Q I am constantly having pain in the breast. Could this be a warning sign of breast cancer?

A A sharp pain or tenderness in your breast can be scary.

As our body tends to send out pain signals to us when something is not right, it is understandable that many women often associate pain in the breast with breast cancer.

However, breast pain is rarely the first noticeable symptom of breast cancer.

There are many other more common causes of breast pain. The clinical name for breast pain is mastalgia.

Some of the more common causes of breast pain are hormone-related, such as the fluctuation of hormones caused by menstruation, some birth control pills and certain infertility treatments or physical causes such as an ill-fitting bra, breast cysts and large breasts which may be accompanied by back pain and stress.

Breast cancer most often shows with lumps in the breast.

However, it is important to note that only around 10 per cent of all palpable breast lumps are cancerous and around 90 per cent of breast lumps are non- cancerous.

The non-cancerous lumps include breast infection, where the breast may be hot and tender, and the patient may feel generally unwell and has a fever; fibrocystic breast disease, which is sometimes labelled as "lumpy breasts"; fibroadenoma, which refers to a non-cancerous tumour; and fat necrosis, which refers to damaged breast tissue.

Even though the majority of breast lumps are non-cancerous, new, painless lumps are still the most common symptom of breast cancer.

Some early signs of breast cancer to look out for are:

•Changes in the shape of the nipple.

•Breast pain that does not go away after your next period.

•A new lump that does not go away after your next period.

•Nipple discharge from the breast that is clear, red, brown or yellow.

•Any unexplained redness, swelling, skin irritation, itchiness or rash on the breast.

•Swelling or a lump around the collarbone or under the arm.

•An irregular, hard and painless lump.

Later signs of breast cancer include inward turning of the nipple (nipple retraction); enlargement of one breast, skin dimpling of the breast surface (peau d'orange); an existing lump that gets bigger; ulcerating/ bleeding breast lumps; and multiple lumps in the armpits.

It is important for you to know your breasts well. If you notice any persistent changes in your breasts, you should consult your doctor to clarify if there is anything sinister going on.

Dr Sue Lo

Senior consultant medical oncologist at The Harley Street Heart & Cancer Centre

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