When it comes to breast cancer, most people associate it with one telltale symptom, a lump in the breast. But doctors warn that this is only part of the picture. Many women overlook early, subtle changes that may not involve a lump at all, allowing the disease to progress silently. In India, breast cancer is now the most common cancer among women, accounting for nearly 28% of all female cancers, according to the Indian Council of Medical Research (ICMR) and the National Cancer Registry Programme (NCRP). What's even more concerning is that over half of breast cancer cases in India are diagnosed at advanced stages, often because early signs are missed or misunderstood.
Experts say the key lies in paying attention not only to lumps but also to the other, less obvious signs your body may be sending. We spoke to two oncologists about the other key signs and symptoms of breast cancer, and here's what they revealed.
Not Every Breast Cancer Sign Shows Up As A Lump
"When most people think of breast cancer, the first thing that comes to mind is a lump. But the truth is, not every warning sign of breast cancer shows up that way. Sometimes, the body gives subtler clues that are easy to miss or too easy to dismiss," says Dr Rahul S. Kanaka, Consultant - Surgical Oncology, Manipal Hospitals, Yeshwanthpur.
He adds that breast cancer isn't a single disease, there are several subtypes, and some aggressive forms can spread early, showing symptoms far beyond the breast. "Fatigue, bone pain, and unexplained weight loss can sometimes be the first signs of cancer spreading to other organs. That's why even a small, painless lump shouldn't be ignored," Dr Kanaka says.
This is especially true for triple-negative breast cancer, which is more common in younger women and tends to spread faster. Early recognition is vital, he explains, because "awareness and education are the first steps toward early detection. Every woman should know her individual risk factors and get regular screenings, especially those in higher-risk categories. Survivors, too, should stay vigilant about recurrence in either breast and follow up regularly."
Hormonal Changes Vs Cancer Warnings: How To Tell The Difference
Many women notice breast changes due to hormonal fluctuations during their menstrual cycle, pregnancy, or menopause, and it's easy to mistake warning signs for normal changes.
Dr Kanaka points out a key difference: "Hormonal changes are generally predictable and affect both breasts uniformly. Warning signs of malignancy, on the other hand, include progressive lump growth, skin tethering, puckering, satellite lesions, an orange-peel texture, nipple retraction or discharge, and swelling in the armpit area."
Doctors emphasize that even the smallest or most subtle change should be investigated, especially if it's confined to one breast or persists for more than a few weeks. "Early diagnosis doesn't just save lives. It makes treatment simpler and recovery easier," he adds.
The Hidden Signs Of Breast Cancer You Might Miss
According to Dr Sachin Sekhar Biswal, Consultant - Medical Oncology, Manipal Hospitals, Bhubaneshwar, not all lumps are cancerous, and not all cancers present as lumps. "It's well known that a lump is often one of the earliest signs of breast cancer but not all lumps are cancerous, and not all cancers present as lumps. Many cases begin with small, often overlooked changes in the breast's skin or nipple," he explains.
Dr Biswal says to pay close attention to surface changes. "Watch for redness, thickening, or dimpling that gives the skin an orange-peel look. These changes can happen when a tumour affects the skin or lymphatic drainage and should never be ignored. Nipple inversion, scaling, persistent itching, or unusual discharge, especially if it's blood-stained or spontaneous, also warrant immediate medical attention."
He adds that while breast pain alone is rarely a red flag, it should not be dismissed outright. "Persistent or localized pain that comes with other changes should be checked. Hormonal fluctuations, cysts, or benign conditions can cause discomfort, but combining pain with dimpling or discharge raises suspicion," says Dr Biswal.
And the most important advice: "Don't wait for a lump to appear. If something feels off, get it checked. Trusting your instincts and seeking help early can make all the difference because when it comes to breast cancer, timing truly matters."
Why Early Detection Is Still The Best Defense
According to the National Cancer Grid of India, nearly 60% of breast cancer cases in the country are detected only in Stage 3 or 4, stages where treatment becomes more intensive and survival rates decline. The 5-year survival rate for early-stage breast cancer can exceed 90%, but drops dramatically when detected late.
Screening and self-awareness are therefore non-negotiable. The Indian Cancer Society and Ministry of Health recommend:
- Monthly self-breast examination (SBE) after age 20
- Clinical breast examination by a doctor every 3 years (ages 20-39)
- Annual mammography for women above 40 or those with high-risk family history
- These steps can help catch abnormalities well before they develop into advanced cancer.
Dr Kanaka emphasizes the need for personalized screening based on risk profile. Women with dense breast tissue or family history should discuss genetic testing and MRI-based screening options with their oncologist.
While medical technology and treatments continue to improve, the first line of defense remains self-awareness. Noticing changes early, even subtle ones, can literally save lives. Breast cancer is not always about the lump, it's about listening to what your body is trying to say. As Dr Biswal concludes, "If something feels off, get it checked. Timing truly matters."
Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.
