In 2004, Nancy Cappello, PhD from Connecticut, was diagnosed with advanced stage breast cancer.
She was shocked as she had no prior risk factors, and normal screenings for a decade.
“I was shocked my cancer had metastasized to 13 lymph nodes and was the size of a quarter, I asked my team of doctors, with my latest ‘normal’ mammogram report in hand, how could this happen since I just had a normal mammogram.” -Nancy
Each physician told her that her cancer was hidden by the mammogram due to her dense breast tissue.
Dense breast tissue is comprised of less fat and more connective tissue which appears white on a mammogram. Cancer also appears white thus tumors are often hidden or masked by the dense tissue.
As a woman ages, her breasts usually become more fatty. However, 2/3 of pre-menopausal and 1/4 of post menopausal women (40%) have dense breast tissue.
Additionally, as the density of the breast increases, the risk of breast cancer also increases.
Radiologists have been reporting a woman’s dense breast tissue to her referring doctor for twenty years. Most often, that information is not conveyed to the patient.
Displaying heterogeneously or extremely dense breast tissue on a mammogram is considered dense (BIRADS C, D).
“After an extensive search of the literature, which existed for decades before my diagnosis, I learned that 40% of women have dense breast tissue, that mammograms are limited in ‘seeing’ cancer in dense breasts and that there are other technologies, such as ultrasound or MRI that can significantly ‘see’ cancers that are invisible by mammogram.”
When Nancy asked her doctors to report dense breast tissue to women in her community, each of them refused.
“My Italian heritage with our tenets of truth and justice immediately kicked in.”
Her doctors’ rejection led to action when in 2009, Connecticut became the first state in America to report dense breast tissue to the patient through the mammography report.
As of today, thanks to Nancy Cappello’s unplanned advocacy, thirty-one states have a density reporting law and more are pending.
Nancy has since been honored by UNICO at its national convention with the 2017 Americanism Award for her breast health advocacy through the work of her two non- profit organizations, Are You Dense Inc. and Are You Dense Advocacy Inc.
The Americanism award recognizes an Italian-American who has made an enduring impact on humanity which encompasses the cornerstone of UNICO’s foundation.
“When I received notice of this prestigious honor, I bowed to give thanks to my parents and my Italian ancestors, who paved the way for me to relentlessly pursue an early diagnosis for women with dense breast tissue, through the democratic process, turning an injustice to justice for women’s breast health.”
Check out the following map link to find out if your state has a law and updates:
BREAKING HEALTH NEWS: Senators Dianne Feinstein (CA) and Dean Heller (NV) and Representatives Rosa DeLauro (CT) and Brian Fitzpatrick (PA) introduce anationalbill requiring physicians to notify patients whether or not they have dense breast tissue.
On Twitter: Representative Mike Rohrkaste @RepRohrkaste and Senator Alberto Darling @SenDarling introduce bill in Wisconsin to prompt patient notification if they have dense breasts, which increases cancer risk.
Consequently, this blog describing 7 signs of breast cancer courtesy of Care.com posted years ago, has been our most popular. These rare symptoms aren’t from physicians. They are from women who experienced them first-hand.
Many are odd symptoms that would otherwise go ignored.
After this blog was shared on Facebook, one woman even spotted a symptom in herself, sought medical attention. She learned she had breast cancer, but it was detected early enough to get treatment and she thanked us.
Sharing this again to raise awareness. Also note that 1% of men also get breast cancer. Know the signs and please share this with loved ones.
Next, we’ll share the most innovative ways to diagnose breast cancer as well as treatments available. Make sure to click the red FOLLOW key on this blog (on upper right hand corner) to be updated.
by Melanie Haiken
The earliest and most surprising signs of breast cancer, as described by the women who know: breast cancer survivors themselves.
Breast cancer warning sign #1: Pain in the breast or chest
Whether it’s an ache, throb, twinge, or sharp stab, pain or discomfort in the breast or chest area isn’t a good sign.
