From Pam Stephan,
Your Guide to Breast Cancer.
FREE Newsletter. Sign Up Now!

About.com Health's Disease and Condition content is reviewed by V.K. Gadi, MD

Symptoms: the physical signs of a disease

Why You Need To Know About Breast Cancer Symptoms
Breast cancer begins in a cell, which divides and multiplies at an uncontrolled rate. A small clump of cancer cells are too tiny to be felt, so the earliest stages of breast cancer usually have no symptoms. A mammogram can detect cancer before you can feel a lump, which is why your annual screening mammogram is so important. Some benign breast conditions can seem like cancer, so it’s good to know the difference, and get a health professional to check out worrisome lumps.

Understanding Symptoms
The classic symptom for breast cancer is a lump found in the breast or armpit. An aggressive type of this disease, inflammatory breast cancer (IBC), grows in sheets of tumor cells that invade the skin and resembles a rash. Doing your monthly breast self-exam (BSE) is a great way to be familiar with your breasts’ texture, cyclical changes, size, and skin condition. Early detection is the best way to protect your health and improve your odds of survival. Don’t hesitate to see your doctor or nurse for a clinical breast exam (CBE) if you have a question about a change in your breasts.

Symptoms You Can See or Feel

• swelling or lump (mass) in the breast
• swelling in the armpit (lymph nodes)
• nipple discharge (clear or bloody)
• pain in the nipple
• inverted (retracted) nipple
• scaly or pitted skin on nipple
• persistent tenderness of the breast
• unusual breast pain or discomfort

Symptoms Seen On Breast Imaging

• Microcalcifications in tight clusters
• Dense mass with spiky (spiculated) outline

Some Symptoms of Advanced (Metastatic) Breast Cancer
Stage 4, or metastatic breast cancer is the most advanced stage of this disease. Metastatic breast cancer is defined as having spread beyond the breast and underarm lymph nodes into other parts of the body.

• bone pain (bone metastases)
• shortness of breath (lung metastases)
• drop in appetite (liver metastases)
• unintentional weight loss (liver metastases)
• headaches, neurological pain or weakness (could be brain metastases)

Inflammatory Breast Cancer (IBC) – Aggressive and Unusual Symptoms
One type of breast cancer that does not appear in lumps is called inflammatory breast cancer (IBC). This aggressive cancer grows in sheets instead of lumps, and it invades nearby skin, resembling a rash. It will not respond to topical creams or antibiotics, and should be treated very promptly. Symptoms:

• a sudden increase in mature breast size (as much as a cup size in a few days)
• itching in the skin of the breast that is continuous and not relieved by pills or creams
• a change in the breast skin color, resulting in pink, red, or dark-colored areas
• breast is excessively warm to the touch, or harder or firmer than usual
• unusual pain, which occurs out of the regular cycle
• sometimes a change in skin texture, similar to the skin of an orange
• breast skin ulcers (later stage IBC)

Symptoms of Breast Cancer Recurrence
Recurrence of breast cancer is classified as local, regional, and distant. A distant recurrence is the same as advanced (metastatic) breast cancer. A local recurrence is breast cancer that has returned after treatment, in or close to the original tumor location. It can often be effectively treated. Regional recurrence may be in the chest wall muscles, or in lymph nodes located beneath your sternum, just above your collarbones, and around your neck.

Local Recurrence Symptoms:

• a small lump or rash in the excision scar, on or under the skin

Regional Recurrence Symptoms:

• swollen lymph node in the same armpit where cancer was previously removed
• swollen lymph nodes above collarbones or sides of neck

A New Tumor Is Not a Recurrence
If a new tumor appears and has a different pathology than the original breast cancer, it is not considered a recurrence. It is called a new primary, and can occur in a different area of the breast that was originally affected, or in the opposite breast. A new cancer is diagnosed and treated independently from the original tumor.

_{Source:
National Institutes of Health. Medline Plus. Breast Cancer. Symptoms. Updated: 4/3/2007}