• Breast lump or breast mass noted upon breast exam -- usually painless, firm to hard and usually with irregular borders
• Lump or mass in the armpit
• A change in the size or shape of the breast
• Abnormal nipple discharge
  • Usually bloody or clear-to-yellow or green fluid
  • May look like pus (purulent)
• Change in the color or feel of the skin of the breast, nipple, or areola
  • Dimpled, puckered, or scaly
  • Retraction, "orange peel" appearance
  • Redness
  • Accentuated veins on breast surface
• Change in appearance or sensation of the nipple
  • Pulled in (retraction), enlargement, or itching
• Breast pain, enlargement, or discomfort on one side only
• Any breast lump, pain, tenderness, or other change in a man
• Symptoms of advanced disease are bone pain, weight loss, swelling of one arm, and skin ulceration

Breast Cancer Symptoms: Risk factors

• Age and Gender -- As with most cancers, age is a significant factor. In fact, 77% of new cases and 84% of breast cancer deaths occur in women aged 50 and older. More than 80% of breast cancer cases occur in women over 50. Less than 1% of breast cancers occur in men. The risk of breast cancer is clearly related to hormonal influences, but how these affect the disease and particularly types of the disease is not yet clear.

• Genetic Factors and Family History of Breast Cancer -- Some families appear to have a genetic tendency for breast cancer. Two variant genes have been found that appear to account for this: BRCA1 and BRCA2. The genes p53 and BARD1 also appear to be important. Researchers have identified some other defective genes that may cause breast cancer, including BRCA3 and Noey2 (which is a disease inherited only from the father's side of the family).
  
  These facts suggest that breast cancer is caused by the growth of genetically damaged cells. Such genetic damage is known to gradually accumulate in the cells of the body over time. Women carrying mutated BRCA1 and/or BRCA2 genes have a "head start" in this process.
  
  Hormonal influences are important because they encourage cell growth. High levels of hormones during a woman's reproductive years, especially when they are not interrupted by the hormonal changes of pregnancy, appear to increase the chances that genetically damaged cells will grow and cause cancer.

• Early Menstruation and Late Menopause -- Women who started menstrual periods early (before age 12) or went through menopause late (after age 55) are at higher risk. Also, women who have never had children or who had them only after the age of 30 have an increased risk.

• Oral Contraceptives (birth control pills) -- Birth control pills may slightly increase the risk for breast cancer, depending on age, length of use, and other factors. No one knows how long the effects of the pill last after stopping it.

• Hormone Replacement Therapy -- Use of HRT for more than 5 years has been shown to slightly increase the risk of breast cancer and risk increases with longer use.

• Physical Characteristics -- Obesity is controversial as a risk factor. Some studies report obesity as a risk of breast cancer, possibly associated with higher levels of estrogen production in obese women.

• Alcohol Consumption -- Excessive alcohol use (more than 1-2 drinks a day) has been associated with an increased risk of breast cancer.

• Chemicals -- Some studies have pointed to exposure to estrogen-like chemicals that are found in pesticides and other industrial products as a possible increased risk of breast cancer.

• DES -- Women who took diethylstilbestrol (DES) to prevent miscarriage may have an increased risk of breast cancer.

• Radiation -- People exposed to radiation, particularly during childhood may face an increased risk for breast cancer in adulthood. Especially at risk are those that received chest irradiation for prior cancers.

• Additional Risk Factors -- Some studies show previous breast, uterine, ovarian, colon cancer, and a strong history of cancer in the family may increase the risk for breast cancer.

• Family history of breast cancer in mother or sister
• Early onset of menstruation and late menopause
• Reproductive history: women who had no children or have children late in life and women who have never breast fed have increased risk
• History of abnormal breast biopsies.

Breast Cancer Symptoms: Other considerations

However, more than 70% of women who get breast cancer have no known risk factors. While a breast cancer gene was discovered in 1994, only about 5% of breast cancers are believed to be related to the gene.

In addition, some studies suggest that high fat diets, bottle feeding instead of breast feeding, or using alcohol may contribute to the risk profile. Some studies have also found that for certain women, hormone replacement therapy may contribute to the development of breast cancer. However, these findings have been criticized.

It is important to realize that not all lumps detected in the breast are cancerous. Many are benign and require only the removal of the lump. While having several risk factors may boost a woman's chances of having breast cancer, the interplay of factors is complex. The best way to assess breast cancer risk is by doing monthly self examinations to detect any lump at an early stage. The second is to have a regular mammogram, an x ray of the front and side of the breast that will detect cysts or tumors at the earliest possible stage. Seeking risk assessment consultation at one of the many breast cancer centers located throughout the United States is also helpful.

The changes in the breast that may be a sign of breast cancer include:

• Lump or thickening in breast or armpit
• Changes in a nipple (thickening, pulling in, bleeding or discharge)
• Dimpled or reddened skin over the breast
• Change in size or shape
• Abnormality on a mammogram.