How it feels: One breast cancer survivor describes the pain she brought to her doctor’s attention as a “sharp pain that comes and goes.” Another describes it as “a mild electric sensation that went from my left breast to my right nipple.”
What causes it: Breast tumors can take many different forms; there can be a single lump, but there can also be an area of scattered seed-like tumors or an amorphous shape with multiple tentacles extending into the tissue. The tumor might also be directly behind the nipple or in one of the milk ducts. All of these growths cause different types of pain and discomfort.
Scary stat: As many as 30 percent of all breast cancer tumors aren’t lumps, which makes them harder to detect.
What to do: Keep track of when, where, and how often the pain occurs. Tell your doctor, being as specific as possible. Make sure to be clear that this is a new symptom, different from any other sensation (such as the sore breasts of PMS) you’ve experienced before. If your doctor diagnoses mastitis and prescribes antibiotics (a typical response to breast pain), take the full cycle. But if the pain hasn’t gone away, inform your doctor and ask for additional tests. Many women are told repeatedly that they have mastitis before they’re able to make clear to the doctor that this isn’t the case.
Breast cancer warning sign #2: Itchy breasts
This symptom, primarily associated with inflammatory breast cancer, is often missed. You’d be surprised how many women with inflammatory breast cancer spend months visiting the dermatologist, only to be sent home with creams and medications for a rash.
How it feels: Extremely itchy — the type of itch you might have with poison oak or ivy, which makes you feel like you absolutely have to scratch. Except scratching doesn’t help, and neither do the ointments that typically relieve itchiness. Your breast may also feel irritated, or the skin may be scaly or dimpled like cellulite.
What causes it: Fast-growing cancer cells block blood and lymph vessels that feed the skin. The normal flow of lymph through breast tissues is impeded, and fluid builds up in and under the skin.
Scary stat: The median age of diagnosis for inflammatory breast cancer is 57 (54 among African-American women), and it’s typically more aggressive than other types of breast cancer, with a five-year survival rate of 34 percent.
What to do: If the skin of your breast looks odd or your breasts feel different, see your doctor right away. If the doctor suggests a skin ailment or an infection and sends you home with a prescription, return immediately if your symptoms don’t go away.
Breast cancer warning sign #3: Upper back, shoulder, and neck pain
In some women, breast cancer is felt in the back or shoulders rather than in the chest or breasts. For this reason, spine specialists routinely look for the presence of tumors when treating chronic back pain that’s unrelieved by physical therapy.
How it feels: The pain, which is typically in the upper back or between the shoulder blades, is easily confused with sore muscles, a pulled tendon or ligament, or osteoarthritis of the spine. The difference is that it doesn’t go away with stretching muscles or changing position. Bone pain feels like a deep ache or throbbing.
What causes it: Most breast tumors develop in the glandular tissue of the breast, which extends deep into the chest, close to the chest wall. If tumor growth pushes backward toward the ribs and spine, the resulting pain may be felt in the back rather than in the breast. The first place breast cancer usually metastasizes, or spreads, is to the spine or ribs, becoming secondary bone cancer.
Scary stat: According to one study, the five-year survival rate for breast cancer patients whose cancer has spread to the bone is only 8.3 percent, compared with an overall survival rate of 75 percent.
What to do: Pay close attention to how back pain feels. If it doesn’t go away with rest, stretching, or physical therapy, see your doctor. Keep the doctor informed if back pain continues despite treatment, and request a bone scan.
Breast cancer warning sign #4: Changes in breast shape, size, or appearance
Contrary to popular belief, not all breast tumors cause a hard lump close enough to the surface to be noticeable. “Instead of feeling a lump, I noticed that one of my breasts was more oval than the other, hanging down lower and sort of sticking out to one side,” says a California woman who discovered she had breast cancer at the age of 42.
How it feels: Because this change is one of appearance more than feel, your partner may notice it before you do. Or you might become aware of it as you put on your bra or look at yourself in the mirror at the gym.
