6 Red Flags for Early-Onset Breast Cancer All Women Should Know About

“Young women in particular need to be vigilant for physical signs of breast cancer, because they are their own front line,” says Cynthia Drogula, MD, a board-certified breast surgeon and the medical director of the Aiello Breast Center at the University of Maryland Baltimore Washington Medical Center. “They are too young to be screened annually with a mammogram, and most only get an exam from their gynecologist once a year.”

While most breast changes are benign, knowing what to look for can empower you to advocate for your health.

1. New Bumps or Lumps

Dr. Drogula encourages women to become familiar with the normal feel of their breast tissue so they can identify when something is off. She says the best time of the month to check your breasts for changes is the week after your period, when hormonal fluctuations are the quietest.

“We no longer advocate for monthly self-breast exams, but instead recommend checking regularly — in the shower, for example — so if a change occurs, it’s noticeable to you,” she says.

“A breast cancer lump may be hard, firm, or irregular, but it can also be soft, round, or tender,” says Katarina Vasiljevic, MD, a medical oncologist specializing in breast cancer at City of Hope Orange County in Irvine, California. “You can’t reliably tell whether a lump is cancerous by how it feels.”

2. Skin Texture Changes

Changes to the skin texture of your breast can be a warning sign of cancer, though it’s usually not a reason to panic, says Debra Mangino, DO, the clinical director of the Risk Assessment, Imaging, Surveillance and Education (RISE) Program at Memorial Sloan Kettering Cancer Center in New York City.

“The majority of the time, redness or skin change is due to a benign cause, such as dermatitis or infection,” she says. “Very rarely can it be a sign of inflammatory breast cancer.”

“These changes can occur when cancer affects breast tissue or blocks normal lymphatic drainage,” says Vasiljevic. “A new rash, scaliness, or persistent skin change on the breast or around the nipple also deserves attention, particularly if it isn’t improving.”

3. Nipple Changes or Discharge

Breast cancer can sometimes affect the tissue and ducts behind the nipple, causing visible changes, says Vasiljevic. “A nipple that suddenly turns inward, becomes flattened, changes position, or develops persistent crusting, scaling, redness, or irritation should be checked,” she says.

Sometimes, nipple discharge can be a sign of breast cancer, though it has many causes that aren’t harmful.

“Most nipple discharge in young women is benign,” says Dr. Mangino. “Nipple discharge that is spontaneous (without squeezing the breast), escalating in amount or frequency, or bloody should be evaluated.”

4. Changes in Breast Size, Shape, or Fullness

“The breasts are sisters, not twins, so for most women, they aren’t symmetrical,” says Drogula. “With that said, they will change together with weight loss, weight gain, and pregnancy.”

5. Swelling and Redness

While rare, swelling and redness can also be a symptom of inflammatory breast cancer.

“New redness, warmth, or swelling or enlargement of part or all of the breast can be a warning sign, especially when it develops rapidly or doesn’t go away,” says Vasiljevic. “The breast may feel heavier or warmer, and the skin can become thickened or develop an orange peel-like appearance.”

6. Breast Pain

“Occasionally, a high-grade tumor will ache, causing a sensation of pain,” says Drogula.