7 Subtle signs of breast cancer you might be overlooking

A lump or bump in your breast is the most well-known sign of breast cancer and the most common too. But it’s far from the only one—a variety of other abnormalities could signify cancer and warrant a conversation with your doctor. And being able to spot these early symptoms of breast cancer is critical because the sooner you catch this condition, the quicker you can start treatment and the better chances you’ll have of making a full recovery.

The challenge is, breast cancer symptoms can look and feel different from person to person. They can also vary depending on the type of breast cancer and its location—for instance, behind the nipple versus toward the chest wall, Meghan R. Flanagan, MD, MPH, a surgical oncologist specializing in breast health at Fred Hutch Cancer Center, in Washington, tells SELF.

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And take note: Some people don’t have any noticeable signs in the early stages of breast cancer, Monique Gary, DO, a breast surgical oncologist at St. Luke’s Cancer Care Associates Surgical Oncology, in Pennsylvania, tells SELF. That’s why it’s so crucial for people of screening age (40-plus) and younger women who are at high risk to get their routine mammograms (or other doctor-recommended screenings), Dr. Gary says.

Seven common early signs of breast cancer

1. Noticeable lumps

If you feel a firm lump anywhere around your breast, don’t ignore it. Plenty of benign conditions like cysts and growths called fibroadenomas can show up as little bumps and nodules, but these can also signal cancer. “Lumps from breast cancer can happen in any part of the breast or in the armpit but most commonly occur in the outer quadrants of either the right or left breast,” Carmen Calfa, MD, a breast medical oncologist at Sylvester Comprehensive Cancer Center in the University of Miami Health System, tells SELF.

Take note: In young people, especially, breast cancer lumps can look similar to fibrocystic breast changes, or noncancerous lumpy or ropelike breast texture caused by hormonal changes around your period. This is extremely common, affecting approximately 50% of women between the ages of 20 and 50. So it’s important to pay attention to whether any lump seems to change with your cycle, Dr. Calfa says: “If it doesn’t go away after your period ends, within a couple weeks, be sure to seek an evaluation from your doctor.”

2. Breast asymmetry (that’s different from your norm)

Plenty of people naturally have one boob that’s bigger or differently shaped than the other—and that’s totally fine. But if you notice a new-to-you form of asymmetry between your breasts, that may be a signal of breast cancer below the surface, Dr. Calfa says. After all, only about 2% to 11% of breast cancers are bilateral—the rest crop up in a single boob.

This might look like one breast suddenly being a cup size larger than the other (again, despite this not previously being the case for you), one breast that seems to stay closer to your chest wall (while the other dangles more), or new asymmetry in terms of how your breast skin or nipples look or feel.

3. Changes in breast shape and contour, like dimpling or thickening

Your breast shape will change naturally over time. After all, your breasts at 20 are not what you’ll see at 50 (thanks, gravity!), especially if you’ve been pregnant or nursed a baby.

Don’t Miss These 7 Early Breast Cancer Clues. Image: Freepik

That said, it’s time to talk to a doctor when those changes seem to have happened quickly and don’t seem to be associated with your menstrual cycle, significant weight gain or loss, pregnancy, or breastfeeding. For example, Dr. Gary says changes in the contour of your breast, such as dimpling, could be an early sign of breast cancer. Also key to note is thickening or swelling of the breast, even if you do not feel a lump. Dr. Gary says these changes may become more apparent as cancers grow inside the tissues.

4. Nipple changes or discharge

Another potential early sign of breast cancer is certain changes to your nipples, such as nipples that turn inward, pull to one side, or change direction. Inflammation around the nipple, scaly skin, crusting, and itchiness or a burning sensation also warrant a convo with your doctor, particularly when it occurs in only one nipple, Dr. Calfa says.

Abnormal nipple discharge is another thing worth paying attention to. If you’ve been pregnant, you’re likely familiar with fluids dripping out of your nipples (hello, colostrum and breast milk). But discharge that is new and not obviously related to pregnancy, breastfeeding, or another medical reason is a potential cause for concern, especially if it’s bloody, leaking from only one nipple, or comes out on its own without any squeezing.