What causes it: Tissue growth that’s deeper in the breast or masked by dense breast tissue may push out the shape or size of the breast without causing a noticeable lump. If you’ve been told you have dense breast tissue, be particularly alert for this sign.
Scary stat: Mammograms miss up to 50 percent of tumors in women with dense breasts.
What to do: Study the size and shape of your breasts in a mirror. Sit facing the mirror and look at both breasts dead-on, then raise your arms, turn sideways, and look from each side. If there’s a difference in size or shape you haven’t noticed before, bring it to your doctor’s attention.
Breast cancer warning sign #5: A change in nipple appearance or sensitivity
One of the most common locations for a breast tumor is just beneath the nipple, which can cause changes in the appearance and feel of the nipple itself. In particular, nipple changes are often the giveaway for men with breast cancer.
How it feels: You may notice that one of your nipples sticks up less than it used to, or it might have become inverted, flattened, or indented. Women with breast cancer often recall that they noticed a decrease in nipple sensitivity, which is most likely to come to your attention — or your partner’s attention — during sex. Another nipple change to take seriously is discharge when you’re not breastfeeding, whether it’s bloody, milky, or watery. The skin of the nipple may become crusty, scaly, or inflamed.
What causes it: Many breast cancers start in the milk ducts just under and around the nipple, affecting the nipple’s appearance or causing pain or discharge. There’s also a rare cancer, Paget’s disease of the breast, that specifically strikes the nipple. A tumor in the milk ducts, just behind or to one side of the nipple, pushes the skin up around the nipple or pushes the nipple aside. As tumors grow, they may attach to — and thus retract — the skin or the nipple itself. The tumor might also cause irritation and infection, leading to discharge.
Scary stat: The American Society of Breast Surgeons recently released research that male breast cancer is typically identified later and is deadlier than breast cancer in women.
What to do: Because some women have naturally inverted nipples or have discharge during and post-pregnancy, a doctor won’t necessarily notice this symptom. Since you’re the one who knows best what your nipples look like, pay close attention to any changes and discuss them with your doctor. Mastitis is a common conclusion for doctors presented with nipple changes, in which case you’ll be sent home with antibiotics. If they haven’t cleared up the symptoms within ten days, go back and request scans.
Breast cancer warning sign #6: Swelling or lump in your armpit
You know how the lymph nodes in your neck and throat can feel sore when you have the flu? Any pain in the armpit is a sign to check the area carefully with your fingers. A lump under the armpit is likely to be hard and attached to surrounding tissues, so it doesn’t move when you touch it. Or tissue may feel thickened and dense compared with the armpit on the other side.
How it feels: Like a sore or tender spot under the arm. You may also feel a lump, though not necessarily. Affected lymph nodes may feel swollen or tender or develop a lump before a tumor is big enough to be felt in the breast itself. In some women, the swelling is more prominent under the arm or up under the collarbone.
What causes it: The lymph nodes in your armpit are where breast cancer spreads first, by way of lymphatic fluid that drains from the breast. Since the lymph nodes are the first place it’s likely to metastasize, breast cancer is staged according to whether it’s lymph-node positive or negative.
Scary stat: If breast cancer has spread to the lymph nodes, the five-year survival rate declines to 84 percent, as compared with 98 percent for node-negative breast cancer.
What to do: Colds, flu, and infection can also cause swollen lymph nodes, so if you’re sick or have an infection, wait for it to clear up before you worry. But if a lump or tender spot in the underarm area persists for a week with no apparent cause, see your doctor.
Breast cancer warning sign #7: Red, swollen breasts
When your breasts hurt, it’s easy to conclude that it’s the typical soreness of PMS. And if your breasts feel hot or look reddened, you might suspect an infection such as mastitis. But these are also signs of inflammatory breast cancer.
How it feels: It’s as if your breasts have a fever. They may feel swollen and sore, or the skin and underlying tissue may feel hot or look red or even purple.
