It takes quite a long time for a cell that has become cancerous in the breast to form a tumor and for this to be noticed by a specialist during examination or to become apparent on radiological investigation. Women can usually notice a lump that has reached a size of at least 1 cm by means of manual examination. Today most breast cancers are found thanks to people examining themselves by hand. Cancerous lumps are hard, have irregular edges, have a bumpy surface and cannot be moved easily within the breast tissue. If the cancer has metastasized (spread) to distant organs, these spreads only rarely form the first sign of breast cancer. The areas to which breast cancer frequently spreads are the hip and spine bones, the lungs and the liver.
However, in some patients none of these signs is present and the cancer can only be detected by mammography. If at least one of the following signs is present, a specialist should be consulted without wasting time.
The Main Signs That May Indicate Breast Cancer
- A lump (hardness, swelling) that can be felt in the breast or armpit
- Discharge from the nipple (bloody or clear-colored, from a single duct)
- Inward pulling, sinking or deformity of the nipple
- Changes in the skin of the nipple (peeling, crusting)
- A sore or redness on the breast skin
- Edema, swelling and inward retractions of the breast skin (orange-peel appearance)
- Enlargement, deformity or asymmetry of the breast or a change in its color (redness, etc.)
Breast Lump
Many women notice a hardness in their breasts at some point in their lives. Although cancer comes to mind first, most of these lumps are benign tumors. Nevertheless, every situation must be evaluated clinically.
The lump you feel can be one of 2 different structures. The lump may be a fluid-filled sac. We call this a cyst. Cysts usually grow larger around the time of the period and are painful. They are seen more often especially in the 40s, before menopause. Another possibility is a lump filled with a different tissue; this is called a solid mass. The best way to distinguish these two different structures is to examine the lump with ultrasound.
Discharge from the Nipple
Discharge may come from the nipple of every woman at various times. In particular, a discharge between yellow and green in color with a porridge-like consistency when the nipple is squeezed is considered normal. Milk coming from the nipple in women who are not pregnant is also not a sign of cancer; this may be related to the body’s hormonal changes. What is important in terms of cancer is that the discharge comes spontaneously without squeezing the nipple. This is noticed as wetting of the bra or underwear. A discharge that is dark brown, black or blood-colored is an especially important finding. In such a case, a sample from the nipple discharge needs to be taken and examined in the laboratory.
Breast Cyst
Cysts are usually benign tumors of the breast. Their sizes vary between a few millimeters and a few centimeters. They are rare in women under 25 and more frequent in women approaching menopause.
The inside of cysts can be emptied with a needle and the fluid in them examined. If it contains bloody fluid, the cyst needs to be removed with surgery and examined. If a cyst has appeared in a woman receiving hormone therapy after menopause, the fluid it contains needs to be examined in pathology whether it is bloody or not.
If a cyst recurs within 4-6 weeks after being emptied with a needle, removal with surgery may be recommended. In addition, if part of the cyst contains a structure different from breast tissue, which we call solid, removal of the cyst with surgery is again recommended.
Solid (Hard) Mass
We call masses in the breast that contain no fluid and are filled with different cells solid (hard) masses. The likelihood of solid masses being cancer is higher than that of cysts. A solid mass detected in the breast of a woman over 40 carries suspicion of cancer until proven otherwise, so it must definitely be investigated.
A mass detected in the breast is evaluated with mammography and ultrasound, and the likelihood of it being cancer is investigated. It is not possible to make a definitive diagnosis with these methods. However, a definitive diagnosis can be made by examining a piece taken from the mass in pathology.
Thickening, Swelling and Color Change in the Breast Skin
Sometimes, without a lump in the breast, cancer can begin directly with some changes in the breast skin. Redness, thickening and, in places, retractions such as an orange peel in one area of the breast skin can be considered the first sign of cancer. If you notice such changes in the breast skin, you must definitely consult a doctor.
Thickening, Redness or a Sore on the Nipple
Changes in the nipple are also important in terms of cancer. Changes such as redness and sores that appear especially around the nipple can be a sign of cancer even if there is no lump in the breast.
Inward Retraction in the Breast or Nipple
In some women both nipples may be inverted from childhood. This does not mean any disease. In such cases it is often not possible to breastfeed a baby. Such structural abnormalities can be corrected with surgery for cosmetic purposes, that is, only for appearance. What is important in terms of cancer is that the nipple of only one breast has recently been pulled inward. In such a case you definitely need to consult a doctor.
Change in the Position of the Nipples
There may also be a change in the position of the nipples. The nipple may be pulled to one side. This may also be a sign of cancer.
Change in the Shape of the Breast
Usually the two breasts are not symmetrical and one breast may be larger than the other. This is a normal structure. Sometimes there may also be a change in the overall roundness or shape of the breasts. What is important in terms of cancer is a change in symmetry that develops later.
A Lump That Can Be Felt in the Armpit
A lump that can be felt in the armpit may be a lymph node enlargement caused by many reasons. Sometimes it may also be the first sign of breast cancer. Therefore, if you have not recently had an infection in your hand and arm, this lump needs to be examined.
