When Meghan Hall, 34, was diagnosed with breast cancer, it wasn't because she (or a doctor) felt a lump.
"I noticed something green spilled on the front of my shirt, I didn't think anything of it—until I tried to take it off and realized it was stuck to my nipple," Meghan says. "My breast was leaking green fluid."
That's right: Meghan's breast cancer symptom was green fluid leaking from her nipples—and her experience isn't unique. According to preliminary research presented at the UK National Cancer Research Institute's (NCRI) 2016 conference, one in six women who discovered their cancer themselves caught it based on a less-obvious breast cancer symptom, like nipple abnormalities and weight loss (a.k.a. not a lump).
These self-reported breast cancers—especially ones that don't involve the typical lump—highlight why it's so important to pay attention to any strange signs or symptoms or changes you may be experiencing, in addition to staying on top of your mammograms and annual checkups, says Neelima Denduluri, MD, the associate chair of the U.S. Oncology Network Breast Committee.
Instead, it's best to examine your breasts as a whole—keeping track of what they normally feel and look like—so you can report any changes to your doc, whether they’re cancer or not, she adds.
Here are some of the most surprising signs and symptoms of breast cancer in women, so you know what to look out for besides lumps:
1. You notice dimply, scaly, patchy, or inflamed skin
You know your boobs and all their little quirks (like how Leftie fills out your bra so much better than Rightie) so if you notice any changes to their normal appearance, pay attention, says Debra Patt, MD, ob-gyn and breast cancer expert with Texas Oncology, a practice in the US Oncology Network.
"Any unusual thickening, redness, rash, dimpling, or puckering of your breast skin, or around the nipple, should be checked out by your doctor," she explains.
2. Your nipples have changed
Only mannequins have perfect, pointy, well-behaved nipples. Real, human women have to deal with different colors and sizes, positions, textures, and (gasp) hair.
Fortunately all of these things are totally normal and not a problem as long as they're your normal, says Dr. Denduluri. For example, if your nips have always been inverted, that's just how you're shaped, but if they change suddenly, going from pointy to fully or partially inverted, call your doctor stat. Any change in your nipples, including their color and texture, needs to be checked to rule out cancer, she says.
Oh, and BTW, hairy nipples on women have nothing to do with cancer and are totally normal—one in three women have nipple hair, even if they won't admit it, she adds.
3. Or, your nipples are leaking
Is there anything more alarming than having your breasts start squirting liquid when there's no baby involved? "It’s normal to have some leakage during pregnancy, while breastfeeding, and up to a year after weaning your baby, but if you notice any discharge any other time it needs to be evaluated by a doctor," says Dr. Patt.
Random discharge, especially if it's red or green or has an odor, can mean you have a problem, including cancer of the breast or the pituitary gland, she explains.
4. You've got painful swelling
Swollen and painful breasts are, well, a pain—and while they're mainly due to hormonal changes (like PMS or pregnancy), they can be linked to breast cancer.
It's all about the size and placement of the tumor, says Dr. Patt, which can be responsible for a change in the size or shape of your breast, or cause of painful swelling. While the vast majority of women who report breast pain do not have cancer, if breast pain and swelling isn't linked to your menstrual cycle, you're not breastfeeding, and it appears suddenly or doesn't go away, give your doctor a call because whatever is happening needs to be addressed, adds Dr. Patt.
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5. You feel a strange tickling sensation
How your breasts feel internally can be just as important as how they feel on the outside, says Sherry Ross, MD, an ob-gyn and author of She-ology. Some women report feeling a sensation almost like they’re being “tickled from the inside,” their breast feels like it’s “buzzing” or “prickly” inside, or like their breast milk is “letting down” (when they’re not breastfeeding), she says.
Weird feelings can happen for no reason at all but if you’re experiencing strange sensations in your breast that are abnormal and recurring, it’s time to call your doc, she says.
6. You can’t face the stream in the shower
Does wearing a bra suddenly irritate your nipples? Are your breasts so painful that you have to face away from the stream of water in the shower? Have your breasts become so sensitive that you don’t like your partner to touch them anymore? Breasts or nipples that become more sensitive than normal can be a sign of cancer, Dr. Ross says.
Breast sensitivity is often tied to hormone changes, which is why many women experience breast tenderness as part of PMS and it’s one of the earliest signs of pregnancy. “However, some types of breast cancer can affect your hormones, giving you a similar feeling,” she explains.
So if your breasts are suddenly way more sensitive than normal and it’s not around that time of the month and you’re not pregnant, give your doctor a call, she says.
7. Your boobs look really veiny
Being able to see your veins on the surface of your breasts depends on a lot of things—skin color, amount of subcutaneous fat, pregnancy, genetics—but you should be paying attention to those squiggly blue or green lines as changes in their appearance can be an early sign of breast cancer, Dr. Ross says.
Being veiny in general is nothing to be concerned about, but if you’ve never been able to see them before and now you can, or if they’ve suddenly become much bigger, darker, or more prominent, then it’s time to be concerned. “Visible veins can indicate the presence of a tumor as they require more blood flow and therefore more veins,” she explains. “Or the tumor may be blocking the blood flow, causing the veins nearby to swell.”
8. You can’t stop itching your nipples
Sometimes the girls just need a good scratch, especially if you’re wearing a bra edged with lace or sequins. (Why, bra manufacturers, why?) But if your nips are constantly itchy there’s a good possibility something else is up and you need to get them checked, Dr. Patt says.
Many things can cause itchy nipples, including a yeast infection or other infection, allergies, and irritation from clothing. But there is a rare type of breast cancer that can cause a dry, red, itchy rash to appear on or around your nipples, similar to the type you get with eczema, she explains.
Regardless of the cause, an itchy rash is one symptom you should always have your doctor take a look at, particularly if it doesn’t go away after a week or two.
9. Your armpit is sore (and you didn’t do pushups)
Fun fact: Your breast tissue extends far past the circular (boobular?) part you stick in your bra cups. “Your breasts actually go along the side of your chest and up into your armpits,” Dr. Ross explains. You can get breast cancer in this bonus boob tissue or cancer can cause lymph nodes in your armpit area to swell, she says. So if your armpits become painful or swollen—and you didn’t go overboard on the chest press machine—or you feel a mass when shaving, give your doc a call.
Armpit discomfort is a common complaint and most of the time it’s nothing to worry about but it’s always better to be safe than sorry when it comes to your breasts (and pits), Ross says.
10. You have a zit that won’t heal
Didn’t know that you can get zits on your breasts? It’s true. It’s not uncommon to get small sores, including pimples and even warts, on your breasts or nipples, Dr. Ross says. In women who workout, you may find them in places you sweat heavily, like between your breasts, or along the line of your sports bra where sweat can get trapped and clog your pores.
Most zits will go away on their own with time and good hygiene. But if you’ve got a small sore of any type that doesn’t go away after a week or two, it’s worth it to get it checked out. “Having sores or bruises that won’t heal can be an early sign of cancer,” she explains.
11. You notice changes that aren't related to your boobs at all
Back pain, neck pain, and unexplained weight loss were all listed as other breast cancer symptoms that led women to seek medical care and ultimately get diagnosed with breast cancer, according to the NCRI study.
That's because breast cancer can spread before it's caught, causing symptoms in body parts that have nothing to do with your boobs. It's not possible to identify every possible sign of breast cancer (or, rather, that list would be way too long to be meaningful) so when it comes to early detection, you are your own best weapon, says Dr. Denduluri. Overall, any persistent, noticeable change should be checked by a doctor.