Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast. Some breast cancers are invasive, which means they have spread from where they started in the breast ducts or lobules to surrounding breast tissue. Invasive breast cancers are called infiltrating ductal carcinoma and infiltrating lobular carcinoma. There is also a type of breast cancer that occurs only within the milk ducts and is referred to as non-invasive or in situ breast cancer. Non-invasive breast cancers include ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS). Ductal carcinoma in situ starts in a milk duct but does not go through the wall of the duct into the surrounding tissue. Lobular carcinoma in situ starts in a milk-producing gland called a lobule, but does not invade the surrounding breast tissue.
When you hear the term “breast cancer,” it generally refers to a malignant tumor that has developed from cells in the breast. Usually breast cancer either begins in the cells of the lobules, which are the milk-producing glands, or the ducts, the passages that drain milk from the lobules to the nipple. Less commonly, breast cancer can begin in the stromal tissues, which include fatty and fibrous connective tissues.
Invasive cancers have spread beyond where they started and into other surrounding tissue. Noninvasive cancers haven’t spread beyond where they started and are often referred to as pre-cancers or carcinoma in situ (CIS).
Painless lump or thickening
Most lumps aren’t cancerous. But it’s best to have them checked by your doctor. Most breast lumps are painless, but some are painful.
- A benign (not cancer) lump may be:
- hard or soft
- different from the rest of the breast tissue
- easy to feel and move around under the skin
- sometimes get smaller or go away during your menstrual cycle
Change in size or shape of breast
- A change in the size or shape of your breast.
This may be the first sign of breast cancer. For example, you may have a new lump or thickening in or near your breast or underarm. This is not a normal process of aging and should be taken seriously. It is not a sign of a benign cyst.
Change in skin texture such as puckering or dimpling
- You or your loved one might have skin texture changes. When the skin puckers or dimples—for example, if it looks like an orange peel—this may be a sign of breast cancer. This texture change can also appear as redness or rash on the breast, scaly or pitted skin, swelling of all or part of the breast, and swelling of the breast that is only on one side.
- Another common symptom is a lump that you can feel. Most often these lumps are found in either underarm (axillary) lymph nodes or in the area near your collarbone (supraclavicular lymph nodes), but they can sometimes be felt in other areas as well.
Change in nipple position or nipple retraction
Change in nipple position or nipple retraction include the following:
- Your nipple is retracted (pushed in) – it may look like an inverted nipple.
- Your nipple points inward or downward.
- A part of your breast turns inward toward the wall of your chest.
- Part of your breast is pulled inward toward the wall of your chest.
- Nipple pointing in a direction other than straight ahead
Discharge other than breast milk
Other breast discharge that is not milk can be alarming. Discharge may be clear, yellow, green or brown, and can come from one or both nipples. It may come out of your nipple on its own, without squeezing it. Or it may happen after you squeeze the nipple or have a mammogram.
It’s important to find out what is causing this discharge other than breast milk. That’s because bloody discharge in women who are not pregnant or breastfeeding is often a sign of breast cancer.
The most common causes of non-milk breast discharge are:
- Hormone changes: These changes might cause your body to produce a milky substance from your breasts when you’re not pregnant or breastfeeding—a condition called galactorrhea (say: guh-lack-tuh-REE-uh). This can happen during pregnancy and while taking birth control pills as well as after menopause. Galactorrhea is also sometimes caused by medicines used to treat high blood pressure, depression and Parkinson’s disease. Some herbs and supplements do the same thing, including fennel seed, aniseed oil and dong quai root (also known as Chinese angelica).
- Benign tumors: A benign tumor made up of glandular tissue doesn’t usually cause symptoms such as pain, but it can cause bloody discharge
Nipple itching, burning, or tenderness
While many women first notice a change in their breast because of a lump, nipple itching, burning, or tenderness can also be an early sign of breast cancer. Any of these can indicate inflammatory breast cancer (IBC), which causes the skin and tissues around the breast to become inflamed. IBC is more aggressive than other types of breast cancer and often grows quickly. It rarely gives warning signs such as lumps or masses until it’s spread beyond the breasts.
If you’re having any of these symptoms, talk to your doctor right away. If it turns out to be IBC, your chances of survival are better the sooner you start treatment.
Redness, swelling, scaling, darkening, or thickening of nipple or areola
Redness or swelling of the nipple, scaling or thickening of the skin, darkening of the area around the nipple (the areola), or ulceration can also be symptoms. Sometimes the nipple is retracted and dry.
If you notice any of these symptoms, talk with your health care provider. They are not necessarily caused by cancer and sometimes they may be a sign of another problem that needs to be treated. Your provider can do an exam to find out if it’s due to something other than cancer.
A skin ulcer that does not heal
A skin ulcer is a break in the skin that does not heal. Skin ulcers may be caused by injury, infection, inflammation, or cancer (such as breast cancer).
The best way to treat a skin ulcer is to find out its cause and treat it. Antibiotics are used to treat infections that cause ulcers. Surgery or medicine may be needed to remove an object stuck under the skin that causes an ulcer. Ulcers caused by cancer may be treated with surgery and/or radiation therapy. A doctor also can tell you how to care for an ulcer. It is important for you to keep your wound clean and covered so it will heal as quickly as possible. This will help prevent infection and other complications of the wound such as bleeding, additional pain, swelling, or scarring.
If you notice any of these signs or symptoms and notice them persisting for weeks to months, consult your doctor
- Breast lump (found by you or your doctor)
- Changes in breast: size, shape, texture of skin
- Inverted nipple (pulled inward instead of sticking out)
- Peeling, scaling, crusting or flaking of nipple skin
- Redness or pitting of the skin over your breast
- Swelling beneath your armpit
Why might you consider enrolling in a breast cancer clinical trial
If you are living with breast cancer, you may want to consider enrolling in a clinical trial. Clinical trials provide the opportunity to try out new treatments before they are widely available, which could mean having access to the latest potential therapies. If the treatment doesn’t work for you, you may have a chance to try something else.
Enrolling in a clinical trial can also help others by contributing to medical research and boosting the likelihood that new treatments will be developed and approved in the future.