Breast Cancers Without Lumps

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There are several types of Breast Cancer that don’t normally present as a palpable lump or as a tumor detected on a mammogram. These are the types of cancers that are usually detected in advanced stages and may have already become metastatic. The signs and symptoms are not definitive. Because of this, they are not always obvious or are mistaken for something other than what they are. Two such cancers are Inflammatory Breast Cancer (IBC) and Paget’s disease of the Breast.

Signs and Symptoms

Inflammatory Breast Cancer (IBC) is a rare type of cancer that is usually aggressive and fast growing. There is no distinct tumor or lump and occurs when abnormal cells infiltrate the skin and lymph vessels. When the lymph vessels become blocked by the cancer cells, the fluid is unable to flow and do its job. This is when symptoms begin to appear. The following are common symptoms of IBC (

  • Redness of the breast: Redness involving all or part of the breast is a hallmark of inflammatory breast cancer. Sometimes the redness comes and goes.
  • Swelling of the breast: Part of or all of the breast may be swollen, enlarged, and hard.
  • Warmth: The breast may feel warm.
  • Orange-peel appearance: Your breast may swell and start to look like the peel of a navel orange.
  • Other skin changes: The skin of the breast might look pink or bruised, or you may have what looks like ridges, welts, or hives on your breast.
  • Swelling of lymph nodes: The lymph nodes under your arm or above the collarbone may be swollen.
  • Flattening or inversion of the nipple: The nipple may go flat or turn inward.
  • Aching or burning: Your breast may ache or feel tender.

“Paget’s disease of the nipple is a rare form of breast cancer in which cancer cells collect in or around the nipple. The cancer usually affects the ducts of the nipple first (small milk-carrying tubes), then spreads to the nipple surface and the areola (the dark circle of skin around the nipple). The nipple and areola often become scaly, red, itchy, and irritated”. (

Symptoms of Paget’s disease often come and go, commonly occur in only one breast, and are frequently mistaken for mastitis, infection, or skin irritation. Topical treatment of the nipple and areola can often make it appear as if the skin is healing. Paget’s disease is almost always associated with Ductal Carcinoma In Situ (DCIS). A palpable breast lump is only detectable in 50% of cases and only 50% of these will show up on a mammogram. Possible signs and symptoms include (

  • Flaky or scaly skin on your nipple
  • Crusty, oozing or hardened skin resembling eczema on the nipple, areola or both
  • Itching
  • Redness
  • A tingling or burning sensation
  • Straw-colored or bloody nipple discharge
  • A flattened or turned-in (inverted) nipple
  • A lump in the breast
  • Thickening skin on the breast

Because the symptoms of these two types of breast cancer seem to mimic other diseases or infections, delaying diagnosis can lead to a life threatening condition. Persistence is important in finding the cause and ruling out breast cancer. A breast thermogram, which can detect inflammation throughout the body, is an invaluable test to check for IBC and other forms of breast cancers.

This article was extracted from a Memphis Thermography blog for Dr David Jensen 


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