Cleveland Clinic Explains Myths Surrounding Breast Cancer Symptoms

Tue, Oct 29th 2024, 11:17 AM

You can never be too safe when it comes to breast cancer. Doing self-exams, having mammograms and watching for warning signs can save your life.

Raised awareness and more candidness about breast health is a good thing. But it also has fueled some common misperceptions.

Cleveland Clinic, Ohio oncologist Megan Kruse, MD, explains the common breast cancer symptoms and the truth behind five false signs of breast cancer.

Breast cancer is the second-leading cause of cancer death in women and while there are different types of breast cancer, symptoms typically vary. They can include a change in the size, shape or contour of your breast, a mass or lump, a lump thickening in or near your breast or in your underarm that present during your menstrual cycle, a change in the look or feel of your skin on your breast or nipple, a marble-like hardened area under your skin, or a blood-stained or clear fluid discharge from your nipple.

It’s important to note that symptoms can vary from person to person — and that some people might not even notice any symptoms.

While you should speak to a healthcare provider if you have any concerns, there are some common myths out there. Dr. Kruse sets the record straight.

Myth number one is that if a breast lump is moveable, its not cancer.

“Actually, most breast cancers begin in a movable state,” Dr. Kruse says. “It’s often not until they grow larger that they attach to something and stop moving.”

You should tell your healthcare provider about any lump you feel in your breast.

When doing a self-exam, feel around your breasts for something hard that doesn’t belong there, Dr. Kruse advises. It may feel like a frozen pea or lima bean, or be smooth and very firm, like a marble.

The second myth is that breast cancer doesn’t cause pain, however, that’s not entirely true. Breast cancers can be painful depending on where they occur in a breast, especially if growing quickly. Breast pain in one consistent particular spot is a warning sign.

Can dense breast tissue cause pain? Tenderness or pain in your breast isn’t generally related to breast density.

“Most women experience general breast pain or soreness that comes and goes,” Dr. Kruse says. “That’s not a sign of cancer, but usually due to hormone fluctuations or too much caffeine.”

Another myth is that women with lumpy breast tissue have dense breasts, which is false. “Lumpy breast tissue has nothing to do with breast density,” Dr. Kruse clarifies. “Your breasts can feel lumpy but not appear dense on a mammogram.” Nearly 1 in 2 women have dense breast tissue, indicated by the amount of milk glands and ducts and supportive tissue, which appear solid white on a mammogram. Because cancer can appear the same way, women with dense breasts may choose to have 3D mammography for better cancer detection and fewer false positives. Women at high risk may qualify for MRI screening.

Myth number 4 is that doctors can tell if a lump is cancer just by feeling it. This is also wrong. Neither you nor your healthcare provider — no matter how good they are — can tell whether a lump is cancer without diagnostic imaging.

“Providers who say, ‘It’s probably OK,’ without investigating further may cause a delay in diagnosing breast cancer,” Dr. Kruse cautions. “Don’t let your doctor guess. Get imaging.”

When there’s a lump of concern, women age 30 and older will have a diagnostic mammogram and ultrasound. An ultrasound helps evaluate a mass by assessing whether it is solid or fluid filled. Women under age 30 will have only an ultrasound because younger, denser breasts are difficult to evaluate by mammogram.

Suspicious lumps should be biopsied. Typically, a sample of tissue is drawn through a needle. Then, the tissue is studied under a microscope.

Is there such a thing as breast cancer discharge? In most cases, no, which brings us to myth number 5, that nipple discharge is usually a sign of cancer. Many women have leftover milk in their ducts after breastfeeding, or they have debris that can cause greenish or even black discharge that can be squeezed out of the ducts, Dr. Kruse explains.

“What’s more concerning is bloody or clear discharge that leaks out when you’re not squeezing,” she says. “This type of discharge can be a sign of breast cancer about 10% of the time. Even with bloody nipple discharge, the cause is usually a benign condition inside the milk duct.”

Lumps, pain and other breast abnormalities affect almost every woman at some point. Usually, they aren’t cancer but getting them checked out is a must. Most of the time, you can’t safely rule out cancer without a proper evaluation.

“Many of my patients with breast cancer note that they had the lump for a number of months before bringing it to medical attention. The sooner a lump is evaluated, the better the chances of cure if it’s found to be cancer and the sooner a patient will receive reassurance if the lump is not cancerous,” says Dr. Kruse.

“Many types of medical providers can help to evaluate a breast lump, including primary care providers, Ob/Gyn providers and other breast specialists. The more familiar you’re with your own breasts, the better you will be able to help your provider act appropriately when a change is found.”

About Cleveland Clinic 
Cleveland Clinic is a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. Located in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. Cleveland Clinic is consistently recognized in the U.S. and throughout the world for its expertise and care. Among Cleveland Clinic’s 81,000 employees worldwide are more than 5,743 salaried physicians and researchers, and 20,160 registered nurses and advanced practice providers, representing 140 medical specialties and subspecialties. Cleveland Clinic is a 6,690-bed health system that includes a 173-acre main campus near downtown Cleveland, 23 hospitals, 276 outpatient facilities, including locations in northeast Ohio; Florida; Las Vegas, Nevada; Toronto, Canada; Abu Dhabi, UAE; and London, England. In 2023, there were 13.7 million outpatient encounters, 323,000 hospital admissions and observations, and 301,000 surgeries and procedures throughout Cleveland Clinic’s health system. Patients came for treatment from every state and 132 countries. Visit us at clevelandclinic.org. Follow us at twitter.com/CleClinicNews. News and resources available at newsroom.clevelandclinic.org.

