Symptoms of Breast Cancer

Keep in mind. Be alert. Be aware.

What are the
symptoms of breast cancer?

A 'symptom' means, 'observing' or 'feeling' something in the body, which 'feels' abnormal - meaning, it is something which has just recently come up and was not there earlier, and does not feel normal. 'Symptoms of Breast Cancer' means, certain 'signs' which make a lady realize that something is not normal in her breast.

There are just 6 or 7 symptoms that one has to keep in mind, that's it! And keep checking for them regularly. They are as follows:

  • A 'Lump' or a 'Knot'

  • A 'Lumpish' feel

  • Retraction of nipple

  • 'Bloody' or 'blood stained' nipple discharge

  • Thickening of skin over an area of the breast

  • Lumps in the armpit

All the symptoms are explained in detail below.


A lump in the breast

The normal breast tissue is 'soft'. Hold the four fingers of your hand together (except thumb)(left hand for the right breast and right hand for the left breast), keep them straight (don't bend them), and then 'dip' or 'sink' about half the fingers (from the finger tips) into the breast tissue, and 'roll' them ('rotate' them) in a 'clockwise' or 'anticlockwise' manner. In a normal breast, the fingers will 'easily' sink in and 'little beady' feel of the breast can be noticed. Some women will have a softer breast tissue, while some will have very dense tissue. Whatever the density, the normal breast is 'soft' to feel. There is no hardness anywhere.

Now imagine there is, for example, a 'lemon' inside the breast, on one side (sorry for this crude example, but that's the best way to make you understand); how would it feel with the four finger method above? You will surely feel there is something round, and to some extent, you can even press it, it feels 'firm'. Breast cysts and non cancerous lumps like fibroids feel like this. They feel 'firm'. Also, usually, you can even 'move' a fibroid by holding it between fingers.

Next, imagine, there is a 'walnut' inside the breast, on one side, how would it feel with fingers? While you are rolling the fingers, you will feel that there is something round, a 'lump' or a 'knot' and it is 'real hard' as compared to rest of the breast, which is so soft. Distinctly, your hands will make out the 'hard feel'. A cancerous lump, usually feels like this. A cancerous lump feels 'fixed' and cannot be moved if you hold it between fingers and try to move it. It feels 'stuck all around'

A Lump in the breast is the most common symptom of breast cancer and about 90 to 95 percent patients in our OPDs present with the complaint that they can feel something 'hard'. Some of them noticed it while they were bathing, while others felt it when they were changing their clothes etc.

Sometimes, a 'round' lump cannot be felt but a 'spread out flat' little hard 'feel' is noticed. This is called 'Lumpish Feel'. Lumpish feels can be felt in many non cancerous conditions, but occasionally also in cancer.

In the photo above, we can clearly see in lump in the 'inner half' of the left breast. A few arrows are showing one part of the lump curving below the skin. And the area of the lump has been marked out by a pink line. Please note: The lump in the photo is too large. Most women present with smaller lumps. But a smaller lump is difficult to show on a photo. Hence showing this large lump.


Bloody nipple discharge

Different types of liquid can come out from nipple. Watery, milky, greenish are common and are not problematic. But if the nipple discharge is 'bloody' or is 'blood stained', then it could be a sign of an underlying cancer.


Nipple Retraction

Sometimes, a cancerous tumour develops in the breast tissue just 'behind' the nipple. As we know, a 'cancer' tends to 'pull' tissues nearby or get 'stuck' to it. So, the cancerous tumour behind the nipple, tends to 'pull it inwards'. The nipple looks as if it has gone 'inside' as compared to the opposite nipple. It is just not possible to 'pinch' this nipple outwards. This is called 'retraction' of the nipple. And this would have happened 'recently', and the patient will say that earlier the nipple used to be normal. In most cases, such 'recent onset' retraction will be due to cancer, while in some cases, it can also be because of some infection; in rare cases, many women have retracted nipples on both sides since a long time, which is normal.
In the image, you can clearly see how the nipple has gone inwards.


