Symptoms and Diagnosis of Breast Cancer
In its early stages, breast cancer usually has no symptoms. As a tumour develops, the following symptoms may develop:
- A lump in the breast or underarm that persists after the menstrual cycle; often the first apparent symptoms of breast cancer, breast lumps are painless, although some may cause a prickly sensation. Although lumps are usually painless, pain or tenderness in the breast can be a sign of breast cancer.
- Lumps are usually visible on a mammogram long before they can be seen or felt.
- Swelling in the armpit.
- A noticeable flattening or indentation on the breast, which may indicate a tumour that cannot be seen or felt.
- Any change in the size, contour, texture, or temperature of the breast; a reddish, pitted surface like the skin of an orange could be a sign of advanced breast cancer.
- A change in the nipple, such as an indrawn or dimpled look, itching or burning sensation, or ulceration; scaling of the nipple is symptomatic of Paget's disease, a localized cancer.
- Unusual discharge from the nipple that may be clear, bloody, or another colour. It's usually caused by benign conditions but could be due to cancer in some cases.
- A marble-like area under the skin.
- An area that is distinctly different from any other area on either breast.
These changes may be found during a breast self-exam.
Invasive Breast Cancer: Symptoms, Treatments, Prognosis
Breast cancer can happen to anyone. It is not bound by age, gender, or ethnic group. Invasive breast cancer is cancer that spreads outside the membrane of the lobule or duct into the breast tissue. The cancer can then spread into the lymph nodes in the armpit or beyond to the brain, bones, liver, or lungs. There are several types of invasive breast cancer, including:
- Invasive ductal carcinoma (IDC). With IDC, cancer cells start in a milk duct, break through the duct walls, and then invade fatty breast tissue. IDC can remain localized, or the cancer cells may enter the bloodstream or lymphatic system and metastasize anywhere in the body. IDC is the most common type of invasive breast cancer and accounts for 80% of invasive cancers.
- Ductal carcinoma in situ (DCIS). DCIS is the stage 0 of ductal carcinoma which hasn't spread beyond its point of origin. If left untreated, it can become invasive cancer.
- Infiltrating (invasive) lobular carcinoma (ILC). This cancer accounts for about 10% to 15% of invasive breast cancers. ILC starts in the lobules or milk glands and may spread in a way similar to IDC. With ILC, most women feel a mass or thickening instead of a breast lump.
Signs of invasive breast cancer
Breast cancer may have no signs or symptoms at all, especially during the early stages. As the cancer progresses, one or more of the following warning signs may be observed:
- a lump or thickening that persists through the menstrual cycle in or near the breast or in the underarm
- a mass or lump, which may feel as small as a pea
- a change in the size, shape, or contour of the breast
- a blood-stained or clear fluid discharge from the nipple
- a change in the feel or appearance of the skin on the breast or nipple -- dimpled, puckered, scaly, or inflamed
- redness of the skin on the breast or nipple
- a change in shape or position of the nipple
- an area that is distinctly different from any other area on either breast
- A marble-like hardened area under the skin.
Tumour grading
After surgery to remove the breast tumour, a pathologist will check the breast tissue. The pathologist will then assign a grade to the tumour. The grade depends on how closely the cancer cells resemble normal tissue cells when viewed under a microscope. Low-grade cancer cells are similar to normal breast cells. Higher grade breast cancer cells look more abnormal. They indicate the breast cancer is more aggressive.
The pathologist will also do a test called the oestrogen progesterone receptor test. This test will show whether female hormones -- oestrogen or progesterone -- influence the cancer cells. If the test is positive, it means hormones cause the cancer cells to grow. In that case, hormonal therapy may be effective in treating the cancer.
Breast Cancer Diagnosis/Detection
As with any type of cancer, the earlier breast cancer is detected, the better it may be for the patient's long-term health. For women at normal risk of breast cancer, self-exams, clinical exams, and mammography starting at 40 may screen for breast cancer. Abnormal results or high-risk women may need earlier screening or additional tests.
Tests
- Breast Self-Exam
- While some cancers are too tiny to feel, and most lumps aren't cancer, self-exams are a proactive way to diagnose breast cancer.
- Clinical Breast Exam
- A clinical breast exam is a breast exam performed by a health care professional. It's a basic part of women's check-ups, starting at age 20.
- Mammogram
- A mammogram is a special type of X-ray taken to look for abnormal growths or changes in breast tissue. It's a key tool in breast cancer detection, though no test is perfect. Learn more here. Most abnormal mammogram results aren't breast cancer and require additional testing to ensure.
- Breast Ultrasound
- Doctors sometimes use ultrasound images to check whether a breast lump is a cyst (a fluid-filled sac that is not cancer) or a solid mass.
- Breast MRI
- MRI stands for magnetic resonance imaging.
- Breast Biopsy
- When doctors perform a biopsy, they remove cells from a suspicious mass to see if it's cancer.
- Minimally Invasive Breast Biopsy
- This type of breast biopsy generally uses a needle, not surgery.
- Sentinel Node Biopsy
- In a sentinal node biopsy, doctors check a few lymph nodes under the arm to see if cancer has spread into the lymph system.
- Ductal Lavage
- Ductal lavage checks cells from the milk ducts for precancerous cells.