6 Overlooked Signs of Breast Cancer

Over the last few years, and again now that my cancer has returned, many people have asked me if I had any signs of breast cancer before I found the first tumor in my breast. Yes, I did have a few of these signs, and I had pain. Please, remember to do your monthly breast self-exam and watch for these signs.

Medically reviewed by Amy Tiersten, MD — Written by Jennifer Bringle on October 5, 2020

Everyone talks about the importance of catching breast lumps as early as possible. But did you know there’s a host of lesser known breast cancer symptoms that might not show up on a self-exam or mammogram?

According to the American Cancer Society (ACA), breast cancer is the most common cancer in American women, other than skin cancers, and it’s the second-most deadly cancer for women behind lung cancer.

On average, there’s about a 1 in 8 chance that a U.S. woman will develop breast cancer at some point in their life. The ACA estimates that more than 40,000 women will die from breast cancer in 2020.

The most common form of breast cancer is invasive breast cancer, which is any type that has invaded the breast tissue.

Less common forms include inflammatory breast cancer (which is caused by cancer cells blocking lymph vessels in the skin, causing the breast to look inflamed) and Paget’s disease, which involves the skin of the nipple or areola.

With the high rates of breast cancer, the American Cancer Society recommends women have the choice to start annual mammograms at age 40. The organization says women between the ages of 45 and 54 should get mammograms every year.

And while the disease is most commonly discovered by detecting a lump during a mammogram, there are other lesser known signs and symptoms of breast cancer that women should look out for.

Nipple discharge

Unusual discharge from the nipple can be an indicator that something is wrong in the breast.

According to Marisa Weiss, MD, breast oncologist and founder of BreastCancer.org, discharge that’s bloody or pink and generally only on one side can possibly indicate the presence of cancer in the breast tissue, particularly if it’s persistent.

Skin changes

Skin changes are actually one of the most common lesser known signs of breast cancer.

“Thickness or redness of the skin, along with a little puffiness like the skin of an orange is a sign,” says Weiss. “You see dimpling where the hair follicles are, like a navel orange.”

Skin differences like thickening, dimpling, and changes in color can indicate the presence of inflammatory breast cancer.

Nipple crust

Redness, scaling, crusting, or flaking of the nipple or areola can be a sign of Paget’s disease, which can be an early indication of breast cancer.

The skin changes on the nipples often look like more benign conditions like psoriasis or eczema, but don’t respond to traditional treatments for those issues and instead worsen.

New shape or increase in breast size

An enlarged breast — particularly if the swelling is isolated to one breast — or a change in the shape of the breast, can indicate issues within the tissue.

“An unusual shape where the contour is distorted and there’s a bulge in one part of the breast can be a sign of cancer,” says Weiss.

“It could feel like a lump, but it could also just be a region of the breast that feels firmer, and you can’t really feel a lump within it,” she says. “It also often becomes more pronounced when moving in different positions.”

Inverted nipple

A nipple that looks flat or inverted, as well as a nipple that points in a different direction than it once did, can be a sign of breast cancer.

“Instead of pointing straight outward or downward, it no longer looks in the same direction, but in a different spot,” says Weiss.

A flat or inverted nipple is another sign of Paget’s disease.

Red or hot spots

Red or hot spots on the breast, sometimes covering the entire breast, can be an indicator of inflammatory breast cancer.

While red or hot spots can also indicate mastitis — inflammation of breast tissue due to infection, most often experienced during lactation — mastitis symptoms are usually accompanied by fever.

Red or hot spots without fever that persist and don’t improve can mean breast cancer is present.

The takeaway

Weiss says it’s important to remember that these signs and symptoms can indicate other benign issues that aren’t breast cancer, but it’s critical to monitor the symptoms and act if they don’t subside.

And for those who’ve already had breast cancer, it can be even more difficult to discern the innocuous from the malignant. In that case, Weiss says it’s particularly crucial to monitor changes in the breasts and alert your doctor when something doesn’t look or feel right.

“You’re always worried about recurrence of a new problem, so the ability to recognize the less common symptoms and signs may be a little trickier,” she says.

It’s sometimes difficult to distinguish between leftover scar tissue from your prior breast cancer. And if you’ve had mastectomy and reconstruction, you could have lumps and bumps in there that are due to scar tissue from all the healing where they removed and recreated your breast, says Weiss.

No matter what, Weiss advises women to pay attention to their bodies and maintain regular self-exams and mammograms. And should they notice something out of the ordinary? Let their doctor know.

