Breast cancer is very common, with about one in eight women in the U.S. developing it over the course of their lifetime. And while most know to get regular mammograms and check for lumps, knowing the sneaky signs of breast cancer besides a lump can help you identify the illness sooner and get the life-saving treatment you need.
“Early detection is so important with breast cancer because early-stage breast cancer is highly treatable and highly curable,” says Tara Olson, M.D., an ob/gyn and physician manager at Simmonds, Martin & Helmbrecht of Advantia in Frederick, MD. According to the American Cancer Society, the survival rate for cancer that has not spread outside the breast is over 99%. “We have gotten significantly better at detecting breast cancer early,” adds Amy Bremner, M.D., the medical director of breast surgical oncology at MemorialCare Saddleback Medical Center in Laguna Hills, CA. “With greater awareness, improved imaging techniques, and widespread mammography implementation, the proportion of breast cancers diagnosed at an early stage has increased greatly.”
Meet the experts: Tara Olson, M.D., an ob/gyn and physician manager at Simmonds, Martin & Helmbrecht of Advantia in Frederick, MD; Amy Bremner, M.D., the medical director of breast surgical oncology at MemorialCare Saddleback Medical Center in Laguna Hills, CA.
Here, the sneaky signs of breast cancer that doctors say you should be aware of, plus the most common risk factors and when to give your doctor a call.
Top signs of breast cancer to know
While a mass or lump on the breast is the most recognizable sign of breast cancer, not everyone is going to have one at first. “One in six women with breast cancer will present with a symptom other than a palpable mass,” says Dr. Bremner. That’s why knowing the other possible signs is essential. “The National Comprehensive Cancer Network (NCCN) Breast Cancer Screening and Diagnosis guidelines categorize key signs and symptoms into the following: palpable changes, nipple changes, skin changes, breast pain, and axillary mass,” Dr. Bremner says. How might these manifest? Dr. Olson says to keep an eye out for the following signs:
- A lump in the breast
- Redness, dimpling, or an orange peel appearance to the skin
- Bloody, green, or black nipple discharge
- Swelling in your armpits
- Pain that is concentrated in one area
“Really any changes to your breast are worth calling [your healthcare provider] about,” Dr. Olson adds. You know yourself best; anything that seems out of the ordinary for you deserves a second look.
Risk factors for breast cancer
If you’ve noticed something that seems unusual but you’re not sure if it fits into one of the above categories, knowing what causes breast cancer and your current risk for developing it can help you determine if your symptoms are worth looking into. “The biggest risk factor is age. The older you get, the more likely you are to get breast cancer,” says Dr. Olson. According to the National Cancer Institute, your risk of developing breast cancer is just one in 204 (or 0.5%) in your 30s, climbing all the way to one in 24 (or 4.1%) at age 70 and beyond.
In addition to your age, Dr. Bremner adds that other non-modifiable risk factors (a.k.a. risk factors that are out of your control) include inherited gene mutations, family history, breast density, and a history of childhood chest radiation.
There are also risk factors over which you do have some control. “Modifiable risk factors account for approximately 30% of breast cancers,” Dr. Bremner says. “Those include obesity, alcohol use, physical inactivity, and hormone replacement therapy.” It’s worth noting that the U.S. Food and Drug Administration (FDA) recently removed the black box warning from hormone replacement therapy products, noting that the latest research suggests it can be safe for many people and that when you start it significantly impacts whether it will increase your risk of breast cancer.
The bottom line
“I always tell my patients that if something doesn’t look right or feel right to you or your partner, please schedule an appointment with your gynecologist or primary care provider,” says Dr. Olson. In the meantime, regular screening mammograms are essential; the U.S. Preventive Services Task Force recommends that women between 40 and 74 years old with an average risk of breast cancer get a mammogram every two years. “A landmark article showed women aged 40 to 69 years who participated in organized mammography screening had a 60% lower risk of dying from breast cancer within 10 years of diagnosis and a 47% lower risk of dying from breast cancer within 20 years of diagnosis compared with women who did not participate in screening,” Dr. Olson says. Taking the right preventive action can make all the difference.
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