The Silent Signs Of Breast Cancer

Added: 2026-05-13

[00:00:00]Are you scared you're going to get breast cancer because it's everywhere?

[00:00:04]Celebrities are getting it, your friends are getting it, and you're worried that you'll be next. But how will you know?

[00:00:09]Because it's not all about the lump.

[00:00:11]There are 12 signs of breast cancer, and knowing them all could save your life.

[00:00:16]I'm Dr. Liz, a breast surgeon who's had breast cancer. And today, I'm going to teach you all 12 signs. Save this video, share it with every woman you know, because lives could depend on it. But before we start, there's something important I want you to understand. When most people imagine having cancer, they imagine feeling ill, tired, pale, in pain, losing weight. They think their body will warn them. But early breast cancer doesn't work like that. Unless the cancer has already spread, and that's rare, you're going to feel completely normal. No fatigue, no nausea, no sense that anything is wrong.

[00:00:56]And I know this because I've been there three times. And each time I found it, I felt completely fine. And I write about this in my book, The Complete Guide to Breast Cancer, that it can be genuinely hard to believe you have cancer because you feel so well. And that is exactly why these signs matter so much. Because your body isn't going to give you a warning. These signs, what you see and feel, are all you have. So, let's go through them. All 12. The first is a skin color change. And this is a sign that most people hadn't heard of. Now, when doctors and medical websites describe this, they usually say, "Look for redness." And if you have lighter skin like me, that's fine. The skin of one breast might look pink or red or reddish purple. It might also be warm and tender to touch. It might look like a rash or a bruise or even an insect bite. But if you have darker skin, you might not see redness at all. And in women with darker skin tones, inflammatory breast cancer, which I'll come to in a moment, can make the breast just look darker than usual, a darker brown or a purple bruising color, not red. Now, the Inflammatory Breast Cancer Network Foundation, who works specifically on inflammatory breast cancer, have highlighted this because it causes dangerous delays in women who don't have pale skin like me. The question is, has the color of one breast changed compared to the other? Now, this change in color is caused by a type of breast cancer called inflammatory breast cancer that I mentioned earlier. It happens when cancer cells block the tiny lymph vessels in the skin of the breast.

[00:02:41]These vessels are supposed to drain fluid away, but when they're blocked, the breast becomes inflamed and it can look red or dark. And this can happen quite quickly. Now, inflammatory breast cancer is rare. It makes up between 1 and 5% of all breast cancers, but it causes 10 to 15% of all breast cancer deaths, and it's because it's so often dismissed as a breast infection or a skin reaction or mastitis when you're breastfeeding, but it takes a long time to diagnose. Now, the key difference between inflammatory breast cancer and an infection is this. A course of antibiotics will start to clear an infection within a week or so. And it's not a bad thing for your doctor to give you that first. But if it doesn't help, if the color change is still there, it's spreading, or it's getting worse, go back and see your doctor because you could have inflammatory breast cancer.

[00:03:35]And one more thing about this, it comes on fast. It could be days to weeks, not years to months. Some women describe waking up and finding one breast looked completely different overnight. And it's almost always one breast, not both. So any new color change in one breast that doesn't clear with antibiotics has to be seen by a doctor and you need a biopsy, not reassurance, a biopsy to find out what it is. Sign number two is skin swelling and po durange, which is French for an orange appearance in the skin or cellulite. And these are also often seen with inflammatory breast cancer, but it looks and feels different. There might not be the redness, and that's why I'm mentioning it by itself. It's a swelling of the breast. One breast becoming noticeably larger, heavier, or thicker than the other could be a sign of breast cancer. And it's not the kind of swelling that you might get before your period, which generally affects both breasts. This is just one side. And sometimes with that swelling you'll notice a change in the breast skin. Now we call it pod derange which is French for orange peel and it looks a bit like cellulite and it describes what happens when the lymph blockage from the cancer causes the skin pores to become enlarged and dimpled. So the surface of the breast starts to look exactly like the skin of an orange. Now, it might only be a small patch of skin to begin with, or the texture might only be obvious when the breast becomes swollen and the skin is stretched. The breast might also feel warmer than the other side and heavy and uncomfortable. Again, none of this means you definitely have cancer. Mastitis, infection of blocked milk ducts can cause this. But one breast that is swollen, that is bigger, that has orange peel skin, especially if you aren't pregnant or breastfeeding, this needs to be assessed urgently. Get your GP to send you to the breast clinic and get it checked out. Sign number three is skin dimpling or tethering. And it's the one I want you to pay particular attention to because it's one you can only see if you look in the mirror properly. Skin dimpling or tethering is a small indentation in the skin of the breast.

