Early Signs of Breast Cancer

Breast cancer is the most common cancer in women after skin cancer. Over a lifetime, women have a 1 in 8 chance of being diagnosed with breast cancer, and for men, it is 1 in 833. The medium age for breast cancer diagnosis for women is 62. Treatments have been increasingly successful, leading to growing numbers of breast cancer survivors each year. Treatments for cancer also have many side effects which can interfere with the body’s normal functioning. So it is very important that patients and caregivers are aware of the benefit of physical therapy from diagnosis through the course of treatment to help minimize the negative effects. It can also be crucial to understand the early signs of breast cancer and what they can look like.

What is usually the first sign of breast cancer?   

Often breast cancer is asymptomatic and does not cause any noticeable changes in the body. It is crucial to follow medical recommendations for routine screenings that include mammograms, ultrasounds, MRIs, and self-breast exams. Perhaps your early breast cancer sign is your feeling that something is not “right,” so be your own advocate and insist on a proper workup. One early breast cancer symptom that some may notice is a breast lump. Other signs include pain in the breast, nipple, or axilla, nipple discharge, and any changes in breast tissue texture or color. If you notice any breast cancer symptoms or signs, it’s important to seek a specialist for breast health screening.

What does early-stage breast cancer look like?   

During the early stage of breast cancer, the cancer cells are contained in breast tissue or local lymph nodes.  The abnormal cancer cells begin to grow haphazardly and replace the normal cells, interfering with the normal cell function. Early-stage breast cancer is contained in breast tissue only and has not spread to other parts of the body. It is also easier to treat when it has been diagnosed early. Breast cancer is staged from 0-4 based on the size and location of the cancer cells. Breast cancer also has a TNM designation. TNM designation is broken up like:

• T for the tumor size
• N for nymph lode involvement
• M for metastasis, or spread of breast cancer cells to other parts of the body  

You may also see designations of ER/PR negative or positive and HER2 negative or positive. This provides your oncology team with more information to provide the most appropriate breast cancer treatment. Genetic testing may be recommended to determine if a gene mutation may be the cause of breast cancer, which will allow family members to be proactive about their screenings. 

What are the seven warning signs of breast cancer?   

Since breast cancer can affect both women and men, it’s important to distinguish the warning signs based on gender.

WOMEN

Breast cancer symptoms and signs can look different for men and women. Breast cancer signs in women can include:

• Lump or swelling in the breast 
• Changes in the size or shape of the breast
• Skin changes: rash, redness, flaking, or dimpling  
• Inverted nipples  
• Fluid leaks from nipples
• Pain in breast 
• Swollen lymph nodes 

MEN 

Male breast cancer signs can include:

• Hard, painless lump that does not move 
• Inverted nipple
• Nipple discharge
• Persistent sore or rash around the nipple or other skin changes, including dimpling 
• Swollen lymph nodes 

What does the pain feel like when you have breast cancer?  

Often breast cancer is not painful. A breast lump, whether it is painful or not, needs to be evaluated by a physician. Breast cancer pain may differ from other breast pain in that it can be persistent and causes pain in only one spot, and can come on suddenly. The pain has been described as a burning, tender, sharp, stabbing, or tightness in the breast tissue. 

We’re Here For You

Cancer treatments, including breast cancer recovery treatment, can affect all body systems including the musculoskeletal, cardiac, respiratory, and nervous systems. Physical therapy can help in a number of ways:

• Pain: Breast pain can definitely be present post-treatment. Physical therapy can help decrease the intensity of post-op and postural pain, and provide tools to control pain from cancer and peripheral neuropathy. 
• Swelling: Chest wall and arm swelling is a common side effect of surgical intervention and radiation of the lymphatic system. Physical therapy and lymphedema therapists can assist in catching early changes and provide manual lymph drainage and compression to prevent further swelling.  
• Fatigue: Cancer and cancer treatment can cause overwhelming fatigue that can affect a person’s daily activities and quality of life. This fatigue is not relieved by sleep or rest. It is been found that even a low level of exercise early in the morning can combat some of this fatigue. Therapists can provide a structured exercise program for both high-energy and low-energy level days.   
• Cognition changes: Physical therapists may recognize early changes in cognition so that the oncology team can intervene more quickly. 
• Balance: Loss of balance can have many causes such as de-conditioning post-hospitalization and surgery, peripheral neuropathy (numbness and tingling in feet from chemotherapy), and issues with the inner ear. Physical therapists can assist in safer mobility by testing for balance deficits pre-treatment and routinely during the course of care.  
• Joint stiffness: Stiffness can be the result of inactivity, postural changes, loss of muscle mass, scarring, and axillary web syndrome due to cancer treatment and reconstructive surgery. Radiation can have long and short-term effects on joint mobility. Physical therapists take a graded approach to regaining movement with manual and stretching techniques. 
• Difficulty sleeping: Therapists will review post-op positioning of upper extremities post-surgery with the use of a pillow and ongoing sleeping positions. Getting a good night’s sleep is very important in the healing process. 
• Urinary incontinence: Whether it’s due to a pre-existing condition or post-reconstruction, therapy can help increase pelvic floor control and decrease urinary frequency. 
• Home/assistive device assessment: At any time during treatment, a physical therapist may provide recommendations to make your home and daily life activities safer by making home modifications or use of assistive devices.  

How Physical Therapy Can Help

Understanding early signs of breast cancer can allow time for early treatment and recovery. While post-cancer care can be painful and discomforting, there are ways to ease the process. Physical therapy can help with improving or learning to cope with the side effects of cancer at the time of diagnosis and throughout the course of treatment. The goal of physical therapy is to prevent a decline in function, education, support caregivers, and provide effective exercise prescriptions to maximize functional mobility. Physical therapy may aid in improving a patient’s tolerance to treatment options and avoiding ending treatments early. Visit our website for location information or to request an appointment online.

Article By: Karin White, PT, CLT 

Karin began her physical therapy career 44 years ago. She is currently treating patients who have been diagnosed with cancer and believes in the importance of providing compassionate therapy techniques to address side effects of cancer treatment, education, and caregiver support. She currently specializes in oncology rehab and lymphedema. Karin is providing physical therapy to men and women who have just been diagnosed with cancer, undergoing treatment, or completing their treatment in order to address any issues that arise throughout their journey. She treats patients at Ivy Rehab in Blue Bell, Pennsylvania.