By Dr Evelyn Ho; Photos courtesy of Dr Ernest Yeoh
There were many suggestions and requests received requesting for pictures to illustrate the different signs of breast cancer.
This pictorial essay depicts some of the more obvious signs of breast cancer. Most of these are relatively advanced and therefore the signs are more “developed”. We should be alert to earlier changes before it has progressed to some of the stages shown. However for clarity, these pictures actually illustrate the various changes that should alert you when you perform your monthly Self Breast Examination.
We hope that instead of staring with disgust or fear at these illustrations, one will be motivated and have a better idea how to pick up abnormalities in their breasts.
This shows the right breast (the breast on the left side) being larger than the left. Look carefully and you can see that the level of the nipples are not the same and the right nipple is pointing downwards.
(Left) View from the right side. (Right) View from the front.
The lump can be seen mainly in the upper part of the breast. The “pointing down” nipple is better appreciated in the view from the side. There is some discolouration of the skin in the upper outer part of the right breast and the skin is thin and stretched. The breast lump is enlarging and with time, without surgery, the cancer will break through the skin.
This is another lump in the right breast (the breast on the left side). Here, the “bulge” caused by the lump can be seen. The lump is therefore growing in the superficial parts of the breast tissue (parts closer to the skin)
The right nipple is at a lower level than the left nipple. With the hands down beside the body, this is noticeable already. However, it becomes more obvious when both arms are raised (as shown above left). Both the position and direction of the nipples are better appreciated. The close up view shows what has been described.
This illustrates the importance of going through all the positions while standing and “looking” at your breasts. Please see articles on Self Breast Examination.
There is a “depression” or sunken dip in the skin of the upper part of the left breast, above the nipple. (breast to your right) This is known as dimpling of the skin. In this patient, even with the hands down the dimpling is visible. Normally when the arms are raised this becomes apparent or more obvious. The right picture shows the dimpling of the skin from the side view.
Dimpling occurs as a result of a growth deep to the skin within the breast tissue, that is “drawing” the surrounding tissue and overlying skin towards it. This is one character of a cancerous growth in the breast. So, even without touching or feeling your breasts, you can see the effects of a growth within your breasts. Hence the importance of the “LOOK” and “FEEL” aspects of Self Breast Examination.
The skin of the breast appears patchy red and “thickened”. This is an example of a type of breast cancer that looks as if your breast has an infection. This is a sign of an inflammatory cancer of the breast.
Compare both nipples. The one to your right (the left nipple) is drawn inwards and this is called retraction of the nipple. The picture on the right shows the nipple retraction from the side view.
Another example of nipple retraction, this time with small lumps on the areola (brownish skin around the nipple). There is reddening and thickening of the skin around the areola as well.
Two examples are shown here. Peau d’ orange refers to the “orange peel” skin appearance of skin affected by cancer. The Sunkist oranges typically have this pitted appearance, hence the description “peau d’ orange”. This is due to “edema” in the skin, akin to water retention. The breast on the right is at a more advanced stage of the “orange peel” skin and the nipple is retracted (drawn inwards) as well.
Explicitly graphic photographs of advanced breast cancer is depicted in the following page. Please do not proceed further if viewing the photographs will cause distress.