Common Presenting Symptoms of Breast Cancer
i) A painless, firm breast lump
The most common presenting breast complaint, for most women who visit their family physician, is a painless, firm breast lump.
In about 70% of cases a woman discovers the lump herself during a self breast examination.
ii) Other Less Common Symptoms of Breast Cancer
However, there are a few less common symptoms of breast cancer that some people may not be aware of. These more infrequent symptoms include:-
- enlargement of the breast (and not in a good way)
- shrinking of the breast
- breast pain
- nipple retraction (when the nipple suddenly appears to be going inwards, rather than outwards)
- nipple erosion (whereby the nipple gets smaller and often has a crusty layer around it). Often, nipple erosion is symptomatic of Paget’s disease, which in turn often indicates an underlying ductal carcinoma.
I just want to let you know that this page is getting a little old, but still has great information. However, I have a newer version of this page with more up-to-date material on Clinical Breast Cancer.
iii) Nipple Discharge
Women also sometimes complain of nipple discharge. Indeed, nipple discharge usually tends to be benign. However, a discharge is more suspicious if it is:-
- Unprovoked: That is you are not breast feeding. Furthermore, nothing has damaged or irritated the nipple.
- Unilateral: That is the nipple charge only occurs on one side
- Uni-orificial: So this means occuring in a single duct
- A serous or bloody discharge.
First port of call is the family Physician
A woman who suspects that she has symptoms of breast cancer will usually firstly present to her general practitioner or family physician.
The Most Common Symptoms of Breast Cancer
The most common symptoms of breast cancer that a family physician encounters are:-
- a palpable lump (painful or painless)
- pain in the breast
- nipple discharge
Indeed all of the above symptoms will lead to a referral for breast cancer screening. Statistically speaking, presenting with a painless breast lump occurs about 56% of the time and a painful lump about 17% of the time.
Ulceration is the main presenting complaint about 16% of the time, and nipple discharge accounts for 11% of presenting breast cancer symptoms. However, the really good news is that overall only about 3% of women who present with these complaints actually turn out to have breast cancer.
… and a few more Statistics
Statistically, there is an elevation in the risk for breast cancer if the patient presents with a breast lump. In the case of a presenting breast lump, an eventual diagnosis of breast cancer occurs around 8% of the time. However, the chances of breast cancer in patient’s presenting with nipple complaints is only about 2%. Even better news for those presenting with breast pain, this turns out to be breast cancer in only 1% of cases.
Family physicians generally do not consider breast pain to be indicative of an underlying malignant breast cancer. Indeed, doctors will only refer about 17% of women who present with ‘pain’ for a specialist assessment.
So, a family physician will refer about 60% of women with a breast lump for screening. Around one third of women with nipple discharge are sent for potential breast cancer evaluation.
On average, and this is shocking, ladies, a woman will wait about 13 months before seeing their GP regarding breast symptoms that could be cancer.
The average age in which breast cancer is detected as a ‘lump’ is about 61
Women between the ages of 25 and 44 tend to present these kinds of breast symptoms to their GP most commonly, and also women over the age of 65. Again, the rate of actual breast cancers following GP visits for these common presenting breast symptoms is only about 3%.
For women under 45, these types of symptoms are even less likely to be related to breast cancer. The average age in which a woman, presenting to her GP with a lump, has actual breast cancer is about 61
Rare Symptoms of Breast Cancer
Sometimes breast cancer can be ‘occult’ and will first present in other areas of the body. For example arm lymphedema, (or swelling). This is an accumulation of lymphatic fluid in the arms or axilla (under the arm) region. Lymphedema is a symptom of breast cancer in about 0.5% of cases more or less.
If inflammatory’ breast cancer is the underlying cause, then presenting symptoms might include swelling as an ‘immune response’ in various areas of the body, such as the:-
- axillary region (under the arm),
- chest which might include a venous thrombosis, or large blood clot.
This is exceptionally rare, however, and would only result from a late stage breast cancer or possibly from an inflammatory breast cancer.
For further reading, I recommend you visit this page with information on Eosinophilic cytoplasm in breast cancer diagnosis.
- Bhattacharya S, Adhikary S. (2006) Evaluation of risk factors, diagnosis and treatment in carcinoma breast – A retrospective study. Kathmandu University Medical Journal (2006), Vol. 4, No. 1, Issue 13, 54-60 https://www.ncbi.nlm.nih.gov/pubmed/18603869
- Eberl MM, Phillips RL Jr, Lamberts H, Okkes I, Mahoney MC. (2008) Characterizing breast symptoms in family practice. Ann Fam Med. 2008 Nov-Dec;6(6):528-33. https://www.ncbi.nlm.nih.gov/pubmed/19001305