Breast Cancer Information Guide

What is Breast Cancer?

Breast cancer is a tumor (a mass of abnormal tissue) within the breast. Most breast cancers begin in the milk ducts (intraductal cancers), however a small number starts in the milk sacs or lobes (lobular cancers).

What are the signs and symptoms of Breast Cancer?

In majority of women, breast cancer is first noticed as a lump in the breast. There are however, other signs and symptoms which are important.

  • Change in shape or size of the breast
  • Change in appearance of the skin in a particular area of the breast
  • Dimpling or puckering of the skin on the breast
  • A lump or thickening inside the breast
  • Discharge from the nipple
  • Rash on the nipple or surrounding area
  • Inversion or turning in of the nipple
  • Swelling of the upper arm
  • Swelling or lump in the armpit

Who is at risk?

All women are at risk of developing breast cancer. There are a number of factors that put some women at a greater risk. These are:

  • Women whose mothers, aunts or sisters have had breast cancer, have an increased risk of developing breast cancer.
  • Chances of developing breast cancer increase as women grow older
    • Women who have already had breast cancer have a slightly higher chance of developing cancer in the other breast.
    • Early onset of periods (before the age of 12).
    • Late menopause (after the age of 50).
    • Women who have never had children and those who delay giving birth until they are over 30 as well as women who do not breastfeed
    • Women who are overweight.
    • Women who have sedentary lifestyle.
    • Cigarette smoking and alcohol has been linked with the risk of developing breast cancer
  • Men can rarely develop breast cancer.

Breast Awareness

Being familiar with your breasts is in the interest of good health.

It is important to know how your breasts normally look and feel, so that you can detect new changes. If you notice any change in your breast appearance or consistency, you should report it to a healthcare provider right away.

If you become pregnant, you should still check your breasts regularly. Changes in size and tenderness of breasts are quite normal during pregnancy, but it is important to inform your doctor if you feel unusual changes in the breasts especially a lump, skin thickening or puckering.

What should you look for?

  • Changes in the size, outline or shape of the breast causing flattening of the skin.
  • Dimpling, creasing or puckering of the skin.
  • A change in direction of the nipple or if it has started to draw in.
  • Nipple discharge (some women produce a clear or milky discharge which is normal for them).
  • New veins which stand out, particularly on one breast and not the other.
  • Any skin changes on the breast or nipple.

What should you feel for?

  • Any areas of thickening.
  • Any lumps whatever their shape or form.
  • Any lumpy areas.
  • New or persistent pain or tenderness within the breasts.

Any changes you find that are new for you, must be checked by your doctor.

How to perform Breast Self-Examination?

There are two steps of Breast Self-Examination and Awareness:
– Looking
– Feeling

Find a place or room in which you feel comfortable that is also well-lit:
1. Stand in front of a mirror; inspect both breasts for anything unusual such as any discharge from the nipples or puckering, dimpling or scaling of the skin.
2. Watching closely in the mirror, clasp your hands behind your head and press your hands forward.
3. Next, press your hands firmly on your hips and bow slightly towards your mirror as you pull your shoulders and elbows forward. Some women prefer to do the next part of the examination in the shower because fingers glide over soapy skin, making it easy to concentrate on the texture underneath.
4. Raise your left arm. Use three or four fingers of your right hand to explore your left breast firmly, carefully and thoroughly. Beginning at the outer edge, press the flat part of your fingers in small circles, moving the circles slowly around the breast. Gradually work towards the nipple. Be sure to cover the entire breast. Pay special attention to the area between the breast and the underarm, including the underarm itself. Feel for any unusual lump under the skin.
5. Gently squeeze the nipple and look for a discharge (if you have any discharge during the month, whether or not it is during Breast Self-Examination, consult your doctor). Repeat steps 4 and 5 on your right breast.
6. Steps 4 and 5 should also be repeated lying down. Lie flat on your back with your left arm over your head and a pillow or folded towel under your left shoulder.

This position flattens the breast and makes it easier to examine. Use the same circular motion described earlier. Repeat the exam on your right breast.

When to report to a healthcare provider?

  1. Appearance: any change in shape or outline/skin puckering
  2. Feel: any pain or discomfort in breast
  3. Any lump
  4. Any change in Nipple.


Mammography is a special x-ray of the breast which gives more information about the lump.

Screening mammography is the key for early detection as a it can pick up very small tumors, even before they can be felt. Diagnosing breast cancer at an early stage can help start treatment early and reduce deaths from breast cancer.

Screening recommendations

Start annual screening mammogram at 40 years of age. Continue as long as a woman is in good health.

Where can you get help?

If you have any queries or problems related to your health, please contact Shaukat Khanum Memorial Cancer Hospital and Research Centre.

Women are advised to use NCI website for breast cancer related patient information.