5 Breast Cancer Warning Signs To Watch Out For

By Anna Redman

We all have fears. Spiders, heights, sharks, needles — whatever they are, they vary from person to person, age to age, and gender to gender, but there is one fear we’re all pretty united in. That horrifying, life-changing moment when a doctor with a clipboard and a white lab coat looks up, grim-faced, and says, “I’m sorry to tell you, you have cancer.” Cancer — “the big C” — haunts every life it touches. Friends and family members feel a loss where loved ones used to be, and even survivors are plagued by the constant, unchanging reality that they used to have this life-threatening, horrifying disease and the fear that one day they could again. And while both sexes could unfortunately battle a wide range of cancers, it is the mission to conquer the breast variety in particular that brings women together, creating an unbreakable bond and an unwavering determination to find a cure.

In May of this year, the Canadian Cancer Society released shocking statistics suggesting that by the time we reach 2030, a mere 15 years from now, cancer cases will have increased by 40 per cent, with breast cancer cases specifically having more than doubled.

So how can we combat this tidal wave of bad news? Regular screenings, staying active, eating well, and skipping the cigarettes can all help decrease your risk. But if you’re wondering when you should stop reading about others and start worrying about yourself, here’s what you really need to know.

“The most common sign of breast cancer is a lump,” says Holly J. Pederson, MD, director of medical breast services at the Cleveland Clinic. “Other less-common signs include pain localized to a discrete area of the breast, nipple discharge that usually comes out on its own and is bloody or clear, a change in the shape or dimpling of the breast, or a rash on the breast or nipple,” Pederson continues. If cancer is growing anywhere within your body, be warned that it can spread to other parts, like your bones, lungs, liver, or brain, and cause symptoms in those organs. However, it’s rare that breast cancer is discovered in another body part before it’s found in the breast itself.

There are also several other, less-traditional telltale signs you should watch out for, just in case! “If the breast cancer is metastatic, you could experience bone pain, fractures, fatigue, poor appetite, weight loss, and breathing problems,” says Janice Lu, MD, PhD, an associate professor at the Clinical Medicine Division of Hematology and Oncology at the University of California in Los Angeles. Should you be suffering from one or more of these symptoms and the dreaded news does come your way, both experts assure that there are numerous treatments to try, and even more in the works.

If it’s caught early enough, breast cancer is often treated by surgically removing the cancer (a process known as a lumpectomy), which is typically followed by radiation therapy. Pederson notes that women may also opt to undergo a mastectomy, with or without reconstruction. “Hormonal blocking therapy is also an option,” shares Lu. Estrogen has been found to increase the growth of cancers which are hormone-receptor positive, and this treatment aims to target that.

As for in-the-works fixes, there are a couple of interesting ones underway. “Two exciting areas of emerging research include investigating the genomic expression of the tumor to guide an individual’s breast cancer chemotherapy, and the breast cancer vaccine that’s ultimately aimed at preventing breast cancer altogether,” Pederson shares. Lu, on the other hand, has high hopes for targeted therapy, which tells researchers more about the gene cells that cause cancer, and immunotherapy, which uses your body’s immune system to fight the cancer cells head on.

And if you’re counting your lucky stars, having dodged this unenviable bullet so far, it’s vital that you exercise caution and take preventative measures to keep your breasts cancer-free. In addition to signing yourself up for regular screenings and annual mammograms, keep an eye out for these signs that could signify breast cancer — doing so may be your key to catching this villainous disease early.

The Symptom: Breast Pain and Tenderness

What could this mean?
“Breast pain is very common,” says Pederson. “Most women experience pain prior to their menstrual cycle, in particular, and it is rarely a sign of breast cancer.” She suggests that this tenderness could be caused by hormonal fluctuations and may be worsened by excessive caffeine intake.

When should you be concerned?
“If the breast pain is localized to a particular area you should have it investigated by a doctor,” Pederson says. Ultrasounds can be particularly helpful for evaluation, even if your regular mammogram has come back normal.

