Premalignant changes (preinvasive neoplasms)
Ductal carcinoma in situ (DCIS), lobular neoplasia (LIN) (formerly: atypical lobular hyperplasia or lobular carcinoma in situ = LCIS).
They usually do not cause symptoms and are often discovered during mammography (usually microcalcifications).
Rarely are:
- Pain in the breast
- A palpable tumor or
- A bloody secretion from the nipple (hemorrhagic galactorrhea).
Malignant changes
The following symptoms and complaints may indicate breast carcinoma:
- Indolent (“painless”), coarse lump, especially in the upper, outer quadrant near the axilla (this is where circa 50% of all carcinomas occur)
- Local edema (local water retention).
- Painful nipple (nipple)
- Retraction of the skin (skin retraction spontaneously visible or occurrence when lifting the arms: spontaneous retraction) or immobility over a hardening.
- Retraction of the nipple in advanced carcinoma.
- Thoracic pain (chest wall pain/chest pain) [very rare].
- Coarse pores of the skin (orange peel; peau d’orange; orange peel phenomenon) – due to lymphedema.
- Plateau phenomenon – retraction over palpable (palpable) tumors when the skin is pushed together with the fingers (sign of connection of the tumor with the skin).
- Newly appearing difference in size of the mammae (breasts).
- Galactorrhea – secretions, often hemorrhagic (bloody), from a nipple (possibly as crusting as an indication of latent galactorrhea).
- Open ulceration (ulceration)
- Paget’s carcinoma with characteristic brown-red changes of the nipple and areola, can be misinterpreted as eczema; often occurs unilaterally as exanthema (rash) with pruritus (itching), scaling and crusting
