Breast Symptoms and Signs
Signs and symptoms in the breast
You should see a consultant surgeon who is breast cancer specialist if you notice any of the changes given below.
Breast cancer most often announces itself as a breast lump, but on the contrary, a breast lump is often not cancerous.
If you are in your twenties or early thirties, the most common cause of a lump is a fibroadenoma - a benign tumour which is generally harmless.
In late thirties and in your forties, the most common cause is a cyst, which typically appears suddenly and can be painful or uncomfortable. Breast cysts are caused because of fluid collecting within the breast usually because of a blockade of a duct.
At any age, lumpy areas can be felt in the breast due to normal changes that occur during the monthly menstrual cycle.
Cancerous lumps are generally single, hard, and painless, and may be irregular in shape. If a new lump appears after menopause it should be considered suspicious.
Diagnosis of the cause of a new breast lump is important and should to be done by the breast cancer surgeon in collaboration with the radiologist and the pathologist in a one-stop breast clinic.
Pain in the breast is rarely due to cancer. It’s normally caused by hormonal changes that occur during the monthly menstrual cycle or a cyst. Pain in the breast after menopause should be taken more seriously.
Discharge of fluid from the nipple can be a sign of cancer, particularly if it is spontaneous, i.e., it occurs on its own without squeezing the nipple and shows up on your bra or nightie. It should be taken seriously if it is bloody, or from a single duct. Even though the cause of a nipple discharge is most likely due to a benign papilloma or just widened ducts, it needs to be properly diagnosed to rule of a breast cancer.
Nipple inversion occurs if the nipple is pulled in. Usually this is because of benign shortening of ducts and is bilateral - on both sides, in which case it is possible to reverse it and bring it out. When a cancer shortens the ducts the nipple remains in permanently remains inverted. So a new one-sided nipple inversion even in the absence of any other symptom needs to be checked up in a breast clinic by a consultant breast surgeon and their team.
Changes in breast size or breast shape.
If there is a cancer in the breast, it may become enlarged, or more commonly the breast may shrink owing to loss of normal breast tissue. The skin may dimple or pucker and the nipple may become inverted. Rarely, the veins over the breast may become more prominent.
Enlarged lymph nodes
A lump / glands/ nodes in the armpit are occasionally the only sign of breast cancer, and a few women find these axillary lumps before the breast lump.
Inflammation or mastitis breast abscess
Mastitis mostly occurs in breastfeeding mothers or those who smoke. It causes pain, inflammation, redness, and fever. It needs to be properly assessed with clinical examination and imaging. Its treatment will be decided by the consultant surgeon and their team. The usual treatment may involve needle aspiration and appropriate antibiotics
Inflammatory breast cancer
Breast cancer rarely presents as inflammatory breast cancer. Most inflammatory conditions of breast are benign and are caused by an infection. Inflammatory breast cancer is a cancer that has cancers cells infiltrating the skin lymphatics and mimics simple inflammation. The diagnosis needs triple assessment by the breast surgeon and their team in a one-stop breast clinic.
During the consultation, Professor Vaidya will take detailed history and perform a clinical examination. If it is thought necessary this will be followed by a breast x-ray (mammogram) and an ultrasound.
After that, you will see Professor Vaidya again to discuss the results of the tests. If you need to have a needle biopsy, it can usually be done on the same day, and you will receive those results at your next appointment.
Throughout your visit, a chaperone or specialist breast care nurse will be present to support you.