[00:05:52]It's like a subtle pulling in like someone is pinching the fabric from underneath. And it's caused by a tumor growing inside the breast, starting to pull on fine connective tissue strands that run from the breast tissue through to the skin. We call these Kooper's ligaments. And when a cancer starts to involve them, it tethers the skin in that spot. So when the breast is stretched, that one area stays fixed.

[00:06:19]You probably won't see this if you're just looking in the mirror with your arms by your sides. Most women normally see this when they put their hands on their hips and push in or when they put their hands in the air. And this video will show you what to do. And I've got a great explanation so you can see what's happening. It's because when the skin is stretched, that tethering causes the pucker that you can see. And that's why the aerobics in the bathroom of moving your arms are so important. So you can see the dimpling and the tethering. If you don't do it, you might be missing one of the earliest signs of breast cancer. The dimpling and tethering can be a sign of cancer even when there's no lump to feel. The cancer could be so deep or so small or just in the wrong position, but it's already affecting that tissue above it. Now, I don't have hard stats on how often dimpling presents as a standalone symptom. The research folds it into wider skin changes, but it's one of the classic early signs that breast surgeons are trained to look for, and now you are trained to see it, too. Sign number four is new nipple inversion. And that means a nipple that has suddenly turned inward. And I want to be clear about what I mean because this one worries women unnecessarily when it shouldn't.

[00:07:32]Some women naturally have inverted nipples. One or both nipples point inwards. They've been like that since puberty and you can pull them out and pop them back in. It's completely normal. And that's not what I'm talking about. What I'm talking about is a nipple that has changed. A nipple that used to point outward or was flat that has now started to go inward and it's stuck and you can't pull it out. It feels fixed and it happens just the same as skin dimpling. There's often a cancer behind or near the nipple pulling on the tissue pulling the nipple inwards. Now, a survey in 2023 showed that only a third of women knew nipple retraction was a sign of breast cancer. And that means seven in 10 wouldn't connect it to cancer at all. So check your nipples. If they have changed direction, if they are going in and you can't pull them out, you need to be checked. Even if there's nothing else to feel. Sign number five is a nipple rash, which we call padits disease. This is the sign that's most likely to be treated as something else for months before anyone considers cancer. It accounts for 1 to 2% of all breast cancers. So, it's rare, but you need to know about it. It looks a bit like eczema. Scaly skin, redness, crusting, itching, sometimes a burning sensation. The skin around the nipple might bleed or ooze, and it can be sore.

[00:08:59]And the reason it gets missed, the reason women go months with a tube of steroid cream before anyone takes a biopsy is that it can look just like eczema or contact dermatitis to the naked eye. Even doctors miss this because they don't see it very often.

[00:09:14]But this is the difference. Eczema on the nipple should respond to treatment.

[00:09:19]And a cream is a reasonable first treatment to give you because most nipple rashes will be eczema. But if it's not getting better, if it's getting worse, if it's spreading, you need to be seen to make sure that it's not cancer.

[00:09:32]It's also worth knowing that the burning and itching can actually start months before the rash becomes visible. Some women report an intense, persistent itch on one nipple with no visible change.

[00:09:43]And that's hard because as a surgeon, I don't want to biopsy a nipple if there's nothing to see. But it's just worth keeping a note. If you have an itchy nipple and it's been there for three or four months and you've changed your washing powder and it's not getting better, it might be worth getting checked at a breast clinic just in case.

[00:10:00]And in around half of all cases of Padget's disease of a nipple, there is a cancer elsewhere in the breast, deep in the tissue, probably one that you can't feel at all. So the rule here is simple.

[00:10:12]A nipple rash that doesn't fully clear with treatment or that keeps coming back needs a biopsy by a breast surgeon. Push for it. You have every right to ask.

[00:10:22]Sign number six is nipple discharge. And like breast pain, this is one that causes a lot of anxiety. So, let me start with a reassurance. Most nipple discharge is completely normal. Your nipples have multiple small openings connected to the milk ducts in the breast. And these ducts produce secretions. And when that discharge comes out of the nipple, it can be cream, yellow, green in color, depending on the natural bacteria in your skin, whether you smoke, what your hormones are like, and whether you're squeezing.

[00:10:57]And please don't squeeze. I've had nipple discharge. I thought it was disgusting. I freaked out in the shower.

[00:11:03]It was this yellowy greeny color and I kept pressing and it kept coming out and I kept pressing and it kept coming out.

[00:11:09]Don't. Squeezing just tells your body to make more. Stop. Leave it alone. It will settle down. It is normal. The discharge that concerns me is this. It's when it's spontaneous. So, you're not squeezing.

