Having regular screening tests is helpful in the detection of breast cancer, but mammograms do not always capture the existence of breast cancer. Therefore, it is very important to be able to identify the signs of breast cancer through self-examination and an awareness of the signs and symptoms is essential. The first step is to be aware of how your breasts normally look and feel. This will enable you to identify any changes and report it to your doctor sooner.

The most common sign of breast cancer is the formation of a new lump in the breast. Most of these lumps are painless and hard, with irregular edges. But sometimes, they can also be painful, tender, soft and round. Any new lump found in the breasts must be reported to a doctor for further examination.

The symptoms of breast cancer vary from person to person, but these are some commonly reported symptoms:

• Visible difference in the breast: This may refer to a change in the shape of the breast, the colour of the skin, or changes in the texture of the skin on the breast.
• Swelling: A swelling may develop in a part of the breast or the entire breast may look swollen.
• Nipple: The nipple may look different from what it used to. Sometimes, it may move backward into the breast.
• Discharge: Any kind of discharge from the nipple, other than breast milk, should be checked by a doctor.
• Lumps: Any lumps or nodes may be felt inside the breast or in the armpit area.
• Pain: Pain may develop in any part of the breast or the entire breast.
• Size: A sudden increase in the size of the breast, over a short span of time, may need investigation.

The skin on the breast or the nipple may start peeling or feel more sensitive than before. There may be a visible redness on the skin. Sometimes, there is itching and irritation of the skin. Pitting of the skin (like the skin of the fruit orange) could also be an indicator. However, we should understand that the above symptoms could be indicative of other conditions like eczema. So a doctor should be consulted to find out the cause of these conditions and to rule out cancer.

In case of the type of breast cancer called ductal carcinoma in-situ, no such symptoms are experienced. However, a mammogram usually detects this type of cancer.

In case of the type of cancer called lobular carcinoma in-situ, there are no symptoms and a mammogram does not pick up on the cancer either. This type of cancer is only detected if the doctor is conducting a breast biopsy for any other reason. The breast cells will appear abnormal under a microscope. 

In case of inflammatory breast cancer, no lump is formed inside the breast. Therefore, no lump is detected during self-examination. Even a mammogram does not detect this type of cancer. However, the changes on the skin of the breast will be visible to the naked eye. This will be the only symptom of this type of cancer. Since this cancer progresses rapidly, any changes on the surface of the breast must be reported to a doctor immediately.

Breast feeding women face similar symptoms, but for a different condition called mastitis. This condition causes breast feeding women to have swelling, redness, pain and several other such symptoms. Mastitis is treated easily through antibiotics.

Breast cancer can spread from the breast to other parts of the body. This is called metastatic breast cancer. Here are some parts that it can spread to:

• Breast cancer can metastasize to the bones. The symptoms will include pain in the bones and fractures.
• If it metastasizes to the lungs, there will be shortness of breath, chest pain, coughing and fatigue.
• If the cancer metastasizes to the liver, the symptoms will include nausea, bloating of the abdomen, swelling of feet and hands due to accumulation of fluids, yellow skin etc.
• If the cancer metastasizes to the brain or spinal cord, there will be pain in the spine, headaches, memory loss, seizures, blurred vision, difficulty in speech etc.

Papillary carcinoma is a type of breast cancer that can be detected during a physical examination of the breasts. It is a cyst or lump that is formed, usually, just below the nipple. This leads to bloody discharge from the nipple.