become cancerous is not something that can be detected by “touching” or “examination”. “A biopsy or post-surgical pathology is needed to determine this; 6. 7. When sudden diffuse enlargement of breast with red, swollen, hot and painful skin manifestation, inflammatory breast cancer needs to be excluded. For those who are at high risk of breast cancer, they should observe their breasts closely, see the article “Have your breasts been “enlarged””, which contains detailed information for those at high risk.