Jennifer Bringle has written for Glamour, Good Housekeeping, and Parents, among other outlets. She’s working on a memoir about her post-cancer experience.

CT Guided Biopsy

A few days ago, I had a CT Guided Biopsy of my 8th rib on the left side, on my back. Everything went well; I am in a little bit of pain, but nothing that Tylenol can’t help. The doctor instructed me to rest for the rest of the day on Thursday, remove my bandage on Friday, and resume my normal activities.

After finishing my paperwork in the hospital registration office, I went to the lab to have my blood drawn for a few panels; among a few other things, they had to check my kidney function before doing the CT, and after that, I went to radiology to wait to be taken to the pre-op area.

Once my nurse was done prepping me for my procedure, my anesthesiologist came to get me and take me to the CT room. He explained that he would only give me enough medication to make me relaxed and a little sleepy but not entirely out. He said that if I did get sleepy not fight it and let myself fall asleep. I did fall asleep for some of the procedure, but I don’t think it was for very long because the process only took about 30 minutes.

When I walked into the CT room, they had me lay on my stomach on the CT table. I was shocked to find out that the lesion is actually on my 8th rib on the left side of my back, not in the front, and it is very close to my spine, so that has me a bit concerned. The rib that I fractured some 18 years ago, that I was thinking was what was showing up in my scans, was a few ribs down from where the lesion is located, so it has nothing to do with the lesion at all. So with that said, I don’t know what to expect when I meet with my oncologist next Tuesday to get my biopsy results.

I have had many people ask me what I think of all of this, how I am feeling, and what my gut is telling me. I can’t help but see the similarities to the first time I went through cancer three years ago. With every appointment, things get worse and worse, more scans, more biopsies, etc. As before, I want to know what type of cancer I have to fight against, and I want to get started on whatever treatment plan my doctors and I agree on as soon as possible so I can get this over with and move on.

I am feeling OK so far. Even if the lesion on my rib is positive for cancer, it appears to be localized like the tumors in my neck, so it is not as aggressive as it was in 2019, and because of that, I have been feeling much better physically this time around so far. Mentally I am up and down; the stress is unreal because this is the moment as a cancer survivor that I have been fearful of, having to deal with recurrence.

Lastly, what is my gut telling me? I will be shocked if the lesion on my rib is negative for cancer. After reading the PET scan report and looking up a few medical terms that I had not seen before, I immediately thought that it would be a bad result once the biopsy results came in. I, of course, hope that I am wrong, and in a few days, I will know for sure.

Radiation Oncologist Appointment

A few days ago, I had an appointment with my radiation oncologist. I hadn’t seen her in over two years, so it was nice to see her, but I wish it had been under different circumstances. After we caught up on where we had been, I was finally able to show her the pictures from our vow renewal ceremony, so that was nice, and what we had been doing; we discussed my cancer.

Unfortunately, since the CT of my neck came back clear, she has to wait for the results from my PET scan. She needs to see the exact size and location of the tumor to figure out if she can treat me or not. If there is even the slightest part of the tumor in my previous treatment area, she can’t put me through radiation. I didn’t know that you couldn’t radiate the same area more than once, so we must have clear images to compare from 2019/2020 to today. My PET scan is tomorrow, Friday, and I am going back to my oncologist next Tuesday for the results.

So after my initial appointment, my doctor asked if I could come back in an hour to do some plotting with the tech. I didn’t need to be anywhere, so I said I could come back, no problem. When I came back, they took me to the CT room, measured a few coordinates, and went ahead and marked me with stickers in case I could have radiation soon. When I laid down on the table, my doctor came over and felt where the tumor was, and she said, ” it seems like it is very superficial; that might be why the CT scan didn’t see it.” I hadn’t thought of that being the reason for the clear CT, but it makes sense.

Next, they had me put both arms over my head, which is the position I will have to be in for the radiation treatments. It has been almost three years since my first surgery in April 2019, and it still hurts to have my arms up over my head for any length of time. I have gained a lot of mobility back since that first surgery but not 100%. Because of the pain I am in when in that position, they will make molds for me to rest my arms in so the pain and pressure will be decreased, making me more comfortable. When I put my arms up, my doctor felt the tumor again and said it had dropped slightly in location, taking it closer to the area where I had radiation before; this is not good if I want radiation to be the primary treatment to get rid of the tumor.

