Signs of Breast Cancer (That Aren't Lumps): Skin & Nipple Changes

Given it’s the most common cancer in women in the U.S., breast cancer is well-known and understood to be a health issue of concern. What’s not so well-known is that there’s more to early detection than just lumps.

According to Dr. Ann-Kristin U. Friedrich of Baystate Surgical Oncology and Breast Specialists, “While the most common symptom of breast cancer is no symptom at all—which is what makes mammograms so valuable—when it does make its presence known, it’s not always in the form of a lump or a mass. That’s not to say lumps and masses aren’t concerning—they definitely are—but there are other signs to look for and pay attention to if you notice them.”

Lesser-Known Signs of Breast Cancer

Friedrich notes that while breast cancers occur beneath the skin, they can cause a variety of changes readily visible to the naked eye.

“It’s extremely valuable for women to be familiar with how their breasts look and feel when healthy,” she says. “This makes it easier to detect even subtle changes when they occur. Changes tell us that something different is going on and you should reach out to your doctor to figure out what’s causing it.” She emphasizes, “Just because it’s not a lump, doesn’t mean it’s not worth getting it checked out.”

Potential warning signs to keep an eye out for include:

Nipple Changes

Changes to your nipples that warrant a call to your doctor include:

• New asymmetry: the shape or size of a nipple changes in any way
• Retracted/inverted or flat nipple: the normally raised tissue of the nipple flattens or even appears to be drawn into to the breast
• Scaliness: the texture of the tissue of the nipple becomes dry or even flaky
• Discharge: fluid leaking from one nipple, often appearing green or brown in color or may be clear or bloody. May occur with or without manipulation.

Skin Changes

Changes to the skin or appearance of your breast that may indicate breast cancer include:

• Thickening skin: may occur small areas or may involve an entire breast
• Redness: skin may appear pink, reddish purple, or bruised and breast may be swollen and tender
• Orange peel: skin appears thicker and pitted like the peel of an orange
• Wounds without injury: an unexplained wound on the surface of the breast

Other Signs

Additional, but less common symptoms of breast cancer include:

• Unexplained pain in breast or arm pit
• Swelling or pain in armpit

Note that while pain in the breast is common, the cause of the pain being breast cancer is usually rare.

Signs of advanced disease include:

• Seizures, neurological dysfunction
• Severe bone pain and spontaneous fractures
• Shortness of breath, coughing, wheezing
• Unexplained weight loss

If you notice any unusual symptoms or unexpected changes in your nipples or breasts, consult your doctor. Be sure to mention any family history of cancer, as this may affect your risk level. And even if you don’t see lumps or any of these less common signs, continue to get mammograms as recommended for your age and risk level.

Don’t Panic but Do Take Action

Not all changes to the nipple or breast are due to breast cancer. Friedrich notes, “Your symptoms may very well be a sign of another underlying condition or even caused by a medication or changing hormone levels due to childbirth or menopause. But, especially with breast cancer where early detection and treatment is key to survival, it’s better to be safe than sorry. If you notice a change, contact your doctor to determine the best course of treatment and care.”