[00:11:23]It just appears on your bra or your night clothes or the bed sheets. It's one side only. often coming from a single spot on the nipple, not all the way around. And that discharge is clear like water or it's blood stained. If you have any of those, you need to be checked in a clinic. So, nipple discharge is the presenting symptom for about 3 to 9% of women seen in breast clinics. And 5% of those have breast cancer. But a lot of women don't realize it's a potential warning sign. They just think it's normal. And that's why I'm telling you this creamy yellowy greeny nipple discharge completely fine bloody clear discharge needs to be checked out.

[00:12:07]Look in your bra, look in your pajama or nighty when you take it off because that could be the only clue. Sign number seven is a thickening, fullness or firmness in the breast. And this is one associated with a specific type of breast cancer and it's a type most likely to be missed or diagnosed late or lead to more extensive surgery. And it's the kind of cancer that I had. It's called invasive lobular cancer and it accounts for 10 to 15% of all breast cancers. Now most breast cancers start in the milk ducts and they grow as a clump and that clump becomes a lump. You can feel it. Lobular cancer is different. It starts in the milk producing glands the lobules and it grows in single file lines not a mass.

[00:12:55]Think of it spreading like fingers through the tissue rather than forming a ball. And this means it doesn't always make a lump you can feel. But you may get a vague area of thickening or fullness or a sense that one area of the breast feels denser or firmer than the rest. It's just changed consistency.

[00:13:14]It's just a vague feeling. Most women say that they couldn't find a lump, but they thought something wasn't right. And most of them were right. it was a lobular cancer because it's really subtle to spot. So, if you notice a thickness, a fullness, a firmness, a change in one breast compared to the other, you need to get it checked out.

[00:13:36]Sign number eight is a change in size or shape of the breast. You might think this is an obvious sign of breast cancer, but you would be surprised how many women just take a change in their breast shape as normal. They're getting older. It's just how they're sitting.

[00:13:50]Now, your breasts are sisters, not twins. One is usually a little bigger than the other. One nipple may sit slightly lower. These are normal variations that have been there since puberty and they may have got worse as you have gained or lost weight or aged.

[00:14:04]What I'm asking you to look for is change. And that's why checking your breasts every month is so important. If one breast is suddenly bigger or smaller than it was before and it doesn't go back to normal after your period. If a breast has flattened or drooped or changed shape or it looks different when you move, this needs to be checked out.

[00:14:25]It can happen when there's a lump that you can't yet feel, a cancer deep in the tissue that can distort the shape of your breast before it becomes painful.

[00:14:33]And that's why knowing what's normal is crucial. Sign number nine is an armpit or collarbone lump. And this is one of the most underappreciated and one of the most important. If you have a new lump or swelling in your armpit or around your collarbone, you need to get it checked out. Now, the lymph nodes in your armpit are part of your immune system. They swell. They get bigger when they're doing their job. During a chest infection, a viral illness, even a bad cut on your hand. So, a swollen node in your armpit by itself doesn't automatically mean that you have cancer.

[00:15:09]But a lymph node that stays big and that feels firm, not squishy when you haven't had an obvious infection or a cold to explain it, that needs to be checked out because in some cases breast cancer spreads to the lymph nodes before you have a tumor that you can feel. And I know several young women in their 30s, mothers who presented like this and it took a long time for them to be diagnosed. And in some cases when breast surgeons do see these women, we can feel the lymph node and we can see cancer there but we can't see a cancer in the breast and we can't find a cancer in the breast. It is so small but it is spread to the armpit and that's why checking your armpit is really important and this video will show you how to do it.

[00:15:54]Sometimes breast cancer can spread to the lymph nodes in your collar bone and again if you see a lump up here and you haven't had an infection you need to get it checked out. Sign number 10 is breast pain. And this is the one I get the most questions about because of everything people see online. So, let me be direct.

[00:16:13]Most breast pain is not breast cancer.

[00:16:17]A large UK study of over 10,000 women found that women who come to breast clinic with pain as their only symptom have a cancer risk of just 0.4%.

[00:16:29]That's four in a thousand of them will have breast cancer compared to 50 in a thousand who come with a lump. Women with isolated breast pain have no higher cancer risk than women with no symptoms at all. And cyclical breast pain, that tenderness that builds before your period and goes away after, is almost never a sign of cancer. It's due to the hormonal changes in your body. But there are exceptions to every rule. And I want to acknowledge the women I've seen online and I've seen in clinic who had breast pain and then they had breast cancer because they're not wrong. Pain can be present. And this is the context.

[00:17:08]Pain that is worth investigating is pain that is persistent. It's not cyclical.

[00:17:15]It doesn't change with your menstrual cycle. It gets worse rather than better.