So, now we are waiting for my PET scan and the results. What will happen if I can’t have radiation? I am guessing that I will have to have surgery to remove the tumor, but after that, I am not sure. I will be asking my oncologist about that when I see him on Tuesday next week.

Scan Results & My Treatment Plan

So I guess if there can be any good news that goes along with having cancer again, that would be the good news I received today.

There is a spot on one of my ribs in the nuclear medicine bone scan. I am confident that it is from when I fractured my rib ages ago. We need to be sure that it is from my fracture and not more cancer, so I have a PET scan scheduled for next Friday. Something odd is that the CT of my neck came back clear, yet that is where the tumor is located; the CT couldn’t find the tumor that I can feel, crazy! My other CT came back clear, so the cancer is isolated to my neck. I will have to go through radiation, so I have an appointment with my radiation oncologist next Tuesday. She will determine how much radiation I need and if I will need surgery after radiation.

After radiation, I will be put on a new inhibitor because the one I have been on for the last two years didn’t work other than possibly keeping the new cancer from spreading. I will also be going through chemotherapy again, but this time, it will be in pill form, not by infusion, and for at least two years. But the good news is that I will not lose my hair while on the chemotherapy drug.

As far as my diagnosis, I have the same cancer I had before, invasive ductal carcinoma, breast cancer stage 3c. Because the tumor is nearby where the cancer was in 2019/2020, in the lymph nodes in my neck, and it has not spread to my organs, it is still considered breast cancer. Oddly enough, the tumor is on the same side of my body this time as well.

All in all, I am very relieved! I will update you after my next appointment.

I Have Cancer, Again

I received my biopsy results yesterday, and they were positive for cancer. My oncologist’s office called me in the morning and scheduled an appointment right away for today to discuss our next steps.

I was hoping that my oncologist could tell me what type of cancer I have today, but we do not have those results back yet, so I will hopefully know in a few more days. There are a couple of possibilities as far as my treatment goes, but I won’t have a definite plan until scans are done, and the results are back.

On Monday, I will be going to the hospital for a bone scan-nuclear medicine, CT neck with contrast, and CT C/A/P with contrast {ct scan of chest, abdomen, and pelvis.} If there is cancer anywhere besides my neck, we will know for sure once the scans are completed and analyzed.

On Friday next week, I will meet with my oncologist to review the scan results and my treatment plan. I do know that I will most likely have radiation therapy on my neck; anything beyond that will be determined during my appointment.

More to come…

Ultrasound-Guided Biopsy: **WARNING: SENSITIVE MATERIAL**

So here we are again, another biopsy, just shy of a few weeks from three years ago when my surgeon did my first biopsy and diagnosed me with breast cancer.

This time I was only in pain when my surgeon gave me the shot of lidocaine. He kept asking me if I was OK because the needle was in for a little bit as he moved it around at different angles to numb the area around the mass. I was facing away from him so he couldn’t see my face for a reaction, so I appreciated him asking me how I was doing multiple times, as it was just another example of what a kind and caring doctor he is.

I had to lay on my right side so he could easily get to the mass because it was at an odd angle on my neck. Since I was lying on my side, I was able to watch the ultrasound monitor and see him put each needle in the mass, collect a sample, then pull the needle back out. As he put each sample into a small container with a tiny amount of saline, his assistant closed each container; there were three in total. He said that the mass is about 1 centimeter, so I hopefully caught it early enough.

All in all, everything went fine. I should have the results back at the latest on Tuesday. I couldn’t help but notice that my surgeon told me that he was taking the samples over to the lab personally, right away. Yes, that did concern me a little, his urgency, and that only made my gut feeling about all of this feel more valid. He also told me that he spoke with my oncologist and that if my results are positive, my oncologist will order the PET scan asap.

Minor bruising today, along with a small hematoma. I am very, very sore, but you would be too if you had four needles poked in you!

My gut feeling is based on these events, are they coincidences? This mass is very much like the first one three years ago in many ways. It feels the same and looks the same on the ultrasound, and there is something else, each time I have had pain in another part of my body before finding a mass. I first had pain in my neck, shoulder, and shoulder blade a few weeks before finding my tumor. I thought I had slept funny, but as the days went by, the pain did not go away. This time, around Thanksgiving, I had terrible pain on the outside of my ear, going up the side of my head to the top of my head. As I said in a previous post, my oncologist ordered an MRI of my head, but it was clear, so we had no explanation for my pain. I was in agony until about two weeks ago when the pain suddenly stopped, and I now have found another mass.

I will update as soon as I have the results…prayers! 💕

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