Signs and symptoms of breast cancer may include:
- A breast lump or thickening that feels different from the surrounding tissue.
- Bloody discharge from the nipple.
- Change in the size or shape of a breast.
- Changes to the skin over the breast, such as dimpling.
- Inverted nipple.
- Peeling, scaling or flaking of the nipple or breast skin.
- Redness or pitting of the skin over your breast, like the skin of an orange.
When to see a doctor
Although the majority of breast changes don’t turn out to be cancer, make an appointment to see your doctor if you find a lump or other change in your breast. Even if you’ve just had a mammogram with normal results, it’s still important to have your doctor evaluate any changes.
Diagnosing breast cancer
Tests and procedures used to diagnose breast cancer include:
- Breast exam. Your doctor will check both of your breasts, feeling for any lumps or other abnormalities. Your doctor will likely check your breasts in varying positions, such as with your arms above your head and at your side.
- Mammogram. A mammogram is an X-ray of the breast. Mammograms are commonly used to screen for breast cancer. If an abnormality is detected on a screening mammogram, your doctor may recommend a diagnostic mammogram to further evaluate that abnormality.
- Breast ultrasound. Ultrasound uses sound waves to produce images of structures deep within the body. Your doctor may recommend an ultrasound to help determine whether a breast abnormality is likely to be a fluid-filled cyst or a solid mass, which may be either benign or cancerous. Breast ultrasound is helpful to guide radiologic biopsy to get a sample of breast tissue if a solid mass is found.
- Removing a sample of breast cells for testing (biopsy). A biopsy to remove a sample of the suspicious breast cells helps determine whether cells are cancerous. The sample is sent to a laboratory for testing. A biopsy sample is also analyzed to determine the type of cells involved in the breast cancer, the aggressiveness (grade) of the cancer and whether the cancer cells have hormone receptors.
- Breast magnetic resonance imaging (MRI). An MRI machine uses a magnet and radio waves to create pictures of the interior of your breast. Before a breast MRI, you receive an injection of dye. This test may be ordered after a breast biopsy confirms cancer, but before surgery to give your doctor an idea of the extent of the cancer and to see if there’s any evidence of cancer in the other breast.
- Other tests and procedures may be used depending on your situation.
What you can do to prepare
- Write down any symptoms you’re experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
- Write down key personal information, including any major stresses or recent life changes.
- Write down your family history of cancer. Note any family members who have had cancer, including how each member is related to you, the type of cancer, the age at diagnosis and whether each person survived.
- Make a list of all medications, as well as any vitamins or supplements, that you’re taking.
- Keep all of your records that relate to your cancer diagnosis and treatment. Organize your records in a binder or folder that you can take to your appointments.
- Consider taking a family member or friend along. Sometimes it can be difficult to absorb all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.
- Write down questions to ask your doctor.
Questions to ask your doctor
Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For breast cancer, some basic questions to ask your doctor include:
- What type of breast cancer do I have?
- What is the stage of my cancer?
- Can you explain my pathology report to me? Can I have a copy for my records?
- Do I need any more tests?
- What treatment options are available for me?
- What are the benefits from each treatment you recommend?
- What are the side effects of each treatment option?
- Will treatment cause menopause?
- How will each treatment affect my daily life? Can I continue working?
- Is there one treatment you recommend over the others?
- How do you know that these treatments will benefit me?
- What would you recommend to a friend or family member in my situation?
- How quickly do I need to make a decision about cancer treatment?
- What happens if I don’t want cancer treatment?
- What will cancer treatment cost?
- Does my insurance plan cover the tests and treatment you’re recommending?
- Should I seek a second opinion? Will my insurance cover it?
- Are there any brochures or other printed material that I can take with me? What websites or books do you recommend?
- In addition to the questions that you’ve prepared to ask your doctor, don’t hesitate to ask additional questions that may occur to you during your appointment.