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Breast Cancer Without a Lump: Subtle Changes Women Should Not Ignore

A lump is often considered the classic warning sign of breast cancer. But doctors point out that breast cancer does not always announce itself as a clearly noticeable lump. Changes in the breast, nipple or surrounding skin can sometimes be the first indication that something needs to be checked.

This is particularly relevant in India, where breast cancer is the most commonly diagnosed cancer among women. According to the International Agency for Research on Cancer (IARC), India recorded an estimated 1.92 lakh new breast cancer cases in 2022, accounting for 26.6% of all cancers diagnosed among Indian women.

So, what should women look out for?

A change in breast size or shape: One breast becoming noticeably different from the other, new swelling, or a change in the contour of the breast deserves attention.

Skin changes: Dimpling or puckering, thickening, redness, swelling or skin that develops an “orange-peel” appearance can sometimes be associated with breast cancer.

Nipple changes: A nipple that suddenly turns inward, changes position, becomes persistently irritated or develops scaling or crusting should not simply be dismissed as a skin problem. Rarely, conditions such as Paget disease of the breast can affect the nipple and resemble eczema.

Unusual nipple discharge: Discharge that occurs without squeezing, particularly if it is bloody or comes from one breast, warrants medical evaluation. Importantly, nipple discharge can also have non-cancerous causes.

Swelling in the armpit: Enlarged lymph nodes under the arm or near the collarbone can occasionally occur even before a breast tumour becomes palpable.

The key message is not to panic over every breast change. Most breast changes are not cancer. But a new, persistent or unexplained change should be evaluated rather than ignored. Clinical examination and, when appropriate, mammography or ultrasound can help determine the cause.

Breast awareness is therefore not about constantly checking for cancer. It is about knowing what is normal for you- and noticing when something changes.

Notice a new or unusual breast change? Don’t ignore it. Speak to a cancer specialist for timely evaluation

Dr. Amol S. Rathod
DNB DrNB ECMO
Consultant Cancer Physician
MOC Cancer Care & Research Centre, Kalyan.