Everything You Should Know About Breast Cancer Signs and Treatments
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If you have breasts, then you’re at risk for developing breast cancer, one of the most common types of cancer that affects people in the United States. According to the American Cancer Society, there is a one in eight chance the average American who underwent estrogenic puberty will develop breast cancer. In other words, that’s a 13% risk over the average lifetime. Breast cancer is also affecting younger and younger people: Currently, per the CDC, about 10% of all breast cancer diagnoses in the US are in people younger than 45.
Advancements in technology can lead to earlier diagnosis, which can improve the survival outlook for some patients. But unless you are at high risk, recommended screenings usually don’t start until around age 40. So experts say it’s crucial to understand the symptoms of breast cancer and how to screen for signs of it.
Ahead, what you need to know about breast cancer symptoms, diagnosis, and treatment to stay vigilant about your health.
Meet the experts:
Mylin Torres, MD, is a radiation oncologist at Winship Cancer Institute at Emory University.
Vered Stearns, MD, is a medical oncologist at Weill Cornell Medicine.
Marleen Meyers, MD, is a medical oncologist at NYU Langone Health.
Dorraya El-Ashry, PhD, is chief scientific officer at the Breast Cancer Research Foundation.
Elizabeth Comen, MD, is a medical oncologist at NYU Langone Health and a Breast Cancer Research Foundation researcher.
Claudia Cotes, MD, is chief of breast imaging at UTHealth Houston.
What are the symptoms of breast cancer?
The early symptoms of breast cancer can be subtle, so it helps to get—and stay—familiar with how your chest looks and feels so that you can become aware of any noticeable changes. Mylin Torres, MD, a radiation oncologist at Winship Cancer Institute at Emory University, says some of the most common symptoms of breast cancer include new lumps or bumps in the breast, new signs of nipple inversion, bloody or clear discharge from the nipple, and arm swelling. In some cases, breast cancer can cause redness or dimples on breast skin.
Breast cancer can also cause swelling in the breast or even breast pain, though these things are less common, according to Vered Stearns, MD, a medical oncologist at Weill Cornell Medicine. The common denominator of all these symptoms is that the patient notices something unusual. “If a [patient] feels something that’s not usual in their breast, they should see their primary care provider for further evaluation,” recommends Dr. Stearns.
How is breast cancer diagnosed?
In people who get regular screenings, most cases of breast cancer are diagnosed through imaging, either mammogram or ultrasound, says Marleen Meyers, MD, a medical oncologist at NYU Langone Health. That said, “there are certainly people who come in with a lump in the breast and get a diagnosis,” she says. This is more common in people under 40, who don’t get routine screenings, explains Dorraya El-Ashry, PhD, chief scientific officer at the Breast Cancer Research Foundation.
If a doctor sees signs of cancer in a mammogram, they may call you back for further imaging, like an MRI. It’s worth noting that not all growths in the breast are cancer. According to the American Cancer Society, benign (non-cancerous) cysts can also cause lumps, and a benign condition called radial scars can also look like a tumor in the breast.
Because screening needs vary based on age and risk factors, Elizabeth Comen, MD, a medical oncologist at NYU Langone Health and a Breast Cancer Research Foundation researcher, says it’s important that women consult with their doctors. “The best prevention is screening, since they may not have any symptoms,” she says. If a growth is detected through a mammogram, ultrasound, or MRI imaging, Dr. Comen says the next step for diagnosis is a biopsy to confirm cancerous cells in the breast. “That’s pretty much the gold standard—to obtain tissue for a biopsy so a pathologist can look at the sample underneath the microscope,” Dr. Torres says.
Typically, people who are getting screened get diagnosed with breast cancer before symptoms emerge—but again, if you’re not getting routine screenings, it’s possible to get diagnosed when you find a lump in your breast during a self-exam. “Usually, breast cancer is caught before the patient has any signs or symptoms, usually on a mammogram,” Dr. Torres says. You may not even feel sick with breast cancer, especially if the condition hasn’t spread beyond the breast. “If those signs and symptoms develop, they can usually be associated with more advanced cancer, but not always.”
What are the screening recommendations for breast cancer?
As of 2023, the US Preventative Service Task Force (USPSTF) recommends all women 40 or older at “average risk” begin getting mammograms every other year. (Previous, guidelines suggested having mammograms starting at age 45). Average risk means you don’t have a strong family history of breast cancer, you haven’t had breast cancer yourself, and you don’t have a genetic mutation like BRCA, explains Dr. Meyers.
People with certain risk factors may qualify for earlier and more frequent breast cancer screenings. For example, the American Cancer Society suggests a mammogram and breast MRI every year, typically starting around age 30, for people who have a BRCA1 or BRCA2 gene mutation, have a first-degree relative (parent, sibling, or child) with this mutation, and have had radiation to the chest before age 30.
Not sure about your specific risk factors? Your doctor is the best resource to figure it out. Right now, only people with high risk for BRCA or other gene mutations typically undergo genetic testing, according to the National Breast Cancer Foundation. Some of these risks include a family history of breast or ovarian cancer and Ashkenazi Jewish heritage.
