Lumps get most of the attention when you think about the symptoms of breast cancer. You’ve probably heard that you should check your breasts regularly and be on the lookout for new or unusual bumps you can’t remember being there before. If you do find one, don’t panic—some women’s breasts happen to be lumpy without it being a sign of cancer. But if it’s a new lump, feels different from other lumps, or you just want some reassurance, it’s a good idea to get it looked at by a doctor.
But there are other breast cancer signs you should know, too. “It’s not uncommon for breast cancer to present itself as something other than a lump,” Jack Jacoub, M.D., a medical oncologist and medical director of MemorialCare Cancer Institute at Orange Coast Medical Center in Fountain Valley, Calif., tells SELF, estimating that anywhere from 10 to 20 percent of breast cancers he’s seen don’t involve one. While the most common symptom of breast cancer is still a new bump or mass, according to the American Cancer Society, here are a few others that should be on your radar, too.
1. Skin dimpling
Tumors can be deep in your breast and cause inflammation around them that tethers to the ligaments and skin, Dennis Holmes, M.D., a breast cancer surgeon and researcher and interim director of the Margie Petersen Breast Center at John Wayne Cancer Institute at Providence Saint John’s Health Center in Santa Monica, Calif., tells SELF. When this happens, part of your skin can be pulled in, creating a dimpled effect. This tends to be more obvious when your arms are raised, Dr. Holmes says, so make sure you also elevate your arms when you’re inspecting your breasts and bring this change up with your doctor.
2. Nipple retraction
Most women’s nipples stick out, but it’s possible to have inverted nipples, where your nipple is pulled into the breast. That’s no biggie from a medical standpoint. What is concerning, though, is if your nipple used to stick out and starts to get pulled inward. Nipple retraction can be caused by a tumor that’s located in the center of your breast, says Dr. Holmes. “It involves the milk ducts and causes them to shorten, pulling in the nipple, ” he explains. Like dimpling, this is more obvious when your arms are raised and is more than enough reason to check in with your doctor.
3. Nipple discharge
It’s important to take a few things into account with this one, says Dr. Jacoub. If you’re pregnant or breastfeeding, it’s normal to have some nipple discharge. But if you’re not and you have bloody or clear discharge from your nipples, even when you’re not squeezing them, it’s important to get it checked out, John Kiluk, M.D., F.A.C.S., a breast cancer surgeon at Moffitt Cancer Center, tells SELF. Keep in mind, though, that nipple discharge isn’t automatically a sign that you have cancer. Noncancerous tumors in the breast, called papillomas, can cause a bloody discharge, according to the Mayo Clinic, and birth control, breast infections, and having fibrocystic (i.e., lumpy) breasts can also cause discharge. In any case, a medical professional can help you determine the cause and figure out the best course of treatment if necessary.
4. Breast asymmetry
It’s pretty likely that your boobs aren’t a perfectly-matched set, but if you start to see that one is suddenly becoming bigger than the other or its shape is changing somehow, it’s time to call your doctor. “The most important thing is noticing a change,” Dr. Kiluk says. A ductal or lobular breast cancer can cause asymmetry in your breasts, although weight gain and loss can as well. Bottom line: You won’t know what’s going on until you get it checked out.
5. Redness or a rash
Your boobs are regularly subjected to things that can irritate them, like your bra, lotions, and soaps. But if you notice a redness or freckle-like rash on your breast that feels warm to the touch and isn’t going away, you should get it checked out. Again, it could just be the soap you found in your partner’s shower or the new detergent you switched to. However, in rare cases, it could be a sign of inflammatory breast cancer, a rare and aggressive form of breast cancer, Dr. Holmes says. Worth noting: People with nipple piercings can develop the skin infection cellulitis, which has similar symptoms, Dr. Jacoubs says. Cellulitis requires a doctor’s care, too, so if you’re dealing with strange nipple symptoms, you might as well make an appointment.
6. Breast or nipple pain
This is an unusual symptom of breast cancer, but it can happen, especially as a sign of inflammatory breast cancer. “It could be an infection, but you might need a mammogram or ultrasound to be sure,” Dr. Jacoub says. If you get an ultrasound or mammogram and it’s inconclusive or negative for breast cancer but doctors can’t find another cause for your symptoms that makes sense, don’t let it go. “Don’t lose sight of it and keep pushing for answers,” Dr. Jacoubs says.