Symptoms of breast cancer

Symptoms of breast cancer can vary, the most common of which are: breast lumps, breast pain, nipple discharge, erosion or skin depression, axillary lymph node enlargement, etc. Today we will study this knowledge together.

Although these symptoms are not necessarily specific, understanding them and recognizing these manifestations will help us detect, diagnose and treat breast cancer early. Of course, the appearance of some symptoms indicates that the disease is no longer in the early stage, so a comprehensive and in-depth understanding and mastery of these symptoms can prevent us from being heartbroken by missing the opportunity for treatment, and we do not need to worry too much and affect our normal life.

Breast lumps

Breast lumps are the most common symptom of breast cancer, and about 90% of patients seek medical treatment for this symptom. With the popularization of tumor knowledge and the implementation of cancer prevention screening, this proportion may increase. If a breast lump appears, you should understand the following aspects.

1. Location: The breast can be divided into five areas, namely, upper inner area, upper outer area, lower inner area, lower outer area and central area (areola), by making a cross with the nipple as the center. Breast cancer is more common in the upper outer area, followed by the upper inner area. The lower inner area and the lower outer area are less common.

2. Number: Breast cancer is most common with a single lump in one breast. Multiple unilateral lumps and primary bilateral breast cancer are rare in clinical practice. However, with the improvement of tumor prevention and treatment, the survival of patients is constantly prolonged. After surgery for breast cancer in one breast, the chance of a second primary cancer in the contralateral breast will increase.

3. Size: Early breast cancer lumps are generally small, and sometimes difficult to distinguish from lobular hyperplasia or some benign lesions. However, even very small lumps can sometimes involve the breast suspensory ligaments, causing local skin depression or nipple retraction, which are easier to detect early. In the past, due to poor medical care, lumps were often larger when they came to the doctor. Nowadays, with the popularization of breast self-examination and the development of census work, the number of early breast cancers in clinical practice has increased.

4. Morphology and borders: Most breast cancers grow in an invasive manner with unclear borders. Some may be flat, with an uneven surface and a nodular feel. However, it should be noted that the smaller the tumor, the less obvious the above symptoms are. In addition, a few special types of breast cancer may grow in an expansive manner due to less infiltration, appearing smooth, mobile, and with clear borders, making them difficult to distinguish from benign tumors.

5. Hardness: Breast cancer lumps are hard, but cellular medullary carcinomas may be slightly softer, and some may be cystic, such as cystic papillary carcinoma. A few lumps are surrounded by more fat tissue and feel soft when palpated.

6. Mobility: When the tumor is small, the mobility is large, but this activity is the movement of the tumor and its surrounding tissues, which is different from the mobility of fibroadenoma. If the tumor invades the pectoralis major fascia, the mobility will be weakened; if the tumor further involves the pectoralis major muscle, the activity will disappear. Ask the patient to put his hands on his waist and chest to contract the chest muscles, and you can see that the breasts on both sides are obviously asymmetrical. Advanced breast cancer can invade the chest wall, which is completely fixed, the lymph nodes around the tumor are invaded, and the skin edema can be orange peel-like, called "orange peel sign", and nodules appear under the skin around the tumor, called "satellite nodules".

Among benign breast tumors, it is not uncommon to present as breast lumps, among which the most common is breast fibroadenoma. This disease is more common in young women, and the incidence is low in those over 40 years old. The tumor is often solid, tough, has a complete capsule, a smooth surface, and feels sliding to the touch. Generally, there is no skin adhesion, and it does not cause nipple retraction. Intraductal papilloma, the lumps are often very small and difficult to palpate. In slightly larger ones, small nodules can be palpated around the areola, and the main clinical symptom is nipple discharge. Breast lobular hyperplasia rarely forms a clear lump, but is mainly characterized by local thickening of breast tissue, which is tough in texture and has no capsule feeling. There is often swelling and pain before menstruation.

