Breast cancer begins from a cell that divides uncontrolled. A small clump is too tiny to be felt. So, breast cancer can be asymptomatic in the early stage, and it may show local and systemic symptoms with the progression of this disease. They may include:
1、Lump: The classic symptom for breast cancer is a lump or swelling found in the breast or armpit. Almost swellings are located in the upper outer quadrant，others in the upper quadrant and nipple and areola. The size of lump varies often with 2～3cm. Mostly masses are round or oval with boundary less clear, indurations and relatively poor activity.
2、Pain: Women with breast cancer mostly lack symptom of pain. The pain usually presents breast tingling, dull pain or sometime cyclical pain if there is cystic hyperplasia surrounding the breast cancer.
3、Breast skin changes: Breast tissue is located in the subcutaneous fascia of the wrapping; the depth of the fascia is connected between the Cooper ligaments. Connected to the superficial fascia and skin, when the invasion of breast cancer between the Cooper ligaments to shorten it, it will stretch the skin, the local skin sag, like dimples, called the “dimple sign.”
- Redness and swelling
- Skin ulceration
- Skin nodules
- Armor cancer: Several skin nodules fusion and cover the entire chest wall and extend to the armpit and back, even more than the sternum midline, extending to the contralateral chest wall. The plate of thick hard skin is like armor worn, so it is called armor cancer.
4、Changes in breast contour：The breast may have local uplift and increased with the growth if tumor. But, when the tumor involved the skin or chest muscle, the breast can be harden and narrow
5、Changes in nipple and areola
- Inverted or retracted nipple
- Eczema-like changes in nipple
6、nipple discharge (clear or bloody)
7、Regional lymph nodes
- Axillary lymph node metastases
- supraclavicular lymph node
- Internal mammary lymph node
8、The performance of distant metastasis：Distant metastasis can occur via blood or lymphatic channels with lung, pleura, bone, liver, brain and soft tissues commonly.
- Lung and pleural metastasis: lung is common site of metastases that often appears as nodular multiple metastases, mostly bilateral. Cough, difficulty breathing, hemoptysis and chest pain can occur. The pleural metastasis presents cough, fatigue, weakness, difficulty breathing, and chest pain in some patients.
- Bone metastasis: The most likely site of involvement followed by the spine, ribs, pelvis and long bones, may also appear in the shoulder blade, skull and so on.
- Liver: hepatic metastasis is small and there is no special symptom. When the mass become larger, there may be more extensive hepatomegaly, liver pain, loss of appetite, abdominal distension. Embolism can occur with advanced jaundice ascites.
- Brain metastases: Brain metastases are mainly for the transfer of meninges and brain parenchyma. Headache and mental status changes are common symptoms and the brain dysfunction and vision disorders may occur, such as the back pain, sensory disturbances, bladder dysfunction, and urinary difficulties.
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