Breast cancer symptoms and diagnosis
It is very unusual for breast cancer to produce symptoms in its early stages. When symptoms do occur, they usually affect only one breast.
Symptoms may include:
- A lump in the breast, which is usually painless and may be situated deep in the breast or just under the skin.
- Dimpling of the skin in the area of the lump, or swelling of the skin with an “orange peel” appearance.
- Inversion of the nipple.
- A bloodstained nipple discharge.
In Paget's disease, which is very rare, the only symptom may be a patch of dry, flaky skin on the nipple, although often there is also soreness and bleeding from the nipple.
Although these symptoms most often result from noncancerous conditions, you should consult your doctor if you notice a change in your breasts. If breast cancer is not treated, it can spread to the lymph nodes in the armpit and then to other organs, such as the lungs, liver, or bones.
How is breast cancer diagnosed?
You should check your breasts regularly (see Breast self-examination) to look for lumps and other abnormalities. Screening using mammography enables tumours to be detected before any symptoms have appeared. Although this procedure is reliable, it may not detect every case, and it is therefore important that you continue to examine your breasts regularly even after a normal mammogram.
If you visit your doctor because you have noticed a lump or other abnormality of your breast, he or she will carry out a breast examination and check for signs of spread to the lymph nodes in the armpit. If your doctor finds a lump or other sign that might indicate breast cancer, he or she will refer you to a breast clinic. At the clinic you will usually undergo triple assessment: breast imaging by ultrasound scanning and/or mammography; and aspiration of the breast lump, in which a sample of cells is taken from the lump and examined microscopically for the presence of cancerous cells.
If the diagnosis of cancer is confirmed, further tests will be performed to find out whether the cancer is sensitive to oestrogen and if it has spread. Certain blood tests provide a measure of liver function and, together with an ultrasound scan of the liver, indicate whether the cancer has spread to the liver. A chest X-ray may be arranged to look for evidence of spread to the lungs, and a bone scan (see Radionuclide scanning) may be carried out to see if the bones have been affected.
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