Breast cancer in women: Oncologist explains subtle size and shape differences you shouldn’t overlook

Although the growing incidence of Breast cancer is scary, there is still hope as it is one of the most treatable cancers. Thanks to the immense research that has gone into it, the superior diagnostic modalities, precise surgical techniques, newer and more effective drugs have aided in ensuring better outcomes of the disease. Another most important factor which directly affects the outcome of the treatment is the stage at which the disease is detected.
Early detection and timely, appropriate treatment will help in giving maximum benefit to the patient. Hence being aware of the signs and symptoms of this disease is very crucial.

The most known symptom is a lump in the breast which may or may not be associated with pain. But there are many other symptoms of which one should have knowledge.

In any woman two breasts need not be identical, a little difference in the size is normal. But if there is a gross difference in size, it would be wise to seek medical help. Not all breast cancer presents with a lump, not all lumps are hard (some of them may be soft yet cancerous), some lumps may be very deep within the breast and close to the chest wall muscles, in such cases the only change would be difference in the size of the breast.
Normally the shape of the breast is smooth, the surface and the contours of the breast are even. But in some cases, there may be a change in the shape which should make the woman alert.

The skin which normally is smooth e can undergo changes when there is underlying cancer. Breast cancer has a potential to spread locally within its tissue. There are structures called as Coopers’ ligament just below the skin of the breast which if affected by cancer can cause distortion or change in the skin of the breast. The skin may seem to be pulled inside, there may be swelling of the skin, skin may have an appearance of an orange peel or rashes. Inflammatory breast cancer, a rare type is a highly aggressive disease which can cause redness of the skin, there may be raised temperature of the skin over the breast mimicking infection. No woman should ignore these warning signs.

Normally the nipples are pointing outwards, but if you notice any change in it, this should make one cautious and not neglect it. While some women naturally have inverted nipples, a recent change in the nipple should be taken seriously. Tumours growing just below the nipple can cause these changes.

There can be many different kinds of discharges from the nipple – milky, yellowish, greenish in colour. Not all are of concern. If there is discharge from only one nipple, bloody discharge and the ones which are spontaneous need further evaluation to rule out underlying cancer

This commonly associated with skin diseases like eczema. But if there is an ulcer over the nipple which does not heal in spite of ointments and cream should not be taken lightly. It could mean there is an underlying cancer or a pre-cancerous condition called as ductal carcinoma in situ. In such cases a nipple biopsy is mandatory

Some of the breast cancer may form very close to the armpit. Also, breast cancer through the lymphatic system spread to the lymph nodes in the arm pit or to the nodes above the collar bone. Such lumps need immediate attention.

Cyclical pain in the breast before the menstrual cycle is common. But if there is persistent pain and discomfort specially only in one breast can occur because of heaviness caused due to a growing mass which could be cancerous.

Although not commonly seen, it could be a sign of breast cancer. It is called as Mondor’s disease.
Monthly Breast self-examination, regular mammograms are essential tools for early detection. While a lump in the breast is the most common symptom, being aware of these other signs are equally important. If you experience any of these symptoms or when in doubt do not hesitate to see your doctor. After all, early detection and timely action can save lives and it all starts with being aware.

Dr Jayanti Thumsi, Lead & Robotic Breast Surgeon, Apollo Cancer Centre, Bangalore