Breast Cancer Signs and Symptoms

1. Breast Lump 
   The first and important sign of breast cancer in approximately 70% of the patients is presence of a lump. It is mostly felt on the upper outer quadrant of the breast by physical examination, borders of the lump generally cannot be identified well, and may have a rough or ragged surface. 90% of the cancerous lumps are not painful. Pain occurs in the later stages of cancer. 8 out of 10 lumps found in breast are benign. However, each lump found in breast should be approached as a cancer until otherwise is proven, and should be investigated accordingly.
2. Nipple discharge
   Approximately 8-10% of spontaneous bloody nipple discharge from unilateral breast is associated with cancer, while the remaining 90% is unrelated with malignancy. Brown or bloody discharge from nipple must be taken seriously and investigated.
3. Pain
   Majority of patients with breast cancer do not feel pain at first. Pain usually occurs in later stages. Breast pain without any other clinical symptom is rarely associated with cancer. It generally occurs from benign diseases such as fibrocystic disease.
4. Nipple Retraction
   It is generally a symptom of cancers localized near areola. However, some women may have genetically retracted nipples which are anatomical features present on both breasts from the birth. Nipple retractions that occur on single side later in life can be associated with cancer, and must be examined.
5. Breast skin edema (Peau d’orange)
   In advanced breast cancer, fluid accumulates (lymphedema) in and under the skin overlying breast as a result of plugged breast lymph vessels by cancer cell groups. Breast tissue thickens, appearing like orange peel.
6. Flaking on Areole and Peripheral Skin
   Flaking may be seen on or around the nipple-areola complex for several reasons. This type of lesions can also be seen in rare types of breast cancer. Lesions associated with irritation or allergy can be treated in 1 to 2 weeks using suitable ointments, whereas cancerous lesions do not heal by ointments.
7. Enlarged Armpit Lymph Nodes
   It occurs due to tumor invasion from breast along the lymph ducts, progressing towards lymph nodes under the armpit.

If one or more of the aforesaid 7 symptoms are identified, you should immediately see a breast surgeon. Breast surgeon is a general surgeon who accomplished further specialty training in this field of surgery.

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