What treatments would be available to you?
“Most of the time a complaint of pain will not require medical treatment,” Pederson explains. But if the pain persists, she does suggest minimizing your consumption of caffeine to dwindle the soreness. “In extreme cases, medications can also be prescribed by a breast specialist.”

The Symptom: Breast Swelling

What could this mean?
“Breast size often changes over time. It is not uncommon for the breasts to enlarge symmetrically,” says Pederson. It could also mean that you have a benign or malignant growth, according to Lu.

When should you be concerned?
“If you have swelling on one side, you should see a doctor,” notes Pederson. “This enlargement could be due to infection, cancer, or even a thyroid imbalance.”

What treatments would be available to you?
“First, have a doctor perform a careful exam and make sure to have diagnostic breast imaging,” Pederson advises. The treatment will depend on what is found through the process, she says.

The Symptom: Breast Lumps

What could this mean?
“This could be benign, but it could also be cancer, so it’s important to find out,” shares Lu. It turns out that breast lumps are actually quite common, as a result of fibrocystic change. When this change occurs, breast tissue can feel lumpy even if no actual mass is present. “Benign cysts (fluid-filled sacs) or benign fibroadenomas (a non-cancerous tumour in the chest) can also present as breast lumps,” Pederson reveals. “But, of course, the most concerning fear is that a lump represents cancer, so any new lump should be evaluated by a doctor.”

When should you be concerned?
“A doctor will order diagnostic imaging for a lump, including a breast ultrasound that will show whether there is a mass present or fibrocystic tissue,” explains Pederson. The ultrasound can also help in determining whether the lump is a cyst or a solid. “For solid masses, there are ultrasound features that suggest malignancy and can prompt a breast biopsy.”

What treatments would be available to you?
While your options would depend on the results of the diagnostic imaging test, there are some common options. “Cysts can be drained if painful, and fibroadenomas can often be observed and resolved over time. If fibroadenomas enlarge or are painful, surgical excision is often recommended,” Pederson shares. “Suspicious findings from mammograms or ultrasounds may also lead to biopsy of the mass.”

The Symptom: Breast Discharge

What could this mean?
“Nipple discharge is a common breast complaint, but it can also be the first sign of breast cancer,” warns Pederson.

When should you be concerned?
“If nipple discharge comes out on its own, is one-sided, and/or is bloody or clear it should be further evaluated,” Pederson states.

What treatments would be available to you?
Doctors will often order special mammographic views and ultrasounds to see behind the nipple so that they can evaluate suspicious discharge more fully. Pederson says this type of discharge is often the result of a less-worrisome benign intraductal papilloma (similar to a polyp in the milk duct), but notes that it can also be a sign that cancer is growing in the same area. “Often with concerning discharge, a surgical excision is necessary to both determine the cause and treat the problem,” Pederson reveals.

The Symptom: Change in Nipple Appearance

What could this mean?
“Many women have inverted nipples, so this is not a concern, unless it’s new,” Pederson clarifies. “Occasionally, cancers that develop in the breast can pull the nipple inward.” Rashes on the areola surrounding the nipple can also be common if cancer is present. But don’t freak out prematurely — sometimes rashes develop in response to a new soap, lotion, or laundry detergent. If the redness persists, see a doctor. “It’s rare, but breast cancers can present as skin changes to the nipple and surrounding areolar complex often involving change in colour, flaking, or itching.”

When should you be concerned?
Pederson advises seeing a doctor for any notable changes to your nipples.

What treatments would be available to you?
“Diagnostic breast imaging will be performed to look at nipple abnormalities,” shares Pederson. “Areolar eczema is very common — this skin is very sensitive.” Rashes can be caused by a number of things, including topical steroid creams. If the reason behind a nipple change is not immediately obvious, a biopsy may be necessary.

Tags: Anna Redman
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