Pinpointing pain: Is it cancer or cancer treatment?
22 Sneaky Signs Of Breast Cancer To Watch Out For
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It can be scary even to confront the thought of breast cancer. However, early detection is critical for the best prognoses and treatment options, so knowing the symptoms — and actively self-screening as a first step — is very important. Here are some breast cancer symptoms to look out for.
Some breast cancer symptoms are commonly known, such as lumps in the breast. Others are more subtle and might easily be overlooked amid life's many demands and commitments. So it's important to know what to look out for so you can reach out to your doctor if anything in your body seems unusual in the course of a regular breast self-evaluation practice.
For instance, did you know that a persistent cough, especially one that comes with breast pain, could be a breast cancer symptom? Tingling sensations in the breast or nipple area and unexplained upper back pain are also symptoms. But these warning signs can help you catch breast cancer early — and potentially save your life.
By staying vigilant (not panicked, but vigilant!), you give yourself the best chance for early detection and successful treatment after a breast cancer diagnosis so you can join the ranks of powerful survivors. Reach out to your doctor if you experience any of these issues.
Lumps on your breastAccording to the American Cancer Society, the most common symptom of breast cancer is a lump or mass on the breast. The lumps can be painful or painless and are tender, soft, or round, though other cancers tend to produce hard, asymmetrical masses.
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Tingling in the breastsThe good news: Breast tingling is much more commonly associated with hormonal issues, and rarely a symptom of breast cancer. Still, if you experience tingling, it could be a sign of a rare breast cancer known as Paget's disease, according to Healthline, so consult a doctor if you have concerns.
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A lingering coughCoughing is a reflex that helps the body heal itself or get rid of harmful particles, and breast cancer coughs are indicative of stage 4 disease that has spread to the lungs. According to Healthline, dry coughs coupled with shortness of breath can be a symptom. (BreastCancer.Org notes coughing can be a symptom of some cancer treatments, such as chemotherapy and radiation.)
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Pain in breast when coughingMost breast pain is not caused by cancer — and it's very unlikely to indicate cancer if it's the only symptom. But if you experience pain coupled with that persistent dry cough, reach out to your doctor.
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Skin dimplingSomeone with aggressive inflammatory breast cancer may notice dimpling on the skin of their breast. According to Medical News Today, dimpling results from swelling due to a buildup of lymph fluid inside the breast.
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Nipple tendernessBreast cancer can sometimes be painless, Medical News Today reports. But sometimes it's not. If you feel any tenderness or unusual discomfort in your nipples or breasts, make an appointment with your doctor for a breast evaluation.
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InsomniaMany patients with breast cancer have trouble staying or falling asleep. A review published in HHS Public Access reports that insomnia is a common complaint for those with breast cancer and results in a "host of debilitating consequences" like negative mood, difficulty concentrating memory problems, and poor health.
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An 'orange peel' texture to the skin.The texture of an orange peel is thick, scaly, and dry. Well, your breast may begin to feel like this if you have breast cancer. Inflammation in the skin cells can lead to skin thickening and scaling around the nipple and areola, Medical News Today reports.
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Persistent itchingThe "orange peel" texture of your breast can be quite itchy. Itching, tingling, or redness is also a sign of a rare type of breast cancer called Paget Disease, which accounts for 1 to 4% of all cases of breast cancer.
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FatigueAccording to WebMD, fatigue is one of the most commonly reported side effects of breast cancer. Fatigue is a lack of energy that doesn't go away — no matter how long or well you sleep. Since cancer cells take essential nutrients away from your healthy cells, this can lead to extreme tiredness.
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Changes in weightAccording to the American Cancer Society, unexplained weight loss of 10 pounds or more can be one of the first signs of cancer. A study published in Acta Oncologica found that 84% of patients developing recurrence breast cancer experienced unexplained weight loss.
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A lump in your armpitLymph nodes are the small structures of the immune system that work to remove harmful substances from the body. The lymph node region of the affected breast is the first place cancer spreads to after it leaves the breast, Medical News Today reports. You may notice swelling that feels like small, firm bumps in the armpit or collarbone.
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Disproportionate breast sizesAccording to Healthline, breast irregularity is common, affecting more than half of women, but usually, breasts are similar in density and structure. If a mammogram reveals asymmetry in density, your doctor will need to investigate whether it's due to a mass.
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A newly inverted nippleAccording to Breast Cancer News, if your nipple inverts or sinks into your chest, this can be a sign of breast cancer. It's caused by inflammation or scarring of the tissue behind the nipple. However, we should note that other conditions can lead to nipple inversion, like trauma, genetics, or anything that causes excessive inflammation.
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Upper-back painEven though this isn't one of the more common signs of breast cancer, any form of pain (including in your back) could indicate that breast cancer has spread in your body. If your upper back pain is unexplained and concerns you, consult with your healthcare provider.
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Redness on your breastsSwelling, inflammation, or redness that affects at least one-third of the breast can signify a rare and aggressive cancer called inflammatory breast cancer, the National Cancer Institute reports. These cancer cells block lymph nodes in the skin of the breasts, which gives them a red or inflamed appearance.