Some cases only show local breast gland thickening without obvious lumps or clear boundaries, and most are diagnosed as "hyperplasia of the breast." However, if the thickening area is relatively limited and accompanied by a little skin adhesion, you should pay attention and take a breast X-ray.

Breast pain

Although breast pain can be seen in many breast diseases, it is not a common symptom of breast tumors. Regardless of whether it is benign or malignant, breast tumors are usually painless. In early breast cancer, pain is occasionally the only symptom, which may be dull pain or a pulling sensation, especially when lying on the side. Studies have shown that the detection rate of breast cancer will increase in postmenopausal women who experience breast pain accompanied by glandular thickening. Of course, there may be distension or tenderness when the tumor is accompanied by inflammation. If the advanced tumor invades the nerves or the enlarged axillary lymph nodes compress or invade the brachial plexus, there may be distension and pain in the shoulder.

Nipple discharge

Nipple discharge can be divided into physiological and pathological. Physiological nipple discharge is mainly seen in pregnant and lactating women. Pathological nipple discharge refers to the secretion of mammary ducts under non-physiological conditions. The latter is usually referred to. Nipple discharge can be caused by a variety of breast diseases and is more likely to be noticed by patients. It is one of the main reasons for about 10% of patients to come to the clinic for treatment. Among the symptoms of various breast diseases, its incidence is second only to breast lumps and breast pain.

1. Nipple discharge can be divided into bloody, serum-like, serous, watery, purulent, and milky discharge according to its physical properties. Among them, serous, watery, and milky discharge are more common, and bloody discharge only accounts for 10% of discharge cases. When the lesion is located in the large duct, the discharge is mostly bloody; when it is located in the smaller duct, it can be light bloody or serous; if the blood stays in the duct for too long, it can be dark brown; when there is inflammation and infection in the duct, it can be mixed with pus, and liquefied necrotic tissue can be watery, milky, or brown liquid; the fluid of mammary duct ectasia is often serous. Bloody discharge is mostly caused by benign lesions, and a few breast cancers can also be bloody. Physiological nipple discharge is mostly bilateral, and the discharge is often milky or watery.

2. The causes of nipple discharge are mainly divided into: external breast factors and internal breast factors.

5% to 10% of breast cancer patients have nipple discharge, but only 1% have nipple discharge as the only symptom. The discharge is often uniductal and can be of various natures, such as bloody, serous, watery or colorless. Breast cancers that originate in large ducts or are intraductal carcinomas are more likely to have nipple discharge, such as malignant transformation of intraductal papilloma and eczematoid carcinoma of the nipple. It is worth noting that although most people believe that breast cancer is rarely accompanied by nipple discharge, and even if discharge occurs, it almost always occurs after or at the same time as a lump, and those without a lump are rarely considered cancer. However, recent studies have shown that nipple discharge is an early clinical manifestation of some breast cancers, especially intraductal carcinoma, and can exist alone before an obvious lump is formed.

Intraductal papilloma is a disease that causes nipple discharge most often, and it ranks first among all nipple discharge lesions. Among them, intraductal papilloma in the areola area is the most common, which can be single or multiple. The age distribution ranges from 18 to 80 years old, and it is mainly common in 30 to 50 years old. The diameter of the tumor varies from 0.3 to 3.0 cm, with an average of 1.0 cm. Tumors larger than 3.0 cm are often malignant. The nature of the discharge is mostly bloody or serous, and others are rare. It is generally believed that papilloma occurring in large ducts is mostly single and rarely becomes cancerous, while those in small and medium ducts are often multiple and can be seen to become cancerous. The two are the same lesions, but they are different in the location and growth process.

Although cystic hyperplasia is not a tumor, it is the most common benign lesion of breast tissue, which is more common in people around 40 years old and rarely seen after menopause. Among them, cysts, ductal epithelial hyperplasia, and papillomatosis are the three pathological changes that are the basis of its discharge. The nature is mostly serous, and only 5% of this disease is combined with discharge.

