Most women don’t know these four breast cancer warning signs

Most women can’t identify common symptoms of breast cancer that aren’t lumps, according to a new survey.

This is worrisome considering most cases of breast cancer aren’t diagnosed due to a lump detected by touch—meaning women need to be aware of all the other warning signs of the disease, too, so they can see a doctor as soon as they notice one.

The survey, conducted by researchers at The Ohio State University Comprehensive Cancer Center, also found that many women are confused about how often and when they should be screened for breast cancer, which is the second most common cancer in women, falling only behind skin cancer.

The results of the survey highlight the fact that more women need to be educated on how to spot breast cancer symptoms and what to do if you notice one.

“We want people to feel empowered about their bodies and know what is normal for them,” Ashley Pariser, MD, a breast medical oncologist at The Ohio State University Comprehensive Cancer Center, said in a statement on the new research. “Many breast changes are the result of aging and childbirth; however, breast cancer can present in a number of ways. It is important that people feel safe to address these concerns in a timely way with their doctor. We have made great strides in detecting breast cancers in far earlier, more treatable stages.”

The new survey looked at how many respondents knew that the following could be symptoms of breast cancer: breast puckering; inverted, retracted, or downward-pointing nipple; nipple discharge; pitting or thickening of the breast skin; loss of feeling in the breast.

Nearly one-third of respondents knew that an inverted, retracted, or downward-pointing nipple could be symptomatic of breast cancer, while nearly 40 per cent knew breast puckering—which causes an indentation that occurs when the arms are raised—is a sign. About 40 per cent knew loss of feeling in the breast could be a warning sign, and a little more than half knew nipple discharge was a symptom. Only 45 per cent knew pitting or thickening of the breast skin could also be a warning sign of breast cancer.

Per the Centers for Disease Control and Prevention (CDC), pain—in any area of the breast—can also be a symptom, as can “redness or flaky skin in the nipple area or the breast”.

Breast cancer is very common: It accounts for about 30 per cent of all new cancers found in females each year, per the American Cancer Society (ACS).

The ACS estimates that in 2023 alone nearly 300,000 new cases of invasive breast cancer will be diagnosed in women in the US. About 43,700 women in the US will die from breast cancer this year, according to ACS data.

In the US, the lifetime risk of having breast cancer for women is 13 per cent, meaning one in every eight women will likely have the disease.

But many women do not think they will be diagnosed during their lifetime: The new survey found 75 per cent of participants do not think they will get breast cancer.

Recommendations around who should get screened for breast cancer—and how often—vary among leading health organisations, and the mixed messaging has taken a toll on cancer prevention efforts; the new survey found that 44 per cent of women under 30 are confused about screening recommendations.

“Screening mammography is our [number one] defense in detecting and addressing breast cancers at their earliest, most treatable stages, but it is also very important for people to be familiar with the look and feel of their own breast tissue so that sometimes subtle changes can be evaluated quickly to give us the best chance at early detection,” Dr Pariser said.

The American College of Obstetrics and Gynecologists (ACOG) and the American College of Radiology (ACR) both recommend that screenings begin at age 40 for women of average risk. However, if you have a history of breast cancer in your family or are otherwise concerned about your risk for the disease, it’s important to speak with your healthcare provider before that age to make an individualised plan for how often you should be screened to minimise risk.

Ultimately, the new survey shows that there’s still much work to be done in effectively communicating both the symptoms of breast cancer and the best screening practices to the public, experts say.

“The best way for us to find breast cancer early is for women to present as soon as they notice a change, ideally even before they see a change,” Dr Pariser said. “Although we are making great strides in terms of detection and treatment, unfortunately we live in a world where breast cancer is still a serious concern for people.”