A breast lump is a common symptom of breast cancer, but there were other signs these women noticed before finding one
TammyLee Marlene, 48, discovered a small lump in her breast in June 2023 when she was in the middle of changing her clothes.
“Because of the way my hand landed, my finger fell right on a lump,” she says. “I literally thought, ‘Eh, I’m sure it’s nothing. I’m sure it’s just a cyst.’ Because I had just gotten a clear mammogram three months before.”
Marlene went to see her doctor a month later and was sent in for an ultrasound and another mammogram, which showed a suspicious result. She received a biopsy in August 2023 and was diagnosed with breast cancer just five days later.
Credit: Courtesy TammyLee Marlene
“I was very surprised about my diagnosis,” says the Nevada-based stay-at-home mom, who’s done advocacy work with the American Cancer Society Cancer Action Network. “I’ve made so many friends who have cancer now because of the work that I do, and no one thinks they’re gonna get it. But I know 1 in 8 women get diagnosed with breast cancer at some point in their lives. And that percentage is very high.”
Although breast cancer signs look different on everyone, the most common one is a new lump or mass. Cancerous masses are often painless, firm, and fixed, with irregular edges. However, soft, round, tender, and painful masses can still be a sign of breast cancer.
Other symptoms include dry, red, or flaky breast skin or nipple discharge. But some women may notice something is wrong well before they ever find a lump.
Subtle Signs That Showed Up Before a Lump
Credit: Courtesy Addie Looper
A month before Addie Looper noticed the lump in her breast, she knew something was off. She was experiencing pregnancy-like symptoms, and an at-home test came back positive. However, a follow-up blood test at her OB-GYN’s office showed that she was not pregnant.
“So I never missed a period,” Looper, now 23, says. “But I was having nausea, weird leg cramps, hot flashes, and sweating in my sleep.”
After receiving her diagnosis, she realized: “My symptoms happened when my tumor was in my milk duct, so my body was like, ‘She’s growing milk.’ I was so confused about what was going on.”
Research has examined how the human chorionic gonadotropin (hCG), the hormone detected by at-home pregnancy tests, is affected by breast cancer. A 2023 study in Scientific Reports notes that approximately 13% of breast cancer cases have been found to express beta hCG.
However, every patient is different, and Maryam Lustberg, MD, MPH, chief of breast medical oncology at Yale Cancer Center, acknowledges that each individual needs proper testing before confirming that a false pregnancy is a cancer sign. “Our bodies are complex, and breast tissue can hide things,” she says. “It can be confusing to tell the difference between lumps, bumps, and things like that.”
Both Looper’s primary care physician and breast surgeon also could not be sure if her symptoms, including the positive pregnancy test, were related to her cancer.
Marlene also didn’t make a connection between her symptoms and her diagnosis until after she found a lump. Six months before Marlene got screened for breast cancer, she was experiencing extreme fatigue.
“It wasn’t like I needed some extra coffee or a nap. But I was running around all the time and thought I was really busy,” she says. “But I later realized, oh my gosh, that was literally my body trying to fight a disease, and I had no idea. I had just dismissed it over and over and over again.”
Cancer-related fatigue can be a symptom of the disease itself. This type of fatigue is a physical and mental feeling of exhaustion that does not get better with sleep.
A New Breast Lump or Mass Might Prompt More Testing
Marlene’s lump was quite small, no more than 1.3 centimeters. So, she considered herself lucky even to feel a mass that size. Her doctors determined she had stage 1A, invasive lobular carcinoma.
Like Marlene, Looper underwent a biopsy after finding a lump in her breast, about a month after experiencing unusual pregnancy-like symptoms. She was diagnosed with stage 1 invasive ductal carcinoma. Looper says that while her cancer was caught early, her doctor told her that her condition would have been more difficult to treat if she’d waited any longer to get screened.
Looper said her oncologist estimated the lump may have been there for about four months and that it would have grown rapidly. Although Looper’s condition could have spread quickly, research has found that most breast cancer is slow-growing, with an average tumor doubling in size in 280 days. However, average tumor growth can vary based on multiple factors, including the stage of the cancer, the body’s immune response, and medical history.
Early Breast Cancer Symptoms Can Be Easy to Miss
Often, some early breast cancer signs can be easily overlooked. Lustberg says that women who’ve entered the postpartum period may think redness or swelling of the breast is a result of lactation.
“Younger patients having breast pain or breast swelling might have been told, These are just cystic changes and you’re too young to develop breast cancer,” she adds. “Inflammatory breast cancer can present as infection or redness in the breast area. Sometimes patients can go months where they’re given antibiotic after antibiotic, but the true diagnosis is missed.”
Credit: Courtesy Maryam Lustberg, MD
Lustberg notes that a subtle lump in the breast is usually the first sign of breast cancer, similar to what Looper and Marlene experienced.
Of course, fatigue or pregnancy-like symptoms shouldn’t necessarily be considered the first sign of breast cancer. “They can be very non-specific,” Lustberg says. “But certainly, I think if it’s new and persisting, it’s something that should be evaluated in an initial workup at the doctor.”
Don’t Wait to Get Checked If You Notice New or Persistent Breast Changes
Marlene and Looper both pushed to get screened soon after noticing their initial symptoms. And they are urging other women with new or persistent breast changes to do the same.
“If I had put my appointment off, my cancer, even though it was very treatable, would have grown very quickly,” Marlene says. Detecting breast cancer early can make a big difference. If cancer is found before it has spread outside the breast, the 5-year relative survival rate is more than 99%. That rate lowers to 87% if the cancer has spread to nearby structures or lymph nodes.
Under the Affordable Care Act, insurance plans are required to cover breast cancer screenings for people aged 40 and above. Carriers may cover breast cancer screenings for younger women depending on factors such as family history or medical necessity.
Lustberg says that while breast cancer is less common in women in their 20s and 30s, it’s best to see a doctor if they notice something’s wrong.
“Normal cyclical changes or normal inflammation or infection should get better, but if it’s something that doesn’t within a week or two, it definitely merits another evaluation,” she says. “Don’t be overly anxious about it, because it could still not be cancer. But it should be looked into.”
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