November 2, 2012
Dear Mayo Clinic:
Other than a lump in the breast, are there other symptoms of breast cancer? Is breast pain something to be concerned about?
Yes, breast cancer can cause symptoms other than a breast lump. To make it easier to spot changes that could be symptoms, you should be familiar with what your breasts usually look like. If you notice any unusual breast changes, have them examined by your doctor.
Breast cancer can lead to a variety of symptoms. The most obvious is a breast lump. But other symptoms include skin changes on your breast, such as redness, dimpling or puckering of the skin. Breast cancer also can cause a skin rash that looks similar to mastitis — an infection of the breast tissue that most often affects women who are breast feeding. If you find a new rash or breast redness, and you are not breast feeding, that should be evaluated by your doctor.
Nipple changes, such as a nipple turning inward, or inverting, or becoming flatter than usual, may be symptoms of breast cancer. In some cases, discharge from a nipple also may signal breast cancer. It is uncommon for breast cancer to cause pain. In fact, less than 10 percent of people diagnosed with breast cancer report pain as a symptom. If you have breast pain that lasts and seems to involve one area of the breast, though, have it checked. It could be a symptom of cancer or another breast condition.
Although all of these breast changes may be symptoms of breast cancer, it is worth noting that they can happen for many other reasons, as well. For some, these changes could be symptoms of another underlying problem. Or they may simply be normal changes that don't indicate any problem at all.
Many women's breasts change slightly over the course of a month. That is particularly true for women who have a common condition known as fibrocystic changes of the breast, where the breasts tend to become more tender or lumpier one to two weeks before the onset of menses, and then improve about one week after menses. These changes often involve all of the breast tissue in both breasts. If there is a persistent area of thickening or a nodularity that persists after two or three menstrual cycles, it is recommended that you be evaluated by your physician. You may need additional evaluation with a diagnostic mammogram or ultrasound or both. The fibrocystic changes tend to decrease with age and after menopause as the breast tissue becomes less dense and fattier over time.
It is important to check your breasts regularly and be familiar with how they usually look and feel. That way, you have a good understanding of what is normal for you and what it not. If you suspect a change is not normal, do not ignore it. Make an appointment to have it checked by your doctor. If it is a symptom of breast cancer, the sooner you have it evaluated and diagnosed, the better the chances of treating it successfully.
Remember, too, that in its earliest stages, breast cancer may not cause any symptoms. In many cases, mammography is key to early detection, before symptoms become noticeable. Mayo Clinic recommends that women start getting mammograms every year beginning at age 40.
Mammograms are particularly important for women who have others in their families diagnosed with breast cancer. For that group, Mayo Clinic recommends they start getting annual mammograms ten years before the youngest first-degree relative (a parent or sibling) was affected, or by age 40 — whichever comes first. For example, if you mother was diagnosed with breast cancer when she was 48, you would begin mammograms at age 38.
To best ensure your breast health, be aware of what is normal and what is not for your body; check for breast changes often; follow the guidelines for regular mammograms; and see your doctor if you notice any unusual breast changes. Taking these steps will help detect breast cancer earlier. In many cases, when breast cancer is caught early, the long-term outlook for a cure is excellent.
— Sandhya Pruthi, M.D., Breast Diagnostic Clinic, Mayo Clinic, Rochester, Minn.