Nipple changes

If breast cancer patients have abnormal nipple changes, they usually manifest as nipple erosion or nipple retraction.

1. Nipple erosion: There is a typical manifestation of Paget's disease of the breast, which is often accompanied by itching. About 2/3 of patients may have lumps in the areola or other parts of the breast. At the beginning, there is only nipple desquamation or small nipple fissures. Nipple desquamation is often accompanied by a small amount of secretions and scabs. When the scabs are removed, bright red erosions can be seen, which will not heal for a long time. When the entire nipple is affected, it can further invade the surrounding tissues. As the disease progresses, the nipple may disappear completely. Some patients may also first develop breast lumps and then nipple lesions.

2. Nipple retraction: When the tumor invades the nipple or the area under the areola, the fibrous tissue and duct system of the breast may be shortened, pulling the nipple, causing it to sink, deflect, or even completely retract behind the areola. At this time, the nipple on the affected side is often higher than the healthy side. It may appear in early breast cancer, but sometimes it is also a late sign, mainly depending on the growth site of the tumor. When the tumor is under or near the nipple, it can appear in the early stage; if the tumor is located in the deep breast tissue and far away from the nipple, this sign usually appears in the late stage. Of course, nipple retraction and depression are not all malignant lesions. Some may be caused by congenital maldevelopment or chronic inflammation. At this time, the nipple can be pulled out with fingers and is not fixed.

Skin changes

Skin changes caused by breast tumors are related to the location, depth and degree of invasion of the tumor, and usually have the following manifestations:

1. Skin adhesion: The breast is located between the deep and superficial fascia. The superficial layer of the superficial fascia is connected to the skin, and the deep layer is attached to the superficial surface of the pectoralis major muscle. The superficial fascia forms the interlobular septum in the breast tissue, that is, the suspensory ligaments of the breast. When the tumor invades these ligaments, it can shrink and shorten them, pulling the skin to form a depression, like a dimple, so it is called the "dimple sign". When the tumor is small, it can cause very slight skin adhesion, which is not easy to detect. At this time, it is necessary to gently support the affected breast under good lighting conditions to increase its surface tension. When moving the breast, it is often seen that the skin on the surface of the tumor has slight pulling and depression. If you have this symptom, you should be alert to the possibility of breast cancer. Benign tumors rarely have this symptom.

2. Superficial varicose veins of the skin: When the tumor is large or grows rapidly, the skin on the surface may become thinner, and the superficial blood vessels and veins underneath may often become varicose. This is more clearly seen in LCD thermal images and infrared scans, and is common in giant fibroadenomas of the breast and phyllodes cystosarcoma. Tumors during acute inflammation, pregnancy, and lactation also often have superficial varicose veins.

3. Redness of the skin: In acute and chronic mastitis, the breast skin may be red and swollen. However, in breast cancer, it is mainly seen in inflammatory breast cancer. Because the subcutaneous lymphatic vessels are all occupied by cancer thrombi, it can cause carcinomatous lymphangitis. At this time, the skin color is light red to dark red, which is relatively limited at first and soon spreads to most of the breast skin, accompanied by skin edema, thickening, and increased skin temperature.

4. Skin edema: As the subcutaneous lymphatic vessels of the breast are blocked by tumor cells or the central area of ​​the breast is infiltrated by tumor cells, the return of the breast lymphatic vessels is blocked, lymph fluid accumulates in the lymphatic vessels, the skin becomes thicker, and the hair follicles are enlarged and sunken, showing "orange peel-like changes". In obese and sagging breasts, mild skin edema is often seen on the outer and lower sides. If it is bilaterally symmetrical, it is caused by local circulation disorders; if it is unilateral, it should be cautious and beware of the possibility of cancer.

In addition, advanced breast cancer can directly invade the skin and cause ulcers, which can have a bad odor if combined with bacterial infection. If cancer cells infiltrate the skin and grow, they can form scattered hard nodules around the main lesion, known as "skin satellite nodules."

