The women we spoke to had quite different experiences regarding the discovery of their breast cancer. It’s important to note that despite some similarities, symptoms were almost never described in exactly the same way, and each woman had their own unique story about the first symptoms of breast cancer.
Noticing a lump
Women can develop lumps in their breast for several reasons. Not all lumps are breast cancer – many lumps can be non-cancerous or cysts caused by hormonal changes such as with menstruation or menopause. All women should be aware of what is normal for their breasts even if they get regular screening tests. Many women, we spoke with, found their own breast cancer by noticing changes in the look and feel of their breasts. It is important to see your health care professional when you notice something unusual in your breast, even if a mammogram was recently normal.
The women who noticed lumps described them feeling like a ‘mass’, or ‘bump’, or ‘something there’. Often, they were discovered while involved in daily activities such as showering, exercising, washing dishes or watching television. Lumps were typically described using words such as small, big, prominent, definable and/or hard. Although less commonly reported, Nadia (A) and Deann had noticed that their lumps increased in size over time, while Melissa had noticed a decrease in size. Julia thought she had a cyst but was advised to still check it out by a friend who is a doctor.
Sometimes a lump was present but women were unable to feel it themselves. Sirkka, for example, could not feel a lump because its placement made it difficult to locate and feel. In other cases, doctors noticed a lump and referred women for further testing.
Other signs and symptoms
Although most women spoke about finding lumps, others described different signs and symptoms. For example, the area around their lump (or affected area) was painful and/or sensitive. Others felt pinching, tenderness and tingling in their breast(s). Debbra described a gut feeling that she needed to get herself tested and asked her physician if she could have an early mammogram. Malika wanted to get herself tested after her mother passed away because of breast cancer and because she found her left breast to be a bit painful.
Reactions to noticing the first symptoms
Many women were alarmed when they first found a lump or noticed other signs. As Nadia(A) said, "I was in the shower I felt a little lump and I said What's that? And then when I finished (my) shower and I came out I start(ed) feeling and there was something there, it was not normal. So I said to myself 'This is wrong.'" While some women were scared or concerned like Nadia (A), others were not worried, or thought the symptoms would go away. Joanne for example, thought it would be nothing as she was still young. One night she visited a friend who was very concerned about her own lump. Later she discussed this with her husband and he encouraged her to go for testing. Sometimes the women decided to share their observations with their doctor while seeing him/her for another health issue.
After finding a lump, some women found it helpful to confide in friends and/or family before seeing a doctor. Tina told her husband about finding a lump, but told us that she found it easier to talk to her friend, who had had breast cancer in the past. Melissa chose not to tell her family initially, so as not to worry them. However, she and some of the other women shared their observations with friends who were health professionals (e.g., radiologists and general practitioners) and who typically encouraged them to see their doctor and/or to go for testing.
Medical history, health care professional and testing
A previous medical history related to breast health made it sometimes more difficult to diagnose breast cancer. For example, a history of cysts or lumpy breasts can make it hard to identify new bumps, and/or to distinguish between a cyst and a cancerous (malignant or benign) lump. Changes in breast tissue, such as those related to normal processes of aging, pregnancy and hormonal fluctuations can also make diagnosis difficult.
Currently in Canada, screening for breast cancer is recommended for women at average risk between the ages of 50 and 69. Research has also shown that regular mammography can significantly lower the risk of dying from breast cancer for women in this age group.
Not all of the women we spoke with, who were eligible for screening, were actually going for regular mammograms; some had not been screened in a long time, or ever, before their diagnosis. At the time of her diagnosis, Sirkka had not gone for a mammogram in 9 years, “That was a huge oversight on my part, I should have been having mammograms but the thing is, I did everything right. I ate right, I exercised, you know what they say, how they say do this to prevent cancer to stay healthy. I did it all and I still got cancer.” Iceni and Donna had encouraged their sister and friends to go for their mammograms and had volunteered to get tested at the same time, as an incentive for them to go. This was the moment that their own breast cancer was detected.
For some women, it took a while before the lump was discovered. In some cases, they had felt a lump but it was not noticed on the mammogram. Or in hindsight, some doctors noticed that the lump had in fact been present on past screening results, but had not been noticed by the technician/radiographer. Ginette’s lump was not noticed in an initial mammogram but then was detected 2 years later at her next check-up. She felt angry that it had gone unnoticed in the screening before. Patricia went for screening only because her doctor encouraged her strongly to go; she had not felt any lump before screening.
Jeanette went for regular mammograms from the time she was 42, and her breast cancer was first noticed during screening. She now tells everyone to have mammograms, because she believes they saved her life.