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Published on June 16, 2020

pink ribbon with the words breast cancer

What Are Warning Signs of Breast Cancer?

When it comes to your breast health, be vigilant and advocate for your own well-being, advises Michelle Bryan, MD, breast surgeon with Avera Medical Group Comprehensive Breast Care.

After age 40, annual mammograms are the best way to help ensure that breast cancer is caught in its earliest stages—before you can feel a lump or before other symptoms appear.

A mammogram detects changes in your breast earlier than a physical examination alone. “Mammograms can pick up subtle changes you can’t feel. Early signs of breast cancer are not always noticed during a physical exam. The mammogram’s strength is the fact it picks up many early breast cancers at stages, before they lead to physical changes,” Bryan said. “Those notable changes an exam might find often come at more-advanced stages of the disease.”

Be On the Lookout

But beyond a suspicious finding on a mammogram or feeling a lump, you can be on the lookout for other symptoms. Not all breast cancers may produce a lump — and may manifest physically in other ways.

Symptoms that are more concerning – ones you should share with a breast cancer expert – include:

  • Skin thickening — similar to the peel of an orange, a hard knot, or a lump — that’s hard, uneven and doesn’t move, especially if appearing in only one breast (learn what breast cancer feels like)
  • Inverted nipple, nipple pulling to the side or dimpling or puckering within the breast
  • Patchy, crusting skin around the nipple (similar to eczema in appearance)
  • Bloody nipple discharge (non-trauma induced), especially if appearing suddenly and in only one breast
  • Redness or darkening of the breast (non-trauma induced and non-nursing women)

Symptoms that are less concerning, ones you may want to mention to your provider at your next visit, include:

  • Pain in the breast
  • Changes in breast shape
  • Changes in breast size (usually related to puberty, pregnancy, body weight, menopause or menstrual cycle)

Know Your Body to Better Detect Changes

The best way to know if your breasts have changed is to know what they normally look and feel like.

“Get comfortable with what your breasts feel like. Ask if you can feel along with your doctor during your annual exam and ask questions about appearance or what a normal feeling is versus something concerning,” said Bryan. “I often take my patient’s fingers and help them feel benign variations in their breasts. You should get to know your body and be comfortable with examining yourself. You are your strongest advocate.”

Various Factors Determine Risk for Breast Cancer

Before mammograms begin or physical symptoms are found, other factors could influence your probability for getting breast cancer. It’s important to note however, “Since 85% of breast cancers are not inherited, mammograms are the best form of surveillance of breast health,” she said.

Your medical background could have factors influencing your risk of breast cancer including:

  • Family history of BRCA1 or BRCA2 gene or a first-degree relative (mother, daughter, sister) with a breast cancer diagnosis; multiple first-degree relatives with breast cancer increases risk—and genetic testing may be recommended
  • High-risk lesions or exposure to chest radiation as a child
  • Previous occurrence of breast cancer
  • Hormone replacement therapy
  • Demographics such as age, weight, ethnicity, pregnancies and/or nursing, eating habits, alcohol consumption, smoking status, age at first monthly period, age at menopause and others

The Importance of Breast Screenings & Self-Exams

In the United States, one in eight women will be diagnosed with breast cancer in their life. Schedule annual physical exams with your primary care provider, receive mammograms annually over the age of 40 (or earlier if you have family history) and perform self-breast exams at home—beginning at puberty. Performing monthly, self-breast exams five days after your monthly period starts is a critical step for consistent monitoring of breast changes.

“The best way to find early breast cancer is to do yearly mammograms. Mammograms can catch cancer earlier, but they do not prevent cancer,” Bryan said. “A healthy lifestyle can help reduce your risk of developing breast cancer by 40%. That includes maintaining a normal body weight, exercising 30 minutes per day for 150 minutes a week and increasing green, leafy vegetables and fruits in your diet,” Bryan said.

For those with dense breasts, other imaging tests may be recommended such as breast MRI, contrast enhanced spectral mammography (CESM) or ultrasound screenings, (in addition to or alternating with mammograms)—as density can make mammogram results difficult to read and to find cancer in breast tissue.

Learn more about breast cancer care at Avera or find a mammogram location near you.

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