Breast cancer screening continues to advance as technology does, says Dr. El-Ashry. For example, the Breast Cancer Research Foundation is currently funding a clinical trial studying the use of AI-aided mammograms that can both diagnose breast cancer and predict a person’s risk for developing the disease in the next five years.
What role does self-exam play?
Experts don’t consider self-exam as a formal screening. “It’s important to clarify this is not a screening method and does not replace a clinical breast exam performed by a doctor and of course, a mammogram,” says Claudia Cotes, MD, chief of breast imaging at UTHealth Houston. But the reality is that isn’t happening routinely until age 40, so that doesn’t mean it’s not helpful: Knowing your breasts and monitoring changes on a monthly basis is important and there are many ways to do that.
Dr. Cotes suggests standing in front of a mirror to look for visible changes in the skin color, texture, shape, or size of your breasts. Then, feel the breast tissue with the pads of your fingers from your clavicle to the lower fold of your breast. Examine your armpits, too, by raising your arms. It can be helpful, Dr. Cotes says, to repeat these steps while lying down, as this position distributes tissue evenly over your chest. Lumps may feel like a hard rock in the breast tissue and they often have irregular edges rather than smooth ones. Breast cancer may also cause swelling in your armpits.
Keep in mind that if you get a period, your breasts can change throughout your menstrual cycle. For that reason, Dr. El-Ashry recommends checking your breasts at the same time each month. “If [a change] goes beyond one cycle, discuss it with your doctor,” she says.
What does it mean if I have dense breasts?
Your breasts are made of glandular breast tissue and fat. If you have dense breasts, you have less fat in your chest, which is more common in people under 40. And that also makes it more difficult to detect tumors: On a mammogram, fat looks black, but the glandular tissue usually looks white. Breast cancer also appears as white on a mammogram, which means it can be difficult to pinpoint tumors in people with dense breasts. “It’s like finding a snowball in a snowstorm,” says Dr. Meyers.
If you have dense breasts and you need a mammogram, Dr. El-Ashry says you might need a mammogram and an additional type of screening, such as an ultrasound or MRI. Your medical provider is the best resource for determining the density of your breasts and the best steps for detecting cancer. And don’t hesitate to reach out to your provider: Especially for women with dense breasts, it's important to speak up if you feel any new lump—even if you think it's just your normal lumpiness.
Can only cisgender women get breast cancer?
While language around breast cancer is typically centered around cisgender women and those who have gone through estrogenic puberty, transgender men, and nonbinary people who have had top surgery can also get breast cancer, but the risk tends to be much lower. “If their breasts have been removed, it’s essentially a prophylactic mastectomy, so the odds of getting breast cancer are exceptionally low,” Dr. Comen says.
For transgender women taking estrogen, one recent study has shown there may be an increase in the risk of breast cancer (though their risk is still lower than for cisgender women). But Dr. Comen says evidence on breast cancer in trans women is still evolving and recommends that any patient taking exogenous estrogen talk with their doctor about their unique concerns.
And while it’s significantly less common, Dr. Comen says cisgender men can get breast cancer, too. The American Cancer Society estimates that in 2024, 2,790 men will be diagnosed with invasive breast cancer.
A man’s breast cancer rate also goes up if he has a BRCA mutation. People with breast cancer should be aware that if they have a history of male breast cancer in their family, they are significantly more likely to have a genetic component to their breast cancer, too.
How is breast cancer treated?
Treatment is unique to every individual and dependent on several factors, including the kind of breast cancer a person has, the extent of the disease, and whether it has spread outside of the breast. “Every situation is a little different, so it’s important to look at all the criteria in the context of the person and her wishes and other medical and social history before determining the best course of action,” Dr. Stearns says. Depending on the case, Dr. Stearns says the oncologist might recommend surgery (either a lumpectomy to remove the cancerous mass or a mastectomy to remove the entire breast), chemotherapy, radiation, or a combination of treatments. Chemo isn’t always a must for everyone with breast cancer. Dr. El-Ashry says other medications can also be effective depending on the type of breast cancer a person has and may result in fewer side effects than chemotherapy. The order of treatment can also vary depending on your case and your doctor’s opinion.
If a person has a specific type of breast cancer involving hormone receptors on the cancer cells—called estrogen-receptor positive or ER+—they might be prescribed hormone therapy pills, which Dr. Torres says are usually taken every day for 5 to 10 years.
Those who are concerned about breast cancer should always make an appointment to speak with their doctors. “If a [patient] has a question, we want to be able to answer it,” Dr. Comen says. “Sometimes that means examining them and offering reassurance or ordering additional tests to find out what’s going on.”
Fortunately, breast cancer survival rates continue to improve as screening methods advance and treatments become more targeted to individual cases. “For those diagnosed, the last 10 years has really moved leaps and bounds with new precision treatments that are effective but not as toxic as chemotherapy,” says Dr. El-Ashry.
But Dr. Comen says doctors and researchers are always working to increase survival rates. “We haven’t done enough work yet because men and women are still suffering and dying,” she says. “We’re all committed to improving outcomes for breast cancer patients.”
To learn more about treatment options and survival rates along with resources for breast cancer support, visit the American Cancer Society, Cancer.net, or Breastcancer.org.
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Originally Appeared on Allure
