Breast Cancer Symptoms — Lumps, Signs and What to Check

The full NHS symptom list

Breast cancer can present in many ways. The most common symptom is a new lump or thickening in the breast or armpit. But there are many other signs. The NHS recommends seeing a GP without delay if you notice any of the following:

• A new lump or thickening in the breast or armpit
• A change in the size, shape or feel of the breast
• Skin changes — dimpling, puckering, redness or a texture like orange peel
• A change in the nipple — a nipple turning inward (inversion), discharge from a nipple (other than breast milk), or a rash or crusting around the nipple
• Swelling in the armpit or around the collarbone
• Pain in the breast or armpit that is new, persistent and not related to the menstrual cycle

The TLC method: Touch–Look–Check

The NHS recommends that all women become "breast aware" — which simply means knowing how your breasts normally look and feel, so that any change can be spotted early. This is sometimes called the TLC approach:

• TOUCH your breasts and armpits with the flat of your fingers, feeling for any new lump, thickening or area that feels different from the rest.
• LOOK at your breasts in the mirror with your arms by your sides and then raised, watching for changes in shape, contour or skin appearance.
• CHECK anything new or unusual by seeing your GP promptly — most changes are not cancer, but only a doctor can confirm this.

There is no single "right" way or set frequency. The goal is simply to know what is normal for you, so that if anything changes you notice it.

What to do about a change

If you notice any of the symptoms above, contact your GP as soon as possible. You should not wait to see if it goes away. In the UK, if your GP suspects breast cancer they will refer you under the NHS two-week-wait pathway — you should see a breast specialist within two weeks.

Most breast changes turn out not to be cancer. But the only way to know is to get checked. Early diagnosis is the single most important factor in breast cancer survival, so acting quickly is always the right decision.

Signs of more advanced disease

In women where cancer has spread beyond the breast (secondary or metastatic breast cancer), additional symptoms may include: persistent bone pain, unexpected weight loss, shortness of breath, and neurological symptoms if cancer has spread to the brain. Any of these warrant urgent medical attention.

What does a breast cancer lump feel like?

A breast cancer lump most often feels hard or firm and may feel fixed rather than moving freely when pressed. It is often irregular in shape. However, lumps vary considerably — some breast cancers feel smooth and rounded, particularly in younger women. The size can also vary greatly: some early cancers are very small and may be difficult to feel at all. The most important rule is this: any new lump or thickening, however it feels, should be checked by a GP promptly. Do not try to judge whether a lump is cancerous from how it feels — only clinical assessment and imaging can determine this.

Is breast cancer painful?

Most early breast cancers are painless — which is one reason they can be overlooked. A painless lump is not a reassuring sign. Breast pain alone (without other symptoms) is rarely a sign of breast cancer and is usually caused by hormonal changes, a benign cyst or musculoskeletal causes. However, new, persistent pain in the breast or armpit that is present most of the time and does not relate to your menstrual cycle should be assessed by a GP, particularly if it is accompanied by a lump, skin change or nipple change.

Can a breast cancer lump be soft?

Yes. Although many breast cancer lumps feel hard or firm, some can feel soft or rubbery — particularly certain subtypes such as medullary breast cancer. The texture of a lump is not a reliable indicator of whether it is benign or malignant. Both hard and soft lumps need to be checked. Similarly, a lump that moves freely when pressed is not necessarily benign — it simply needs the same assessment as a lump that feels fixed. The NHS advises seeing a GP with any new or unusual change, regardless of how it feels.