This page was reviewed under our medical and editorial policy by
Daniel Liu, MD, Plastic and Reconstructive Surgeon
This page was reviewed on February 18, 2022.
Breast cancer is most often associated with having a breast lump. However, your symptoms may vary depending on your specific type of breast cancer. While it’s true that many patients have a lump, it is possible to have breast cancer with no lump. So it’s important to know the other signs and symptoms.
In general, the body produces certain warning signs. The most common is the breast lump, which may be located anywhere along your chest wall to under your armpit. You may have nipple bleeding or discharge, as well as related pain. There may be redness and/or swelling in any area of the breast or in one breast and not the other, and your nipple could look flatter or caved in.
Having some of these symptoms or breast changes doesn’t necessarily mean you have breast cancer. Many other factors go into a diagnosis, not just outward signs.
Early detection of breast cancer is key when it comes to breast cancer treatment options. If you have concerns with any new changes in your breasts, ask your doctor to review your symptoms and determine whether there’s a need for further evaluation.
To help answer your questions on the signs and symptoms to look for with different types of breast cancer, this guide will cover:
A painless lump in the breast is usually the first sign of breast cancer, though you may not feel it yourself. Instead, many lumps are detected by a routine screening mammogram. In fact, at the time of diagnosis, most women don’t have any apparent signs of breast cancer. When the tumor is small in the early stages of breast cancer, it’s rarely noticeable to the touch or the naked eye. That’s why mammograms play an important role.
Mammograms (low-dose X-rays of the breast) may help detect a tumor in the breast long before it’s big enough to start causing symptoms and when the cancer is likely to be more easily treatable. Tumors may be as small as the tip of a pencil (1 mm) or as big as a lime (50 mm). Mammograms are designed to spot tumors on the smaller end of the spectrum, when they can’t yet be seen or felt. Regular mammograms are the most reliable way to catch breast cancer early, according to the American Cancer Society. But mammograms on their own can’t catch every case of breast cancer, which is why it’s important to pay attention to changes in your breasts, because you know your body best.
Symptoms of breast tumors vary from person to person. Some common, early warning signs of breast cancer include:
Symptoms more specific to invasive breast cancer are:
It's important to remember that other, benign conditions may have caused these changes. For example, changes to the skin texture on the breast may be caused by a skin condition like eczema, and swollen lymph nodes may be caused by an infection in the breast or another, unrelated illness. Seeing a doctor for an evaluation will help you determine whether something you notice is cause for concern.
Non-invasive breast cancer is sometimes called stage 0 cancer. It is an early stage of breast cancer, meaning the tumor is often very small. Given that the primary symptom of breast cancer is an abnormal lump in the breast and non-invasive breast cancer usually comes with a tumor that’s so small it’s only detectable by a mammogram, non-invasive breast cancer is unlikely to cause noticeable physical symptoms.
Ductal carcinoma in situ (DCIS) does not cause any symptoms. Rarely, a woman may feel a lump in the breast or have nipple discharge. However, most cases of DCIS are detected with a mammogram.
Lobular carcinoma in situ (LCIS) does not cause symptoms and cannot be seen with a mammogram. This condition is usually found when a doctor is doing a breast biopsy for another reason, such as to investigate an unrelated breast lump. If a person has LCIS, the breast cells will appear abnormal under a microscope.
Most breast cancers start in the ducts, or the tubes that carry milk to the nipple, or in the lobules, the little clusters of sacs where breast milk is made. Invasive breast cancer refers to breast cancer that spreads from the original site to other areas of the breast, the lymph nodes or elsewhere in the body. In these cancers that form in the ducts or lobules, invasive ductal carcinoma (IDC) or invasive lobular carcinoma (ILC), the cancer spreads from the ducts or lobules to other tissue. Depending on the stage, you may notice symptoms.
Invasive breast cancer symptoms may include:
Unlike other breast cancers, inflammatory breast cancer (IBC) rarely causes breast lumps and may not appear on a mammogram. Inflammatory breast cancer symptoms include:
Unlike other breast cancers, inflammatory breast cancer usually does not cause a distinct lump in the breast. Therefore, a breast self-exam, clinical breast exam, or even a mammogram may not detect inflammatory breast cancer. Ultrasounds may also miss inflammatory breast cancer. However, the changes to the surface of the breast caused by inflammatory breast cancer can be seen with the naked eye.
Symptoms of inflammatory breast cancer can develop rapidly, and the disease can progress quickly. Any sudden changes in the texture or appearance of the breast should be reported to your doctor immediately.
For women who are pregnant or breast-feeding, redness, swelling, itchiness and soreness are often signs of a breast infection such as mastitis, which is treatable with antibiotics. If you are not pregnant or nursing and you develop these symptoms, your doctor should test for inflammatory breast cancer.
Because of the aggressive nature of IBC, City of Hope knows it’s critical to detect and diagnose the disease quickly, develop a comprehensive treatment plan and provide supportive care services that help improve patients’ treatment outcomes and reduce their side effects.
Metastatic breast cancer symptoms depend on the part of the body to which the cancer has spread and its stage. Sometimes, metastatic disease may not cause any symptoms.
Although papillary carcinoma may not be present, a routine mammogram may detect its development. For those who do experience symptoms related to this type of cancer, the following may be common:
Another rare form of breast cancer, angiosarcoma forms inside the lymph and blood vessels. Only a biopsy may definitively diagnose this type of cancer. Angiosarcoma can cause changes to the skin of your breast, such as the development of purple-colored nodules that resemble a bruise. These nodules, if bumped or scratched, may bleed. Over time, these discolored areas may expand, making your skin appear swollen in that area. You may or may not have breast lumps with angiosarcoma. If you also have lymphedema, which is swelling caused by a buildup of lymphatic fluid, angiosarcoma may occur in the affected arm. Cancer treatment sometimes damages the lymph vessels, which may lead to lymphedema.
Most phyllodes tumors are benign, but one in four is considered cancerous, according to the ACS. This rare type of cancer is found in the connective tissues of the breast. Most patients don’t experience pain, although they may have a lump. Phyllodes tumors may grow fast but, fortunately, they don’t typically spread to other areas of the body. Because these tumors may grow quickly, causing the skin to stretch, they need to be surgically removed. If a tumor is cancerous, your care team may recommend that you undergo a mastectomy to prevent it from growing back, especially if the tumor wasn’t completely removed during the initial surgery.
Male breast cancer symptoms can be similar to those experienced by women and may include:
At the Breast Cancer Centers at each of our City of Hope hospitals, located across the nation, our cancer experts are devoted to a single mission—treating breast cancer patients with compassion and precision. Each patient’s care team is led by a medical oncologist and coordinated by a registered oncology nurse, who helps track the various appointments, follow up on tests and answer questions that come up along the way. Your care team also may include a breast surgeon, radiation oncologist, radiologist, pathologist and a plastic/reconstructive surgeon with advanced training in helping patients restore function and appearance. Fertility preservation and genetic testing are also available for qualifying patients who need them.
Our pathologists and oncologists are experienced and trained in tools designed to diagnose, stage and treat different types of breast cancer, from early-stage ductal carcinoma in situ to complex diseases such as triple-negative and inflammatory breast cancer. As part of our patient-centered care model, which is designed to help you keep strong during treatment, your multidisciplinary care team may recommend various evidence-informed supportive therapies, such as naturopathic support, psychosocial support, nutritional support, physical and occupational therapy and pain management. The entire team works together with a whole-person focus, which is at the heart of our centers’ dedication to personalized and comprehensive care.
Next topic: What are the types of breast cancer?