What causes it: Inflammatory breast cancer is the most likely cause of this symptom. But breast tumors can also push on tissues, causing breasts to feel swollen and sore. In this case, you may also see, upon checking, that your breast is distended.
Scary stat: Once breast cancer has spread beyond the breast (stage IV), the average survival is less than four years. So it’s extremely important to detect breast cancer as early as possible.
What to do: Call your doctor right away about any symptom that could be inflammatory breast cancer. If the pain is diagnosed as mastitis and you’re prescribed antibiotics, you should feel better within a week to ten days. If you don’t, call your doctor and be assertive about additional tests.
About the Author: Senior Editor Melanie Haiken, is responsible for Caring.com’s coverage of cancer, general health, and family finance, discovered how important it is to provide accurate, targeted, usable health information to people facing difficult decisions when she was health editor of Parenting magazine. She has written about health and family-related issues for magazines such as Health , Real Simple , Woman’s Day , Yoga Journal , and websites such as BabyCenter.com, WebMD, and the Blue Cross/Blue Shield websites (aHealthyMe.com, aHealthyAdvantage.com) managed by Consumer Health Interactive. Melanie has held positions as Executive Editor at the Industry Standard and BabyCenter.com , and Managing Editor at San Francisco magazine. She has also worked for San Francisco’s renowned Center for Investigative Reporting. She has a master’s degree in Journalism and a B.A. in English, both from the University of California at Berkeley.
Remember, a mammogram may not detect breast cancer if you have Dense Breast Tissue. Many women aren’t even aware they have it.
40% of women have that. Your doctor may not even if tell you. That’s why one fellow Italian woman in Connecticut went to legislatures to make it a law to notify women within her community. Her doctor didn’t notify her and her breast cancer spread because it wasn’t caught early. And she had no prior family history of it.
SO many women I’ve interviewed share similar stories.
The issue is dense breast tissue and cancer or tumors both show up as white on images. It’s like finding a snowball in a snowstorm. The good news is there is technology to help radiologists differentiate between the two on existing mammogram images. It’s from a company called CUREMETRIX. You can Google it to find out more information and ask your physician about it. The radiologist is the person who would ultimately use it to read your mammogram images.
It’s frustrating when networks do stories on Dense Breast Tissue or Breast Cancer Awareness and repeat the same information without proving progress being made for patients and providers. It leaves millions of women (and 1% of men) misinformed.
It makes you wonder if the doctor reporting health news is tied to the hospital they work at and have to promote the status quo, rather than what’s best for healthcare consumers.
If mammograms are the gold standard in care, followed by an ultrasound if you have dense breast tissue, why are SO many dying from undetected breast cancer? Why so many call-backs when there’s something “suspicious” on an image. The waiting time between appointments causes women so much stress.
Ironically, stress and anxiety causes your body to go into a state of sickness. It’s the complete opposite state you need. Your body and mind have amazing abilities to heal when you get into a calm state.
There has to be a better way. The mammogram image should detect it the FIRST TIME.
As someone healthy, who has no history of cancer in my family, I’m interested in two things in this world. STAYING healthy. As my doctors say, I must be doing something right. Preventing illness. Detecting illness early. Treating it best. If journalists aren’t telling you the whole story about HEALTH –that’s harmful.
Mervin Block, one of my writing mentors wrote an article called, “Health News That’s Not Healthy.” It was in the ’90’s. I commented on it. Then, I wrote about it and it got picked up by nationally by Broadcasting & Cable Magazine. They just recently took the article down to not “offend physicians.” It was about the conflict of interests that exists when physicians report health news.
I’m not anti physician correspondents. I love them. I’m anti- Anchor NOT asking the right questions or doing enough homework to know when vital information is being left out.
It’s one of the reasons I launched this blog. There isn’t enough time to tell the whole story. I now know there is enough time. Producers and on-air correspondents waste valuable air time on fluff, so there’s no excuse not to get important health stories out.
