October is Breast Cancer Awareness Month. Each year I like to take this opportunity to educate others as to why checking your skin is so important, not just in regards to skin cancer, but also in the setting of breast cancer. Breast cancer is the second most common cancer amongst women, with skin cancer being the first. In fact, one in eight women will be diagnosed with breast cancer in their lifetime.
Aside from annual screening mammograms, routine breast self-exams can serve as an important screening tool. What does this have to do with skin, you may ask? Well, not all types of breast cancer form “lumps” that can be felt. Many who perform these self-exams focus only on how the tissue feels, not realizing how important visual inspection is. Breast cancer may cause changes in the outward appearance of the breast or only demonstrate skin manifestations.
In fact, there are two rare types of breast cancer in which the first symptom is often a change in the skin rather than the classic breast “lump.” These skin changes include a change in color, texture, or even altered sensation such as itching, pain, burning, or tingling.
Paget’s disease of the breast is a rare form of breast cancer in which the initial change you may notice is a rash on the breast and/or nipple. The rash is generally seen on one breast, not both, and usually begins on or near the nipple. It may be dry, flaky, itchy, and/or crusty. Patients often attempt to treat the rash assuming they simply have a stubborn irritation. In fact, Paget’s disease often mimics benign skin rashes, such as eczema.
Inflammatory breast cancer is the second type of breast cancer that can present with visible symptoms on the skin. The skin overlying the breast may be red, hot, or sore. The texture of the skin may also feel thicker or bumpy, mimicking the texture of an orange peel. Change in nipple shape, such as inversion of the nipple, is also a red flag.
Of course, none of these symptoms alone is diagnostic for breast cancer, but a healthcare provider should promptly evaluate them. Please do not ignore subtle changes in the appearance or feel of your breasts!