[00:17:20]and especially if it comes along with any of the other signs in this video because pain combined with a skin change or a discharge or a new thickening that changes the picture entirely that could be related to a breast cancer. Pain is also a key symptom of inflammatory breast cancer when your breast is warm and tender and swollen and sore. It can also be a feature of padets disease that burning itching rash around the nipple.

[00:17:47]So, most breast pain is harmless. If it's cyclical, it doesn't need investigating.

[00:17:54]One-sided pain is almost always coming from muscles in your back. And I've got a video about breast pain here. But if it's persistent, it's not going away, and you've got another symptom, you need to get it checked. Sign number 11 is recurrent breast cysts. And this doesn't happen very often. And again, I've got a whole video about breast cysts, but it can happen. You can get cancer in a breast cyst. Breast cysts are really common. They're like little fluid-filled balloons that can suddenly appear and disappear in the breast tissue.

[00:18:25]Normally, they happen in women in their 30s and 40s as they get close to the permenopause. And most cysts just disappear by themselves. They're final.

[00:18:34]They've got clear fluid inside. They're harmless. They don't need treatment.

[00:18:39]Some cysts keep coming back. They don't deflate. They need us to drain them with a needle and a syringe. But first, we do an ultrasound scan just to make sure there's nothing else going on because a small percentage of cysts can be complex. They can have a thick wall with a bit of debris inside and there could be a tiny cancer inside the cyst. And that's why every breast cyst, if it's not going away, should be checked out in a breast clinic just in case. And sign number 12 is a breast lump. This is the commonest sign of breast cancer. And I've left it to last, so you had to listen to all the other ones first. Most lumps just appear overnight. Women say, "I swear it wasn't there the day before and then it was." And that happened to me. I got out the shower and suddenly there was a lump in my left cleavage.

[00:19:23]And I I couldn't believe, how did I not see this yesterday? I describe it a bit like when women are pregnant and they're flat and then they suddenly start to show. It's the doubling time of a cancer. There's one cell, then there's two, then there's four, then there's eight until suddenly it is big enough for you to feel. You need to check your breasts every month to look for a breast lump. Even if you're having mammograms, breast cancers can still appear between the scans. So, make sure you check your breasts. And if you find a lump, you need to get it checked. Now, everything I've described so far assumes that breast cancer starts with a sign or symptom in the breast. But in 6 to 7% of UK breast cancer diagnosis, it is already spread by the time people come to see doctors like me. We call this denovo metastatic breast cancer or metastatic breast cancer from the beginning. Your cancer was already advanced when it was found. And these women often aren't seen for a problem in their breast. They come to a doctor because of symptoms like these. A deep persistent ache in the hip, back, or shoulder, not like a normal muscle pain.

[00:20:29]It's getting worse at night. It's not getting better with painkillers. That could be breast cancer that spread to the bones. Or you could have a persistent dry cough that's been going on for weeks. It's not like a chesty hacking cough. It's dry. It's irritating. Or shortness of breath that appears without having a cough or a cold. That could be breast cancer that spread to the lungs. The women might have experienced significant weight loss when they haven't been on a diet or tummy pain or bloating or a yellowish tinge to the skin and that could be breast cancer in the liver. Some women experience new headaches, double vision, confusion, weakness on one side, and that could be a breast cancer that spreads to the brain. And sometimes women have no symptoms at all. They're having a CT scan for something completely unrelated like a color accident. And they see something either in the breast or in the lung or the liver or the bones. And then that's how they're diagnosed with breast cancer.

[00:21:26]I'm not telling you this to frighten you, and I know it's scary to hear. I just want you to be aware of your body, to do a check-in every month. Am I feeling okay? Are there any new symptoms that I've developed that aren't getting better that need to be checked out? So, I'm going to go through those 12 signs again to make sure you remember them. A change in skin color, a change in skin texture, skin dimpling or tethering, your nipple being pulled in, a nipple rash, a nipple discharge, thickening or fullness or firmness of the breast, a change in size and shape, a persistent lump in your armpit or your collarbone, one-sided persistent pain, a recurrent cyst that keeps coming back, and a breast lump. Now, most of the women I see in clinic with these symptoms don't have breast cancer. Most of the time, it turns out to be something harmless. But the only way to know is to get seen. To tell your doctor that you think you might have breast cancer and get asked to tell your doctor that you think you might have breast cancer and be seen in a breast clinic by someone like me. If this video helped you, let me know in the comments and then save it. Share it with everyone you know because this could save someone's life. And if you want to be reminded how to check your breasts properly the way that I do it as a breast surgeon, watch this video next.

[00:22:50]You've got this. I'm with you. I'm Dr. Liz. Thanks for watching.