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Many women with breast cancer never experience any of its signs or symptoms, such as a breast lump, says Christopher Gallagher, MD, medical director of the Cancer Institute at MedStar Washington Hospital Center. Dr. Gallagher wants women to have their breast cancer discovered before it even has a chance to cause symptoms.
But because not all women get regular mammograms, and because mammograms aren't infallible, women need to know the common signs of cancer and be willing to advocate for their own treatment.
Changes in the Breast
Women with early-stage breast cancer may notice a physical change in one or both breasts. “The main signs or symptoms would be feeling something that felt new or abnormal in the breast — a nodule or a bump," says Dr. Gallagher. "Or sometimes it’s breast pain." A lot of women and their primary care doctors overlook breast pain as a possible cancer symptom, he explains, but it's often the initial sign of a problem.
Sometimes the first signs of breast cancer are visible to the eye. “There could also be skin changes to the breast that are new or different," Dr. Gallagher points out. Nipple discharge is another potential warning sign, though it's one of the less common symptoms of cancer.
In some women, the first sign of cancer appears somewhere other than the breast. That can happen in women whose cancer has spread to other parts of the body. Dr. Gallagher says that sometimes a woman will discover a lump or bump under her arm. "That would be indicative that maybe they had something in the breast that spread to a lymph node."
"If a woman has a new pain in a bone that comes and doesn’t go away, that’s always to me suspicious of something that needs to be evaluated," he says. Other symptoms include involuntary weight loss and new abnormalities on routine blood work such as liver dysfunction and anemia.
Unfortunately, telling the difference between normal breast lumps and cancerous bumps isn't easy. "Historically, we always told women to do breast self-examinations on a regular basis, whether that be every couple weeks or once a month," Dr. Gallagher explains. However, there's not much evidence supporting the diagnostic validity of these exams.
Ultimately, Dr. Gallagher says, whether or not to do breast self-exams is a decision for every woman to make for herself. "I never say not to do it. But some women get so anxious they do it every day." He's noticed that this anxiety is especially strong in women who survived early-stage breast cancer and worry about it coming back.
Familiarize yourself with the feeling and texture of your own breasts, and talk to your doctor about anything that feels unusual for your body. But don't obsess over self-exams.
It's important not to panic if you notice any symptoms that are tied to breast cancer. Dr. Gallagher advises going to your primary care physician, who can then send you for a mammography and imaging or refer you directly to a specialist. "Make sure your primary care physician takes your report seriously," says Dr. Gallagher.
He's seen many breast cancer patients under the age of 40 whose doctors wrote their symptoms off at first. "Women need to follow their gut," he says. "If they think something is new and different ... they need to keep seeking medical attention until someone adequately explains what's going on."
In addition to suggesting women advocate for themselves, he urges them to speak to their friends and other women in their community about getting regular mammograms. He wants women to spread the message that "early-stage breast cancer is curable and you need to have your screening," he explains. "That's the way you're cured — by [your cancer] being found early."