I recently watched a health story that said a pharmaceutical company was giving people a full refund if a new FDA-approved cancer treatment didn’t work. It’s the controversial one costing six figures and up. Story ended there. I knew the pharmaceutical company offered a refund if the cancer treatment was rejected in 30-days. That’s a big difference.
Contact me at email@example.com if you’re a hospital or radiologist wanting to learn more as it’s the provider that needs to know about the latest tools in order to get it to patients.
Again, self-care is one of your most important tools. I’ve believe in healthy habits since I was a little kid. Science is slowly catching up. Exercise daily. Eat clean. Avoid sugar, red meats, soda, soft drinks, smoking, alcohol, get fresh air and sunshine, 9 hours of sleep, meditate. Yes, a lot of people pick their poison or have a vice. This isn’t intended to judge anyone. It’s simply to raise awareness. There is a big difference between someone who knows risks and decides to be sedentary by choice, than someone who ends up crying because they didn’t know and would have made different choices had they known.
Empower yourself to treat yourself the best you can. You deserve that.
Daily exercise (even walking daily), laughing, socializing with positive people, being mindful –all release powerful healing endorphins. Surround yourself with positive people who take life seriously, but not themselves. People who maintain healthy lifestyles themselves. It’s contagious. There’s no need to preach because when people see someone the same age as them who is healthy and feels great –they naturally want to do the same. No one wants to feel sick and tired. No one.
If you’re a breast cancer survivor and had a symptom not listed here, please comment below and share with others, thank you.
Harriet Jodi Levin’s Status Update Saturday, September 8, 2012. She writes:
My dear funny friend Allison Ziering Walmark posted an article a few weeks ago written by her friend Lauren Cahn Schoenfeld about surviving breast cancer. Because Allison posts the most fabulous and amusing things on FB , I felt compelled to read this article.
I got through the first few paragraphs, and there were too many similarities to ignore. I was inspired by this article and decided that is was possible that the lump I had found on my breast might be something. It was, and it turned out I had breast cancer.
Today thanks to Allison’s posting of this article, and her ” behind the scenes” love and support… I AM CANCER FREE!!!!!!!! I intend to stay that way with radiation and possibly a little chemo. Alison..you are my HERO!!! I owe you and Lauren my life..I really do. I always loved you, but now I am indebted to you FOR LIFE!!! xoxo
Allison Ziering Wallmark Replies:
When next you see me, I shall escape into a phone booth and don my fabulous “S” sequined shirt and even more fabulous cape! You did this one yourself, sweet friend! You’re the Superwoman!
[Read in Rod Serling’s VOICE] The power of Facebook. You never know when something you post will be the right message for the right person at the right time. Allison delivered a message that reached her friend when she needed to hear it most.
Miguel Ruiz says messengers are angels. Everyone is a messenger. Some operate on a higher vibrational frequency than others. They sense who needs what when.
Ruiz wrote the book, “The Four Agreements”. He asks that you think about what kind of message you deliver to people you love the most. Most importantly, what message do you tell yourself. He says deliver one of truth to yourself and others because truth exists without you. Especially in health.
People often ignore early warning signs. Symptoms will exist despite that. Truth exists without you. When a health article catches your attention –there may be a reason–a message for you. Don’t discard it. It could save your life.
Allison Ziering Wallmark is an angel. Thanks to her, Harriet Jodi Levin is cancer free and filled with gratitude. Another example of the power of Facebook. And friends. Connected by powerful brain waves. Transported with heart.
I am no longer alive when Miguel Ruiz writes “The Four Agreements” or the Fifth one. Or when Facebook or these two lovely ladies were born. That’s why you have just entered another dimension. The Health Zone.[cue music] -Maria Dorfner
“There is a fifth dimension, beyond that which is known to man. It is a dimension as vast as space and as timeless as infinity. It is the middle ground between light and shadow, between science and superstition, and it lies between the pit of man’s fears and the summit of his knowledge. This is the dimension of imagination. It is an area which we call the Twilight Zone.” —Rod Serling