Breast cancer is one of the most common types of cancer among women around the world, and the chances of successful treatment increase when it is discovered at an early stage, before it spreads to other tissues and organs.
Although the appearance of a lump in the breast is one of the most well-known signs, there are other changes that may indicate infection, including a difference in the size or shape of the breast, changes in the skin and nipple, or the appearance of unusual secretions.
The World Health Organization confirms that most breast lumps are not cancerous, but the appearance of any unusual change requires medical evaluation, even if it is not accompanied by pain. Breast cancer in its early stages may not cause obvious symptoms, which makes periodic examinations important for early detection.
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A new lump or thickening in the breast
A new mass or thickness is one of the most notable changes that require attention, especially if it is hard, firm, or irregular in shape.
These characteristics may appear in malignant tumors, but they alone are not sufficient to judge the nature of the mass, as most breast masses are benign and may result from common changes that are not related to cancer.
The evaluation journey usually begins with a clinical examination, then appropriate medical imaging, and the type of first examination varies according to the woman’s age and the nature of the mass.
According to the recommendations of the American College of Radiology:
– Under 30 years: Ultrasound is usually used as the first examination.
– From 30 to 39 years: Ultrasound or mammography may be used, according to the case.
– 40 years and over: Diagnostic mammogram is usually the first examination, and ultrasound may be added to it when needed.
Not every lump requires a biopsy, that is, taking a tissue sample to examine it under a microscope. Medical follow-up may be sufficient for some lumps that appear benign, while suspicious lumps require a biopsy to confirm their nature.
Even if imaging results are normal, the doctor may recommend additional tests when the mass is suspicious during a clinical examination.
Evaluation is even more important for women who have risk factors, such as advanced age, a previous history of breast cancer, a strong family history of breast or ovarian cancer, a known genetic predisposition, or exposure to chest radiation at an early age.
But the absence of these factors does not mean that infection is ruled out.
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A lump or swelling under the armpit
The changes that require examination are not limited to the breast itself. A lump or swollen area may appear under the armpit, as a result of enlarged lymph nodes.
This enlargement may occur for various reasons, including infections, but it may also be associated with other diseases, including breast cancer.
Therefore, a doctor should be consulted when a new or persistent lump appears under the armpit, especially if it is accompanied by a change in the size, shape, or texture of the breast.
Respiratory viruses may awaken sleeping cancer
A new study revealed that respiratory infections, such as Covid-19 and influenza, increase the risk of latent breast cancer cells reactivating and spreading in patients who previously had the disease. The study warned that this reactivation may stimulate the emergence of new malignant tumors. The results of the study highlight the need for patients to be aware of the risk of infection and the spread of cancer.
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Change in breast size or shape
It is normal for there to be a slight difference in size or shape between the breasts, but the appearance of a new change that was not present before may require examination.
A woman may notice an unusual increase in the size of one of the breasts, a clear change in its shape, or swelling affecting part of it or the entire breast, even without a tangible mass.
The British National Health Service and the Centers for Disease Control and Prevention in the United States list these changes as possible signs of breast cancer.
These symptoms do not necessarily mean the presence of a tumor; they may be related to hormonal changes, especially during the menstrual cycle, pregnancy, or as a result of some hormonal treatments. However, if the change persists or appears in a clear and unusual manner, it is necessary to consult a doctor to determine the cause.
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Breast skin changes
Visible changes in the skin of the breast may reveal problems occurring in the tissues underneath. In some cases of breast cancer, tumors may affect surrounding tissues or lymphatic vessels, leading to changes in the appearance or texture of the skin.
The most prominent of these signs is pitting, that is, the appearance of small depressions in the skin, wrinkles and shrinkage, or swelling, redness, and increased thickness of the skin.
The skin may take on an orange peel-like appearance, which is one of the signs that requires special medical attention. However, these changes may also occur due to benign causes, such as eczema, allergies, skin irritations or infections.
The World Health Organization indicates that breast skin changes, especially when they are new or persistent, require medical evaluation, rather than assuming that it is a simple skin problem.
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Change in the shape of the nipple or the skin surrounding it
The nipple and the dark area around it, known as the areola, may have changes that require examination.
The most prominent signs include a recent inversion of the nipple inward, a change in its direction or shape, or the appearance of peeling, redness, and unusual thickening of the surrounding skin.
Nipple inversion gains special importance if it is a new change in one breast, unlike cases in which the nipple has been naturally inverted for years.
Some skin changes around the nipple may resemble eczema or other benign skin diseases, but they may sometimes be linked to diseases affecting the breast, and therefore their persistence requires medical evaluation.
The British National Health Service lists a change in the shape of the nipple or the appearance of a rash on it among the possible signs of breast cancer.
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Unusual nipple discharge
A woman may notice fluid coming out of the nipple, whether it is clear, milky, or accompanied by blood. The secretions alone do not mean breast cancer, as they may occur as a result of hormonal changes, the effect of some medications, or benign conditions affecting the milk ducts.
But some secretions require greater attention, especially if they appear spontaneously without pressure on the nipple, come out of one breast, are bloody, or are accompanied by a lump or other changes.
The evaluation method varies according to the woman’s age, the nature of the secretion, and the signs accompanying it, and an ultrasound or mammogram may be required.
It is not recommended to squeeze the nipple repeatedly to confirm the presence of secretion, because repeated stimulation may lead to its continuation or increase.
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New or persistent breast pain
Breast pain causes concern for many women, but it is not in itself a typical sign of breast cancer. Most cases of pain are related to benign causes, such as hormonal changes, inflammation, local injuries, or problems with the surrounding muscles and tissues.
The British National Health Service explains that breast pain alone is not usually a symptom of cancer, and that the infection may occur without feeling any pain.
However, new or persistent pain, especially if it is concentrated in a specific area of one breast, requires medical evaluation, especially if it is accompanied by the appearance of a lump or change in the skin or nipple, or an unusual discharge.
When should you consult a doctor?
Not every lump or change in the breast means cancer, but the nature of these changes cannot be determined from their shape or texture alone.
Therefore, the appearance of a new lump, an unusual change in breast size or shape, nipple discharge, or skin changes require seeking medical advice without unnecessary delay.
The absence of symptoms does not necessarily mean that the breast is free from any pathological changes, as breast cancer may develop in its early stages without clear signs.
Therefore, early detection, through tests appropriate for age and risk factors, in addition to paying attention to new changes, remains one of the most important means of detecting the disease in a timely manner and improving the chances of treating it.
Negligence and panic
The body does not ask us to interpret every signal ourselves, but rather to listen to it well, and when a new and continuous change appears in the breast, the smartest step is not to fear it, nor to get used to it, but rather to give it its due medical evaluation.
Between negligence that may delay diagnosis, and panic that may precede the truth, awareness remains the most likely path: to know, to ask, and to let science and medicine have their say. Scientific research and medical progress continue to expand what we know, opening new horizons for detection, diagnosis and treatment.
Wisdom does not mean that we search for cancer in every change, nor does it mean that we give every change a reassuring explanation, but rather that we know when to be reassured, when to monitor, and when to ask for a medical evaluation, as the body sends the signal, and medicine reads it, and between the signal and its meaning one step may make the difference.