A new lump or mass is the most common sign of breast cancer.
Since mammograms for screening have become more common, the number of breast cancer cases discovered before symptoms occur has increased.
However, in some instances, the cancer can be missed on a mammogram, either due to error or to the fact that about 15 percent of breast cancers aren’t visible on a mammogram (known as “mammographically occult cancer”).
And many women, for a number of reasons, don’t get mammograms as recommended.
Though most cases of breast cancer have no symptoms until they’re discovered on a mammogram, the most common symptom of breast cancer is a new lump or mass.
Masses that are more likely to be cancerous are painless, hard, and immobile with irregular edges.
But some breast cancers can be tender, soft, or rounded — and even painful.
While the following signs and symptoms can be caused by conditions other than breast cancer, you should contact your doctor if you experience any of them:
- Changes in the size or shape of the breast
- A lump or thickening in or near the breast, or in the underarm area
- Swelling of all or part of a breast (even if no lump is felt)
- Skin irritation on or around the breast
- Puckering in the skin of the breast, or dimpling that looks like the skin of an orange (called “peau d’orange”)
- Breast or nipple pain
- Nipple that is turning inward
- Redness, scaliness, or thickening of the nipple, areola (dark area of skin around the nipple), or breast skin
- Nipple discharge that is not milk
Some breast cancers spread to lymph nodes under the arm or around the collarbone and cause a lump or swelling in those areas before a tumor in the breast tissue is large enough to be felt.
If you experience swollen lymph nodes, call your doctor right away.
Diagnosing Breast Cancer
Your doctor may use the following tests and procedures to diagnose breast cancer:
Breast exam: To check for any lumps or abnormalities, your doctor will palpate (feel) both of your breasts and lymph nodes in the armpit.
Mammogram: A screening mammogram takes an X-ray of your breast to look for any abnormalities or changes in your breasts. If anything looks suspicious, your doctor may recommend a diagnostic mammogram to take a closer look at the abnormality.
Ultrasound: In an ultrasound, sound waves produce images of structures deep within the body. A breast ultrasound may help distinguish between a solid mass and a fluid-filled cyst.
Biopsy: In a biopsy, a tissue sample is taken from your breast and sent to a lab for analysis. The lab will determine the type of cells involved in the breast cancer, the aggressiveness of the cancer, and whether the cancer cells have receptors that may influence your treatment options.
Magnetic resonance imaging (MRI): An MRI uses a magnet and radio waves to create pictures of the interior of your breast.
Your doctor may request other tests or procedures if needed.
Stages of Breast Cancer
Once you receive a diagnosis of breast cancer, your doctor will perform tests to determine the stage of your cancer.
Knowing the stage of your cancer is an important step in deciding how to treat it.
Your doctor may use the following tests and procedures to determine the stage of your breast cancer:
- Lymph node biopsy (lymph node is removed to look for cancer cells)
- Blood tests
- Mammogram of the other breast
- Magnetic resonance imaging (MRI)
- Bone scan
- Computerized tomography (CT) scan
- Positron emission tomography (PET) scan
The stages of breast cancer range from 0 to IV, and each stage from I to III has at least two sub-stages (IA, IB, etc.). The most advanced stage is IV.
The following are brief descriptions of each stage:
Stage 0: The cancer is noninvasive or contained within the milk ducts, lobules, or nipple.
Stage I: The cancer has formed a tumor two centimeters or smaller in size and has not spread outside the breast, except there may be small clusters of cancer cells in the lymph nodes.
Stage II: The cancer is growing but is still only in the breast or has spread to lymph nodes near the tumor, but not beyond.
Stage III: The cancer has spread beyond the tumor into lymph nodes and muscles. However, the cancer has not yet reached other organs.
Stage IV: Also called metastatic breast cancer, cancer in this stage has spread to other parts of the body, including the bones, lungs, liver, or brain.