5. Skin inflammation, discoloration, or swelling

While not as common as other early symptoms of breast cancer, breast discoloration, thickening of the breast skin, changes to breast skin texture that give it an orange-peel-like feel, swelling that affects more than a third of the breast, and swollen lymph nodes near the underarm can be associated with inflammatory breast cancer (IBC), a rare and very aggres sive form of the disease.

Regarding discoloration, in particular, IBC is often linked with “redness” of the breast—but in people with dark skin, it may be tougher to see this color change, as well as the textural shifts and thickening, Dr. Calfa notes. This kind of cancer might cause reddish-purple, bruised, or brown patches on dark skin tones instead—which is critical to note, as research shows IBC disproportionately impacts Black women.

In early stages, IBC can also be mistaken for an infection, particularly in people who are or were recently breastfeeding, Dr. Calfa says. (It can look like mastitis, or inflammation due to a clogged or infected milk duct). So it’s extra important to flag any inflammatory breast changes to your doctor during the postpartum period so that they can assess which bucket they fall in.

6. Breast pain or heaviness

It’s a myth that breast cancer doesn’t hurt. Pain is indeed one of the less common symptoms, but it can certainly happen, particularly when a tumor’s size or location (or both) causes it to press on nearby nerve or muscle structures.

Dr. Flanagon points out that severe one-sided breast pain that persists for two weeks (beyond your period) is especially concerning and should be evaluated. Even more so if you don’t have another potential explanation for it, for instance a recent session of heavy weightlifting (which can sometimes cause breast and chest pain), Dr. Calfa says. It could be associated with IBC, which can cause tenderness, aching, and heaviness in the breast, in addition to the inflammatory symptoms noted above.

7. An abnormal finding on a mammogram

A mammogram uses low-dose X-rays to detect signs of breast cancer—sometimes even ones that don’t cause noticeable symptoms, Jennifer O’Neill, MD, FACS, a breast surgeon at Boone Heath Breast Care, in Missouri, tells SELF. These may include calcifications (tiny calcium deposits within breast tissue), masses of abnormal tissue, and distortions in breast tissue. That’s not always enough to confirm a breast cancer diagnosis, but it should prompt your doctor to order more tests—like a breast ultrasound or MRI, for instance—to get a clear answer. This kind of extra testing may be especially important for people with dense breasts, which have tightly packed tissue that can mask the appearance of tumors on a mammogram.

How to check your breasts for early signs of cancer

If you aren’t intimately familiar with how your breasts normally look and feel, it’ll be tough to notice when one of the above symptoms crops up. While experts no longer recommend doing routine structured self-exams (unless you’d like to)—evidence doesn’t show that these help reduce deaths from breast cancer—they stress being aware of your normal, so you can get in touch with your doctor if you notice anything that strays from it.

Think of this as having “breast self-awareness,” Dr. Gary says. It means getting to know your breasts both outside of and during your period, a time when fluctuating hormones can cause breast changes. This also includes becoming familiar with your natural asymmetry, such as differences in size or nipple appearance between your two boobs.

To do that, look at your breasts in the mirror often, both with your arms at your sides and raised above your head, Dr. Flanagan says. You can also gently press on your breasts moving from the outside in, like the spokes of a wheel, to feel for any lumps or bumps.

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Seek care for any of the above symptoms—and be persistent if you feel like you aren’t taken seriously.

If you suspect something is off with your breasts, it’s important to see your doctor, regardless of your age. “Many of the patients that I diagnose with breast cancer were initially told by a doctor that they were too young to have breast cancer, or their concerns about a lump were taken too lightly,” Dr. Calfa says. So she emphasizes pushing for testing if your doctor tells you it’s nothing. It’s important to figure out exactly what is causing the symptom, breast cancer or otherwise—and that requires a workup with imaging, she says. (If your doctor brushes you off, the experts suggest getting a second opinion if you’re able to.)

The same thing applies if you’ve had normal mammogram results within the past year but you now have a new, potentially concerning symptom. It’s critical to get re-evaluated with a breast exam and possibly a repeat diagnostic mammogram, Dr. Flanagan says. Some of the most aggressive cancers can pop up in between one image and the next, Dr. Calfa points out—doctors call them “interval” cancers. So you don’t want to delay getting a breast symptom checked out just because you recently had a clear mammogram.

Original article appeared on SELF