Breast cancer symptoms: signs to look for and when to see a GP

The NHS says symptoms of breast cancer in women may include a lump or swelling in your breast, chest or armpit, a change in the skin of your breast such as dimpling that may look or feel like orange peel, a change in colour (darker than usual on black or brown skin, red on white skin), a change in the size or shape of one or both breasts, nipple discharge, and changes in the shape or look of the nipple.

It says you may have pain in your breast or armpit with these symptoms but can have these symptoms without any pain, and that breast pain by itself is not usually a symptom of breast cancer. It also says it is important to check your breasts regularly so you know what is normal for you, which makes it easier to notice changes in size, look or feel.

• A lump or swelling in the breast, chest or armpit.

• Dimpling or orange-peel texture of the skin.

• A change in the colour of the skin on the breast.

• A change in the size or shape of one or both breasts.

• Nipple discharge, which may contain blood, if not pregnant or breastfeeding.

• A nipple turning inwards (inverted) or a rash on the nipple that may look like eczema.

The NHS says some symptoms, including breast lumps, are very common and can be caused by other conditions. Having the symptoms does not definitely mean you have breast cancer, but it is important to get checked by a GP.

On breast pain, the NHS says it is not usually anything serious and is often linked to periods, with other causes including medicines such as the contraceptive pill, mastitis or a breast abscess, pregnancy and menopause hormone changes. It says breast pain by itself is unlikely to be a symptom of cancer.

The NHS breast pain page says to ask for an urgent GP appointment or get help from NHS 111 if you have breast pain with a very high temperature, a red, hot or swollen part of the breast, a hard lump that does not move around, nipple discharge streaked with blood, a change in shape of one or both breasts, dimpled skin, a rash on or around the nipple or a nipple that has sunk into the breast.

The NHS says symptoms of breast cancer in men may include a lump or swelling in the chest or armpit, liquid leaking from the nipples which may have blood in it, changes in the size or shape of either side of the chest, sores or ulcers on the chest, and a change in the shape or look of the nipple such as turning inwards or a rash.

It advises checking your chest regularly so you know what is normal for you, and seeing a GP if you have a lump or swelling in your chest or armpit, nipple discharge from either nipple, or any changes in your chest or nipples that are not normal for you.

The NHS says that if breast cancer spreads to other parts of the body it is called secondary breast cancer, and the symptoms depend on where it has spread. It can spread anywhere but most commonly affects the bones, liver, lungs or brain.

General symptoms the NHS lists include feeling tired or having no energy, loss of appetite or losing weight without trying, feeling unwell with no clear cause, feeling or being sick, and difficulty sleeping.

The NHS says the GP will ask about your symptoms, and may ask about any breast screening you have had and whether anyone in your family has had breast cancer. If you have a lump or unusual changes, the GP may ask to look at and examine your breasts. You will need to undress from the waist up behind a screen, and you can have a friend, family member or another member of staff in the room.

You may be referred to a breast clinic if the GP thinks you have symptoms that could be cancer. The NHS says this does not definitely mean you have cancer.

At the breast clinic you will have more tests and scans to check for breast cancer or other breast conditions. The NHS says these may include an examination of your breasts, a breast X-ray (mammogram), an ultrasound of your breasts, and taking a small sample of cells (biopsy), usually with a needle. You may not need all of them, and you will usually have all the tests you need in one visit.

Some results may be available that day. The NHS says others, such as a biopsy, can take 1 to 2 weeks, and you can call the hospital or your GP if you are worried. If breast cancer is found, further scans such as CT, MRI or PET and blood tests may be done to show how far it has spread and what type it is.

The NHS says anyone can get breast cancer and it is not always clear what causes it. You might be more likely to get it if you are over 50, have dense breast tissue, have family members who have had breast or ovarian cancer (you may have inherited a faulty gene such as BRCA), or have certain breast conditions.

Higher hormone levels may also play a part: starting periods before 12, menopause after 55, not having given birth or first birth after 30, not breastfeeding, and use of the contraceptive pill in the last 10 years or HRT, which the NHS says only slightly increase risk. It suggests cutting down on alcohol (no more than 14 units a week), losing weight if overweight and quitting smoking, and going for breast screening when invited.

See a GP if you have a lump or swelling in your breast, chest or armpit, any changes in your breasts or nipples that are not normal for you, or breast or armpit pain and other people in your family have had breast or ovarian cancer.

Ask for an urgent GP appointment or get help from NHS 111 if breast pain comes with a very high temperature or feeling hot, cold or shivery, a red, hot or swollen breast, a hard lump that does not move around, bloody nipple discharge, a change in breast shape, dimpled skin or a sunken nipple.

On the NHS, your GP can refer you to a breast clinic, usually for tests in one visit. The NHS says breast screening with mammograms, when you are invited, can help find cancers that are too small to see or feel.

Some people choose a private breast clinic for assessment. Whichever route you take, symptoms need assessment with examination, imaging and, if needed, a biopsy, and you should ask how results will be shared with your GP.