Breast Cancer Symptoms: Key Questions and Answers

Please clarify your question?

Hello, I have a few questions for Dr.
Lin: Last year, I experienced persistent pain in my left arm, which initially was localized to the arm but has now extended to the entire arm and left chest.
After seeing a doctor and undergoing an ultrasound, I was informed that there are two tumors in my left chest, each measuring 0.5 cm, which appear to be benign, and I was advised to have regular check-ups every six months.
The doctor mentioned that my left arm pain is likely unrelated.

1.
I would like to ask if the doctor can determine whether a tumor is benign or malignant based solely on an ultrasound? If there are symptoms suggestive of breast cancer, such as nipple retraction, will they persist? One of my nipples is smaller and somewhat wrinkled; could this indicate breast cancer? Reports state that breast cancer can lead to lymphatic spread or swelling; how can one detect this? Would there be pain in the armpit or other symptoms?
2.
Recently, I have experienced occasional pain in my left armpit, and my back, parallel to my chest, also hurts.
I sometimes feel something moving inside my chest, but it is not painful.
I would like to know if this could be a symptom of breast cancer?
3.
A while ago, I suddenly noticed swelling in the area between my left collarbone and breast (adjacent to the collarbone); the area is relatively large and feels somewhat firm like muscle, but it is not painful.
After seeing a doctor, I was told it was a lipoma, which has since reduced in size but has swollen again in recent days.
Could this be breast cancer?
4.
My breasts are different sizes, and the left feels thicker than the right.
I noticed this during a previous doctor visit, and the doctor said it is common and normal.
Could this be a sign of breast cancer?
5.
I have a feeling of tightness and pressure in my left chest, and pressing on the left ribs causes pain.
Sometimes, my chest and back twitch, but it is not painful during these episodes.
I feel discomfort throughout my entire left side; is this normal?
6.
I experience soreness and numbness in my left arm, entire hand, and left chest.
Could breast cancer cause these symptoms?
7.
At the onset of breast cancer, aside from a lump, what other signs might be present?
Thank you for addressing these questions!

Mandy, 30~39 year old female. Ask Date: 2005/07/13

Dr. Lin Kecheng reply Surgery

Hello Ms.
Mandy,
After reading your letter, I understand that you are a serious woman who takes great care of herself.
Here are the answers to your questions:
1.
In Taiwan, women tend to have smaller breasts with less fat and denser tissue, making ultrasound a very effective and suitable diagnostic tool.
It can generally distinguish between benign and malignant conditions.
Some doctors may take a more cautious approach and perform fine needle aspiration if deemed necessary.
If the physician believes it is required, they may shorten the interval for regular check-ups.
The doctor you consulted is very meticulous and recommends that you have a check-up every six months.
If breast cancer is left untreated, symptoms will worsen over time, such as an enlarging lump, skin changes resembling orange peel, irregularities in the breast surface, or retraction of the nipple.
It is important to note that asymmetry in breast size or shape is not necessarily indicative of breast cancer.
If breast cancer has metastasized to the lymph nodes, it may be more noticeable when applying soap during a shower.
You can check your left breast with your right hand and your right breast with your left hand, and you may feel small lymph nodes, which may not necessarily be painful.
2.
Early-stage breast cancer often does not cause pain, which can lead to it being overlooked.
Breast pain is usually related to hormonal changes before and after menstruation.
Pain itself is not alarming; understanding the cause of the pain is what matters most.
3.
A lump that has formed between the left collarbone and the breast that is not painful and has since decreased in size is likely not breast cancer.
As mentioned earlier, untreated breast cancer will continue to grow and will not resolve on its own, so there is no need for concern.
4.
The breasts and nipples are not perfectly symmetrical and may have size differences, which is normal as long as the difference is not excessive.
5.
You have repeatedly emphasized discomfort in your left arm, left breast, and left side of the torso.
The soreness and numbness in your left breast are not necessarily symptoms of breast cancer.
I recommend that you visit a breast surgeon or a general surgeon for another evaluation.
If there are no issues, you may want to consult a neurologist to investigate the true cause of your pain.
Please do not worry excessively.
6.
The initial signs of breast cancer can vary; the vast majority of cases present as a lump, while some may have abnormal nipple discharge, such as blood.
Wishing you good health.

Reply Date: 2005/07/13

More Info

Understanding breast cancer symptoms and their implications is crucial for early detection and treatment. Based on your questions, let's address each concern systematically while providing additional insights into breast cancer.

1. Ultrasound and Tumor Assessment: Ultrasound is a valuable tool in evaluating breast lumps. While it can help differentiate between benign and malignant masses based on characteristics such as shape, margins, and internal structure, it is not definitive. A biopsy is often required for a conclusive diagnosis. Symptoms like nipple retraction or changes in breast shape can persist if there is an underlying issue, but not all changes indicate cancer. Asymmetry in breast size is common and not necessarily a sign of cancer. However, if you notice significant changes, it’s essential to consult a healthcare provider.

2. Pain and Breast Cancer: Early-stage breast cancer typically does not cause pain. Pain in the breast or surrounding areas can often be attributed to hormonal changes, especially around menstruation. If you experience persistent pain, it’s advisable to seek further evaluation to rule out any serious conditions. The sensation of something moving inside the breast could be related to benign conditions like cysts or fibrocystic changes.

3. Swelling Near the Collarbone: The area you described near the collarbone could be a lymph node or a benign growth like a lipoma. If it fluctuates in size and is not painful, it is less likely to be cancerous. However, any new or changing lumps should be monitored closely, and follow-up with your doctor is essential.

4. Breast Size Discrepancy: It is normal for women to have breasts of different sizes. Significant changes in size or shape, however, should be evaluated. If your doctor has assessed this and deemed it normal, it is likely not a cause for concern.
5. Chest Discomfort: Feelings of tightness or discomfort in the chest can be related to various factors, including muscle strain, anxiety, or hormonal fluctuations. If the discomfort persists or worsens, further evaluation is warranted to rule out any serious conditions.

6. Numbness and Pain in the Arm: Numbness and pain in the arm and chest are not typical symptoms of breast cancer. These symptoms could be related to nerve compression or other musculoskeletal issues. It’s important to discuss these symptoms with a healthcare provider, who may recommend imaging studies or refer you to a specialist.

7. Early Signs of Breast Cancer: Besides lumps, early signs of breast cancer can include changes in breast shape or size, skin changes (like dimpling or puckering), unusual discharge from the nipple, and persistent pain. Regular self-exams and mammograms are key in early detection.

In summary, while some of your symptoms may cause concern, many are not directly indicative of breast cancer. Regular check-ups, self-examinations, and open communication with your healthcare provider are essential for monitoring your breast health. If you have any persistent or concerning symptoms, do not hesitate to seek further evaluation. Early detection significantly improves treatment outcomes, so staying informed and proactive is vital.

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