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Swelling of all or part of the breastInflammatory breast cancer can cause swelling in and around your breasts, collar bone, or armpit. Stage IV breast cancer can also result in swelling, according to the American Cancer Society.
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Nipple dischargeIt's common for breastfeeding mothers to have a milk-like discharge from their nipples — but any other breast discharge is a red flag. According to Medical News Today, nipple discharge that signifies breast cancer could be thick or thin and white, red, yellow, or green.
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Wounds on the breastSometimes, those with breast cancer develop an ulcerating wound, which are tumors that grow up through the skin and resemble fungi. Ulcerating wounds appear on the breast and develop from a lump or tumor in the breast tissue. Though they are rare in breast cancer patients, ulcerating wounds are more likely to develop in stage IIIB breast cancer, according to the Memorial Sloan Kettering Cancer Center.
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Breast or nipple painAccording to Cancer.Org, most women with breast cancer don't experience sharp pain in their breasts. However, some do. If you are experiencing pain that's persistent and not related to your menstrual cycle, reach out to your doctor.
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Visible veins on the breastsVeiny breasts are common in some instances like breastfeeding, especially when they're filled with breast milk. If the new veins are accompanied by inflammation, a change in the size of the breast, or an "orange peel" texture, Healthline says it could signify inflammatory breast cancer.
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A rapid onset of symptomsIf your breasts rapidly begin to change, (meaning become inflamed, swollen, and/or tender), then you may have inflammatory breast cancer. According to Mayo Clinic, inflammatory breast cancer develops very quickly, and you should contact your doctor for a breast evaluation right away.
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Removing More Lymph Nodes May Not Improve Survival In Muscle-Invasive Bladder Cancer
Removing more lymph nodes during surgery may also increase the risk for death after surgery in muscle-invasive bladder cancer.
Removing more lymph nodes during surgery for muscle-invasive bladder cancer may not improve survival and could even increase the risk of death.
Removing additional lymph nodes, as compared with standard removal of lymph nodes on both sides of the pelvis, did not improve disease-free or overall survival in patients with muscle-invasive bladder cancer who underwent a radical cystectomy, recent study findings demonstrated.
Results from the trial, which were published in The New England Journal of Medicine, also showed that extended lymphadenectomy (removal of common iliac, presciatic and presacral nodes) was associated with higher perioperative morbidity and mortality compared with standard lymphadenectomy (dissection of lymph nodes on both sides of the pelvis).
"The average number of lymph nodes removed at these [academic] centers is 20 to 30, and a minimum number of lymph nodes (approximately 25) as a surrogate for extended dissection has been proposed to serve as a quality-assurance measure for this operation," the study authors wrote in the introduction.
In this trial, 592 patients with localized muscle-invasive bladder cancer were randomly assigned to undergo either extended lymphadenectomy (292 patients) or standard lymphadenectomy (300 patients). Of note, 57% of patients in the trial received neoadjuvant (first treatment given with the aim to shrink the tumor before the main treatment like surgery) chemotherapy, most of whom received cisplatin-based therapy.
During a median follow-up of 6.1 years, recurrence or death occurred in 130 patients (45%) assigned extended lymphadenectomy and in 127 patients (42%) assigned standard lymphadenectomy. The estimated five-year disease-free survival (the time after treatment when a patient with cancer survives without symptoms or signs of the disease) rate was 56% in the extended lymphadenectomy group and 60% in the standard lymphadenectomy group.
The first site of disease recurrence was local (a location near where the cancer began) in 35% of patients in the extended lymphadenectomy group compared with 23% in the standard lymphadenectomy group. Regarding distant recurrence (cancer that returns in another part of the body far away from its original location), this occurred in 51% of patients assigned extended lymphadenectomy and in 62% of those assigned standard lymphadenectomy. Both local and distant recurrences occurred in 11% in the extended lymphadenectomy group and in 12% in the standard lymphadenectomy group.
At five years, the rate of overall survival (the percentage of patients with cancer who are still alive after treatment) was 59% in patients assigned extended lymphadenectomy compared with 63% in those assigned standard lymphadenectomy.
Side effects considered grade 3 (severe) to grade 5 (causing death) occurred in 157 patients (54%) assigned extended lymphadenectomy versus 132 patients (44%) assigned standard lymphadenectomy. More patients in the extended lymphadenectomy group died within 90 days after surgery compared with those in the standard lymphadenectomy group (7% versus 2%).
To conduct this trial, researchers enrolled patients with localized muscle-invasive bladder cancer that that were clinical stages T2 (confined to the muscle) to T4a (invading adjacent organs) and with two or fewer positive lymph nodes. Several areas of interest throughout the study included disease-free survival, overall survival and safety.
Research into the correct approach for lymph node removal has been done in other cancer types.
"Randomized, phase 3 trials in endometrial, gastric and pancreatic cancers
Reference"Standard or Extended Lymphadenectomy for Muscle-Invasive Bladder Cancer" by Dr. Seth Paul Lerner, et al., The New England Journal of Medicine.
have not shown improved survival with extended lymphadenectomy, contrary to what was expected, and among patients with gastric cancer, the incidence of surgery-related complications was higher with the more extensive lymphadenectomy than with standard extended regional lymphadenectomy," study authors wrote.
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