Health / Expert Advice

7 Signs of Breast Cancer That Aren’t a Lump

Be your own health advocate this Breast Cancer Awareness month—and always!

Few things are scarier for a woman than the prospect of having breast cancer. Let’s face it—the statistics are startling, with an estimated one in eight women receiving a breast cancer diagnosis in her lifetime.

While the discovery of inherited cancer genes has been monumental in prevention and/or early detection, they only account for a mere 5 to 10 percent of cases, according to Kristi Funk, M.D., breast cancer surgeon (famous for treating Angelina Jolie) and co-founder of the Pink Lotus Breast Center in Beverly Hills, California. “A solid 50 percent, and perhaps up to 90 percent, of the risk factors that determine optimal breast health lie entirely in your hands. So most of the time you are in control, not your doctors, genes, or fate,” she says. That’s why it’s so incredibly important to be your own health advocate. After all, no one knows your body as well as you do.

When most of us think about self-screening for breast cancer, we think to check for lumps. And we should! Self-screening for lumps is one of the most effective ways to detect breast cancer. But it’s just one symptom of many that can signal breast cancer. Here are seven other breast cancer signs to watch out for and discuss with a healthcare provider.

Breast or Chest Pain

Even mild to moderate discomfort in this region should not be overlooked, especially if it’s persistent. “This can be a dull, non-specific pain anywhere in the chest,” explains Rod Rohrich, M.D., F.A.C.S., internationally-renowned plastic and reconstructive surgeon and co-founder of the AiRS Foundation. “Note whether or not it persists and is increasing, as this may be cause for a mammogram and/or ultrasound.”

Itching

If you notice any itching around your breast or chest region, even non-specific itching where you can’t totally detect its location, contact your healthcare provider. This is especially important if the region starts turning red or becomes irritated, notes Dr. Rohrich. He recommends doing a self-breast exam to check for any lumps and requesting a mammogram.

Upper Back, Shoulder, and Neck Pain

This can be vague at first, but if it localizes in your back or shoulder and radiates to your breast, Dr. Rohrich recommends requesting a mammogram. “If it persists, gets more intense, or does not respond to a pain medication like Tylenol, you need to see a doctor, stat,” he says.

Changes in Breast Shape, Size, or Appearance

While your breasts can change in size, shape, or appearance due to non-breast cancer-related reasons such as pregnancy it’s very important to keep a close eye on any changes that seem to come out of nowhere. You know your breasts better than anyone. It’s important to examine them at least once a month to see if they’re changing in size, are painful to the touch, or if you feel a mass anywhere. All issues, as Dr. Rohrich notes, are cause for seeing your doctor for further evaluation.

A Change in Nipple Appearance or Sensitivity

Although unlikely, any nipple changes, such as retraction or inward pulling, discoloration, or change in texture, such as puffiness, can all be signs of breast cancer. “These changes may be noticeable only in certain positions relative to gravity. So it is important to check for this category of change when you are lying down on your back, rolling side to side, bending over, or upright facing a mirror while positioning your hands behind your neck,” says Richard Reitherman, M.D., Ph.D., medical director of breast imaging at MemorialCare Breast Center at Orange Coast Medical Center in Fountain Valley, California.

Swelling or a Lump in Your Armpit

Lumps in the armpit area (often painless and only on one side) are cause for concern. “It is common to have tender, marble-like masses in both armpits, especially when there is recent infection. However, it is more concerning if the mass is only on one side and painless,” points out Janie Grumley, M.D., breast surgical oncologist and Director of the Margie Petersen Breast Center at Providence Saint John’s Center and Associate Professor of Surgery at John Wayne Cancer Institute in Santa Monica, California.

Thickening of Breast Tissue

Although most likely benign, a thickening area in the breast tissue, even without distinct edges, like a ball or cube, that seems to be new should be looked at by your healthcare provider. “Whatever you feel is not the usual, should be cause for follow-up imaging examinations and/or biopsy or consultation with a specialist, such as a breast surgeon,” says Dr. Reitherman.

No matter what always self-screen.

All breast symptoms are important—lump or otherwise. Early detection can help increase your chances of overcoming a cancer diagnosis. Early symptoms can often be treated more easily compared to late breast cancer, points out Dr. Grumley. To detect any breast cancer signs, she recommends frequent self-screenings as an essential part of being your own health advocate. Here’s how to perform your own self-exam for breast cancer.

Visual Exam

Give your breasts a good stare. Standing in front of a mirror, take a good look at your breasts. “Visually scan them for shape, size, or contour changes, plus skin alterations like thickening, redness, dimpling, retraction, and bulging out,” says Dr. Funk. “Your nipples should be pointing the way they always point—straight ahead, left, right, naturally inverted, or headed south.”

Check to see if your breast tissue dimples or bulges out. “In the first posture, put your hands on your hips and push in so that you’re flexing your chest muscles,” instructs Dr. Funk. “Any funny dents or bumps? In the second pose, raise both hands overhead like you’re getting arrested. All clear?”

Physical Exam

Now that you’ve done the visual exam, begin the physical one. “Either reclining on your bed or standing in the shower—whatever is comfortable for you—put a little lotion or shower gel on your fingers to help them glide across the breast tissue,” says Dr. Funk. “Pick one of the following four patterns to trace over your breast tissue: up and down the length of the breast vertically, left to right across the breast like words on a page, concentrically in circles like a target sign, or radially like spokes on a wheel.” Whatever pattern you choose, the results will be the same—just be sure to use the same technique every month so that your fingers develop an unconscious memory of the tissue.

Starting with your left breast, raise your left arm behind your head to flatten the tissue as much as possible. Using your three middle fingers on your right hand, start feeling for any new lumps or thickening. “Start in your armpit, then transition to the upper outer part of your breast and make tiny circles gliding across the breast until you’ve evaluated the entire breast in whatever pattern you chose,” says Dr. Funk. “Repeat the entire exam three times—first with a light touch, then medium, then deeper still.”

Next, gently squeeze your nipple a few seconds to check for discharge. While it’s normal to have some when you squeeze or stimulate the nipples, Dr. Funk notes that fluid should never come out by itself without touching the nipple (e.g., staining your bra cup or PJs). “If you squeeze out bloody or clear-like-water fluid, or if discharge is spontaneous, see your doctor,” she says.

Repeat on your right breast and mark your calendar for one month so that you can do this all over again!

Be your own health advocate. Be sure to keep your healthcare providers in the loop if you notice any changes or experience any unusual pain or sensations.

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