• A breast lump or thickening that may or may not be painful
• Change in breast size, shape, or symmetry (for example, one breast that has become higher)
• Flattening or indentation on the breast skin
• Dimpling, rippling, or scaling of the breast skin
• A change in breast skin temperature, most often a warm or hot patch
• Dark, bloody, or clear nipple discharge
• Nipple itching, scaling, burning, dimpling, or turning inward
• Lasting pain or tenderness in breast
• Swelling under the arm

Many conditions appear worrisome, but actually aren't cause for alarm. They may be hard to distinguish from cancer until after a biopsy is done:

• Cysts (fluid-filled sacs in breast)
• Fibrocystic breast disease (a common condition associated with breast lumpiness, cysts, and cyclical breast pain)
• Lipomas (round or oval fatty lumps under the skin)
• Breast infection called mastitis (breast is red, swollen and tender; sometimes associated with nursing)
• Breast abscess (a pus-filled area in the breast)
• Fibroadenomas (small, solid breast lumps made of fibrous and glandular tissue)
• Fat necrosis (lumpy scar tissue that replaces fatty tissue after breast injury or surgery)
• Sclerosing adenosis (hardening of glandular tissue in breast)

Don't ignore a problem. And don't try to self-diagnose. Go for a check-up.

Regular screening (through mammograms and breast self-exams) often turns up the first signs of cancer. If a lump or other breast change suggests cancer, your doctor will want to do several tests. First, she should perform a physical exam that includes an assessment of your overall health as well as ask you questions about your personal and family medical history. A thorough manual breast exam is an important part of this initial checkup. Your doctor may also order a mammogram, ultrasound scanning, and a biopsy.

Breast cancer that goes undetected and untreated will spread to surrounding breast tissue, then to the lymph nodes under the arm, then to other parts of the body - a process known as metastasis. Metastasized disease requires more aggressive treatment, including chemotherapy and possibly radiation or other therapies. The more information gathered about a cancer at the outset, the better targeted the treatment can be.

Once a woman is diagnosed with breast cancer, her doctor will run more tests to find out whether the disease has spread from the breast to other parts of her body. This is called `staging' and the results are given a stage designation that describes the extent of the disease. The stage helps a woman and her doctor plan the best treatment. Stage also relates to the odds of recovery because cancer that remains confined to the breast tends to be more treatable than cancer that has spread. During staging tests, a woman with breast cancer may have a chest X-ray to look for cancer in the lungs, and a blood test to check for cancer in the liver. Often, an abdominal CT scan or sonogram will be done to assess the liver. A more complicated test called a bone scan can detect cancer in the bones. An oestrogen-receptor test is done on a biopsied tissue sample. This test can find out whether the cancer cells are of the type that grow when exposed to hormones, usually oestrogen. This condition is more common among post-menopausal women, although some pre-menopausal women with breast cancer fit into this category as well.

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