Breast skin changes: symptoms to notice

Changes linked with breast cancer may include skin pulled inward like small dents, a thickened orange-peel texture, persistent redness or darker discolouration, swelling affecting part or all of the breast, or a sore that does not heal. The nipple may turn inward, develop scaling, or release fluid. Breast cancer can present with these changes, including forms that affect lymph channels in the skin, but infection, eczema, injury and other non-cancerous problems can also cause them. Appearance alone cannot establish the cause.

Arrange a medical appointment for a new, persistent or unexplained breast or nipple change, even if there is no lump or pain. Note when it began, whether it is spreading, and whether fever, discharge or a lump is present. A clinician may examine both breasts and the nearby lymph-node areas. Depending on the findings, assessment can include a mammogram, ultrasound or breast MRI. A breast biopsy samples suspicious tissue and is the test used to determine whether cancer cells are present.

Seek urgent medical help if breast redness or swelling is rapidly worsening and occurs with fever, severe pain, confusion, faintness or feeling acutely unwell, as a serious infection may need immediate treatment. Otherwise, request a prompt appointment for an unexplained ulcer, bloody nipple discharge, a newly inverted nipple, spreading skin thickening, or a breast that becomes noticeably swollen, warm or red. Do not wait for the change to become painful before arranging assessment.

Ask which features of the skin or nipple change guide the choice of imaging, whether infection needs to be treated at the same time, and what follow-up is planned if initial imaging does not explain the symptom. If a biopsy is advised, ask where the sample will be taken, how results will be communicated, and whether further breast or lymph-node tests may be needed.