You can never be too safe when it comes to breast cancer. Doing self-exams, having mammograms and watching for warning signs can save your life.
Raised awareness and more candidness about breast health is a good thing. But it also has fueled some common misperceptions.
Cleveland Clinic, Ohio oncologist Megan Kruse, MD, explains the common breast cancer symptoms and the truth behind five false signs of breast cancer.
Breast cancer is the second-leading cause of cancer death in women and while there are different types of breast cancer, symptoms typically vary. They can include a change in the size, shape or contour of your breast, a mass or lump, a lump thickening in or near your breast or in your underarm that present during your menstrual cycle, a change in the look or feel of your skin on your breast or nipple, a marble-like hardened area under your skin, or a blood-stained or clear fluid discharge from your nipple.
It’s important to note that symptoms can vary from person to person — and that some people might not even notice any symptoms.
While you should speak to a healthcare provider if you have any concerns, there are some common myths out there. Dr. Kruse sets the record straight.
Myth number one is that if a breast lump is moveable, its not cancer.
“Actually, most breast cancers begin in a movable state,” Dr. Kruse says. “It’s often not until they grow larger that they attach to something and stop moving.”
You should tell your healthcare provider about any lump you feel in your breast.
When doing a self-exam, feel around your breasts for something hard that doesn’t belong there, Dr. Kruse advises. It may feel like a frozen pea or lima bean, or be smooth and very firm, like a marble.
The second myth is that breast cancer doesn’t cause pain, however, that’s not entirely true. Breast cancers can be painful depending on where they occur in a breast, especially if growing quickly. Breast pain in one consistent particular spot is a warning sign.
Can dense breast tissue cause pain? Tenderness or pain in your breast isn’t generally related to breast density.
“Most women experience general breast pain or soreness that comes and goes,” Dr. Kruse says. “That’s not a sign of cancer, but usually due to hormone fluctuations or too much caffeine.”
Another myth is that women with lumpy breast tissue have dense breasts, which is false. “Lumpy breast tissue has nothing to do with breast density,” Dr. Kruse clarifies. “Your breasts can feel lumpy but not appear dense on a mammogram.” Nearly 1 in 2 women have dense breast tissue, indicated by the amount of milk glands and ducts and supportive tissue, which appear solid white on a mammogram. Because cancer can appear the same way, women with dense breasts may choose to have 3D mammography for better cancer detection and fewer false positives. Women at high risk may qualify for MRI screening.
Myth number 4 is that doctors can tell if a lump is cancer just by feeling it. This is also wrong. Neither you nor your healthcare provider — no matter how good they are — can tell whether a lump is cancer without diagnostic imaging.
“Providers who say, ‘It’s probably OK,’ without investigating further may cause a delay in diagnosing breast cancer,” Dr. Kruse cautions. “Don’t let your doctor guess. Get imaging.”
When there’s a lump of concern, women age 30 and older will have a diagnostic mammogram and ultrasound. An ultrasound helps evaluate a mass by assessing whether it is solid or fluid filled. Women under age 30 will have only an ultrasound because younger, denser breasts are difficult to evaluate by mammogram.
Suspicious lumps should be biopsied. Typically, a sample of tissue is drawn through a needle. Then, the tissue is studied under a microscope.
Is there such a thing as breast cancer discharge? In most cases, no, which brings us to myth number 5, that nipple discharge is usually a sign of cancer. Many women have leftover milk in their ducts after breastfeeding, or they have debris that can cause greenish or even black discharge that can be squeezed out of the ducts, Dr. Kruse explains.
“What’s more concerning is bloody or clear discharge that leaks out when you’re not squeezing,” she says. “This type of discharge can be a sign of breast cancer about 10% of the time. Even with bloody nipple discharge, the cause is usually a benign condition inside the milk duct.”
Lumps, pain and other breast abnormalities affect almost every woman at some point. Usually, they aren’t cancer but getting them checked out is a must. Most of the time, you can’t safely rule out cancer without a proper evaluation.
“Many of my patients with breast cancer note that they had the lump for a number of months before bringing it to medical attention. The sooner a lump is evaluated, the better the chances of cure if it’s found to be cancer and the sooner a patient will receive reassurance if the lump is not cancerous,” says Dr. Kruse.
“Many types of medical providers can help to evaluate a breast lump, including primary care providers, Ob/Gyn providers and other breast specialists. The more familiar you’re with your own breasts, the better you will be able to help your provider act appropriately when a change is found.”
About Cleveland Clinic 
Cleveland Clinic is a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. Located in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. Cleveland Clinic is consistently recognized in the U.S. and throughout the world for its expertise and care. Among Cleveland Clinic’s 81,000 employees worldwide are more than 5,743 salaried physicians and researchers, and 20,160 registered nurses and advanced practice providers, representing 140 medical specialties and subspecialties. Cleveland Clinic is a 6,690-bed health system that includes a 173-acre main campus near downtown Cleveland, 23 hospitals, 276 outpatient facilities, including locations in northeast Ohio; Florida; Las Vegas, Nevada; Toronto, Canada; Abu Dhabi, UAE; and London, England. In 2023, there were 13.7 million outpatient encounters, 323,000 hospital admissions and observations, and 301,000 surgeries and procedures throughout Cleveland Clinic’s health system. Patients came for treatment from every state and 132 countries. Visit us at clevelandclinic.org. Follow us at twitter.com/CleClinicNews. News and resources available at newsroom.clevelandclinic.org.
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