Nipple Ulcer

An 'ulcer' on the nipple or a 'sore nipple', could be a sign of an underlying cancerous lump. In medical terms, this is called as Paget's Disease. In the image, you can see, the tip of the nipple has been replaced by a 'pinkish' looking ulver or a sore. In that patient, when we examined, there was a distinct 'hard' lump, behind the nipple, which was proven cancerous.


Skin involvement

There are tiny 'lymphatic channels' just below the skin of the breast. Also, there are some thin ligaments (like a thread) going from the skin of breast into deeper tissues, all over the breast. In advanced breast cancer, the 'outgoing' lymphatic channels are blocked, due to various reasons resulting in 'thickening' of the skin. Also, because of widespread cancer, especially centrally located breast cancer, the ligaments are pulled in and in turn, because they are pulled, they produce a 'dimpling' on the skin. This 'thickening' and 'dimpling' of the skin makes the skin look like a 'peel of orange' and is called as 'Peau D'Orange (PDO)'. We can 'pinch' a normal skin, but cannot pinch such a thickened skin. Such a thick skin situation arises mostly in cancers only, though in some infections (mastitis) also, it can happen.

In the image, you can see, the left breast skin if perfectly normal. The right breast has area of very thick skin, marked out with purple arrows.

Other Symptoms

Similar to the lump in the breast, if the cancer has spread into the lymph nodes in thev arm pit, they also start enlarging in szie and one fine day, they can also be 'felt' by hand. In advanced cancers, there can be ulceration of tumour through the skin etc. It's best not to discuss signs of advanced cancer, as we expect you, the reader, to be alert and look for signs of an earrly cancer. You can. I can. Everyone can. We just need to be alert.

The importance of knowing symptoms of breast cancer

Breast cancer is curable. Definitely. No second doubts about that. But for a chance of cure, one has to come to a doctor in the early stages. And to come in an early stage, it is important to catch the symptoms of breast cancer early. And to catch the symptoms early, one needs to know them. It is a known fact that - "What the mind does not know, the eyes cannot see, and the hands cannot feel". it means that, for example, if a lump is small, you will find it only if you have in your mind what you are looking out for, else you are not likely to find it when small. Ultimately, you will notice it only when it has grown a lot bigger. Hence, every single woman should be aware of the symptoms of breast cancer and perform a self examination within a few days after periods. It can save lives, remember.


All the links are in blue colour. You can click the links to go to that page. The page you are presently reading is pink in color

Journey of BC: Diagnosis

1. I feel a lump! - The first visit to doctor
2. Is it really cancer? - Confirmatory tests
3. What is the stage? - Staging and fitness tests
4. Will it be surgery first? or chemo first? - Treatment planning and sequence

Journey of BC: Surgery

5. Should I conserve or remove breast? - Choice of Surgeries for breast cancer
6. How long will be the surgery? - Admission and Surgery
7. Care after surgery - Precautions and guidelines
8. What next? - The Pathology Report

Journey of BC: Further Treatment

9. How many chemo cycles? - Chemotherapy Consultation
10. Is a PORT necessary? - ChemoPORT insertion
11. Will I be normal during chemo? - The Chemotherapy time
12. Is Radiation painful? - Radiation Therapy
13. Yes!! I did it! - Treatment is over
14. How frequently do I meet doc? - Follow up guidelines

Other Topics

Risk Factors - The Risk Factors for Breast Cancer
Symptoms of Breast Cancer - Know the Symptoms of Breast Cancer - You are presently on this page
Early Detection of Breast Cancer - The Guidelines

Neo Adjuvant Chemotherapy (NACT) - For LABC
Sentinel Node Biopsy - How is it done?
Targeted Therapy - Trastuzumab
Hormone Therapy - Who gets it?