In the early stages of breast cancer, there are often no symptoms, although this changes as the disease progresses. Signs and symptoms of breast cancer can include the following:
- A lump in the breast that feels distinctly different from other breast tissue or that does not go away
- Swelling of the breast that does not go away
- Thickening of breast tissue
- Dimpling or pulling of the skin on the breast, which may then resemble the skin of an orange
- Any change in breast shape or contour
- Nipple discharge
- Retraction of the nipple
- Scaliness of the nipple
- Pain or tenderness of the breast
- Swollen bumps or festering sores
These signs can be caused by many conditions, not just breast cancer. It is very important to tell your doctor if you experience any of these symptoms so that the right diagnosis can be made.
There are two main risk factors for breast cancer: older age and having had breast cancer before Table 01.
Table 1. Recognized Risk Factors for Breast Cancer
High risk Moderate risk Low risk Older age Never having given birth Moderate alcohol intake North American or Northern European country of birth History of breast cancer in any first-degree relative Menstruation before age 12 Personal history of breast cancer (in situ or invasive) Personal history of a primary cancer of the ovary or endometrium Menopause after age 55 Family history of breast cancer in premenopausal women or familial cancer syndrome Age >30 y at first pregnancy ? Biopsy showing a proliferative breast lesion with atypia Significant radiation treatment of the chest ? Postmenopausal obesity Upper socioeconomic class
Garber JE, Henderson IC, Love SM: Management of high-risk groups. In Breast Diseases, edn 2. Edited by Harris JR, Hellman S, Henderson IC, et al.. Philadelphia: JB Lippincott; 1991, 153-164.
Older women are at greater risk for breast cancer. If you have been diagnosed in the past, you are more likely to get breast cancer again, even though you have had a successful recovery. Other risk factors associated with the development of breast cancer in women include:
- Having a mother or sister who has had the disease
- Never having children, or having a first full-term pregnancy after the age of 30
- Having had two or more breast biopsies for non-cancerous (benign) conditions, or experiencing changes in the breasts such as atypical hyperplasia or lobular carcinoma in situ
- Having had an early onset of menstruation, before 12 years of age
- Having had a late onset of menopause, after 55 years of age
- Being obese, especially in the postmenopausal years
- Using alcohol excessively
- Having breast cancer in the family, and having over 75% dense breast tissue (if the tissue is mostly glandular tissue), especially in women who are at least 45 years of age
- Having had previous radiation therapy—especially during childhood, for the treatment of Hodgkin’s disease
- Having had increased exposure to estrogen due to the use of hormone replacement therapy, and also having had a strong history of breast cancer in the family.
- Living in North America or Western Europe
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