Swollen lymph nodes in the armpit

Breast cancer gradually develops and can invade lymphatic vessels and metastasize to its local lymphatic drainage area. Among them, the most common site of lymphatic metastasis is the ipsilateral axillary lymph nodes. Lymph nodes often gradually increase in size from small to large, and the number of lymph nodes gradually increases from small to large. At first, the swollen lymph nodes can be pushed, and finally they fuse and fix each other. If the swollen lymph nodes invade and compress the axillary vein, it can often cause edema of the ipsilateral upper limb; if it invades the brachial plexus, it can cause shoulder pain. When checking the axillary lymph nodes, the affected upper limb should be relaxed as much as possible so that the top of the armpit can be palpated. If the swollen lymph nodes can be touched, it is necessary to pay attention to the number, size, texture, mobility and surface condition of the lymph nodes to distinguish them from inflammation and tuberculosis.

If there is no lump in the breast, but enlarged axillary lymph nodes are the first symptom, few people come to the doctor for treatment. When the axillary lymph nodes are enlarged and pathology confirms metastatic cancer, in addition to carefully examining the lymphatic drainage area, lung and digestive tract tumors should be excluded. If the pathology suggests metastatic adenocarcinoma, pay attention to the possibility of "occult breast cancer". At this time, breast lesions are often not found, and mammography may help with diagnosis. The lymph nodes are tested for hormone receptors. If positive, even if all tests fail to find lesions in the breast, breast tumors should still be considered.

Breast cancer can metastasize to the ipsilateral axillary lymph nodes, and can also metastasize to the contralateral axillary lymph nodes through the mutual communication between the anterior chest wall and the internal mammary lymphatic network, with an incidence of about 5%. In addition, advanced breast cancer can also metastasize to the ipsilateral supraclavicular lymph nodes, or even the contralateral supraclavicular lymph nodes.

As long as women can have a strong awareness of cancer prevention, fully understand and master the knowledge, and do self-examinations seriously, I believe that cancer will by no means be an incurable disease as the level of medical care improves.

Symptoms of Male Breast Cancer

Theoretically, breast cancer is caused by the appearance of malignant tumor tissue in breast cells. Men also have breast tissue, so they can also develop breast cancer. However, due to differences in physiological structure, women are much more likely to develop breast cancer than men.

Although there are many similarities between male and female breast cancer, there are important differences between the two sexes. The biggest difference between the two is breast size. Because men have much smaller breast tissue, it is easier to detect small foreign bodies in their breasts. On the other hand, because men's breast tissue is so small, it takes less time for the tumor to spread to the skin and muscle tissue of the breast. And the speed at which cancer cells spread is the most important factor affecting the treatment after diagnosis.

Clinical symptoms of male breast cancer The first symptom usually discovered by the patient himself is a painless lump, which is usually located below the areola, just where the male breast tissue is concentrated. The lump grows faster. When the patient seeks medical treatment, the lump is not the only symptom. Nipple discharge is more likely to occur in male breast cancer. In addition, nipple retraction and skin changes are also more common than female breast cancer. We found that about half of the axillary lymph nodes of male breast cancer patients who were first diagnosed can be touched. .

Generally speaking, male breast cancer is mostly unilateral, often located in the left breast, but bilateral and ectopic breasts can also occur. Male patients are often older than female patients when diagnosed, and are often diagnosed later than female patients.

Men should see a doctor promptly if they experience any of the following symptoms:

Lumpiness and swelling

Dimpling and wrinkling of the skin

Inverted Nipple

Redness of the nipple or breast skin, or abnormal nipple size

Nipple discharge

The above is some knowledge about breast cancer that we have prepared for you today. I hope it will be helpful to you. If you have any other needs, you can also consult our online consulting experts at Feihua Health Network. We are always here to answer your questions. Feihua Health Network is always by your side and cares about your health issues! Feihua Health Network wishes you good health!

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