Breast Symptoms

Extremely common. Can be unilateral or bilateral; cyclical or non-cyclical; originate from breast, or chest wall; intermittent or constant; and can be of different types such as achiness, sharp pain etc. Breast pain often causes anxiety to women especially those with family history of cancer. Fortunately, it is not a sign of anything sinister. Reassurance is all that is required. Very rarely, the pain is severe, limiting daily activities and interfering with sleep, requiring strong painkillers. If you have a new onset pain that is different from your usual period pain, you should get in touch with a doctor.

A variety of breast conditions can cause lumps. Some are benign (innocent) such as fibroadenoma, cysts, hamartoma, lipoma, and adenoma. Others can be cancerous including invasive carcinoma and phyllodes tumours. A combination of clinical assessment followed by breast imaging with or without biopsy is usually required to make the distinction between benign and malignant lumps (triple assessment). It is important to seek medical attention with any lump. Never be complacent with any new lumps, even if you have had multiple presentations with breast cysts.

Another common presentation to the breast clinic. Often difficult to distinguish from a true lump. This is often hormonal in nature. I have also seen an increase in these symptoms with rapid weight loss such as after bariatric surgery or with weight loss injections. Clinical assessment and imaging are often required. Biopsy is rarely needed.

This can be unilateral or bilateral; from a single duct or multiple ducts; spontaneous or only on squeezing; blood-stained, or not. Nipple discharge causes significant anxiety to patients but in more than 95% of patients, it is physiological or caused by an innocent cause like duct ectasia. You should seek medical attention if the discharge is blood-stained or clear, from a single duct, or spontaneous. In these cases, the discharge can be caused by benign tumours like papilloma, or more serious conditions like pre-invasive or rarely invasive cancer.

Change in texture or skin colour is not very common but can be a source of anxiety. They are often caused by transient infection or inflammation or a benign skin condition like eczema. Very rarely it can be the first presentation of inflammatory breast cancer usually in the form of diffuse breast redness, skin thickening and orange peel skin (peau d’orange).

Not very common but can be serious due to an underlying tumour pulling on the skin. Assessment by a medical professional is necessary.

Common symptom. If long standing, it is not a worrying symptom. If new, needs assessment. Often with new nipple inversion, nothing sinister is found after clinical assessment and imaging. Sometimes, new nipple inversion is accompanied by a new cancerous lump. Therefore, assessment is key.

Not a common symptom. Often can be caused by skin conditions like eczema or dermatitis or from trauma e.g. from piercing. Sometimes, it can be the only presentation of an uncommon type of breast cancer called Paget’s disease. Assessment by a medical professional is essential.

Breast infection can occur during late pregnancy, breast feeding, or can be non-lactational. It presents with local symptoms of pain, swelling, and redness, with systemic signs of fever and fatigue. Urgent appointment with your doctor is required with prompt commencement of antibiotics. Often referral to acute surgical unit, or breast unit is required for surgical intervention and ongoing care.