Dimpling of the breast

How a Subtle Breast Dimple Led to an Early Cancer Diagnosis

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-Last Updated February 2015

WHEN Sam Marsden found a dimple on her left boob – the last thing on her mind was breast cancer.

The businesswoman from Sheffield, 46, had assumed it was simply excess skin caused by dieting, after she shed two stone in just two months.

10 Sam was diagnosed with breast cancer six months after finding a dimple on her boobCredit: PA Real Life

A tiny niggling fear was dismissed, after her GP said it was nothing to worry about.

And a mammogram, a year earlier, at a private clinic had shown no worrying results.

However, just six months later Sam was told that she had breast cancer and needed immediate treatment.

Despite noticing the symptom months earlier, Sam only realised quite how serious it was when she went for a family history check in May last year.

She had been called in for the appointment after testing positive for the BRCA 2 gene mutation – which increases the risk of developing breast or ovarian cancer by 85 per cent.

Sam had been putting off the test until her mum, 65, was also found to have the gene mutation in April last year.

10 Sam is the seventh woman in her family to have been diagnosed with breast cancerCredit: PA Real Life 10 This barely visible dimple on another woman, is similar to that Sam found – and didn’t realise was a sign of breast cancer

And during the routine examination, a nurse was left concerned by the dimple on her left breast – which turned out to be cancer.

It meant Sam, who is married to IT technician Mario Rivas-Aguilar, had become the seventh person in her family to be diagnosed with breast cancer.

She said: “I knew I’d got the gene. Everyone else in my family seed to have it, so it would have been some kind of miracle if I didn’t have it, but you still hope you don’t.

“I had gone to the family history appointment with Mario’s sister, Maria Vasquez and we’d been planning on going out for lunch afterwards.

“Instead, I saw the nurse’s face fall when she examined my breasts and said, ‘I’m not happy with that left side,’ where she could see the breast tissue was puckered.”

10 Sam lost her thick red hair as a result of chemotherapyCredit: PA Real Life 10 Sam had most of her left breast and a 4cm mildly aggressive cancer tumour surgically removed in OctoberCredit: PA Real Life

“When I was told I did have breast cancer on September 5 last year at Sheffield’s Royal Hallamshire Hospital, I started to cry and was shaking badly.

“The doctor said, ‘Let’s not get ahead of ourselves,’ but all I could see was my Aunty Fay, my mum’s younger sister, who had tested positively three years earlier, had developed cancer and lost all her hair through chemotherapy.

“When you first hear those words, you think cancer is a death sentence and I was wondering if I’d ever see my daughter, Isabella, who’s 11 now, start secondary school, or whether I’d even live long enough to put a Christmas tree up.

“I asked the doctor outright, ‘Am I going to die?’ and he said ‘No, it’s operable.’

“I told him I wanted both breasts off and both ovaries out there and then, but he said, ‘That’s a massive operation, let’s start with the biggest threat to you,’ by which he meant the cancer in my left breast.”

10 The signs to look for from the experts at charity CoppaFeel

Sam, who runs an educational teaching supply agency, took the medic’s advice and had most of her left breast and a 4cm mildly aggressive cancer tumour surgically removed in October at the same hospital.

She was then forced to endure six rounds of gruelling chemotherapy – after a surgeon detected a small amount of cancer in the lymph tissue under her arm.

Speaking about the treatment, she said: “I have always had the longest and thickest red hair.

“It was as thick as a rope, but I lost it thanks to the chemotherapy.

“I was so sick I was hospitalised with sepsis at one point.

“I felt sick all the time and remember Mario looking at me at the start of this year when, physically, I was just a shell of myself and saying, ‘You’re not the same Sam we all know and love’.”

10 Sam has also had her ovaries removed as a precautionCredit: PA Real Life 10 Sam is still awaiting further surgery to have her right breast removed to prevent the cancer from returningCredit: PA Real Life

Since her treatment finished, Sam has also had her ovaries removed as a precaution – and has decided to buy a holiday home in Mojácar on Spain’s Costa de Almeria to celebrate her recovery.

She revealed: “We’ve always spoken about buying a holiday home abroad and I got a decent pay out from my critical illness policy through work and decided to put it towards that.

“Now we have somewhere to dip our toes into once a year or so – the dreams become a reality.

“If it wasn’t for the cancer we never would have been able to do it. It’s a reminder that good things can come for bad, it’s very bitter sweet.”

More on breast cancer

Comment

KRIS HALLENGA

CoppaFeel! founder Kris Hallenga on the importance of sharing your struggles CoppaFeel! founder on the importance of changing how we think about cancer

SUGAR BOOST

Breakthrough scan uses sugar molecules to boost breast cancer survival rates

CRUEL TWIST

Dad saved by heart transplant loses fiancée to cancer 48 hours before wedding Comment CoppaFeel! founder says checking your boobs is an act of kindness to yourself

MEDICAL TORTURE

I had both boobs removed and chemo after docs WRONGLY diagnosed cancer

‘LUNCH’ FOR TUMOUR

High-fat diets can make breast cancer grow faster, study warns

KEEP DANCING

Strictly’s Debbie McGee says beating breast cancer made her stronger than ever

TAKE A WEIGHT OFF

Sustained weight loss reduces your risk of breast cancer, doctors reveal Comment CoppaFeel! founder Kris talks about Xmas consumerism & making yourself poor 10 Sam is hoping her daughter Isabella (pictured) will have preventative surgery if she tests positive for BRCA2Credit: PA Real Life 10 Sam is now urging other women to live life to the fullCredit: PA Real Life

However, her ordeal is not quite over as she is still awaiting further surgery to have her right breast removed too, at Royal Hallamshire Hospital – again to prevent the cancer from returning.

And while she is hoping her daughter will be tested sooner rather than later for BRCA2 and will opt for a preventative mastectomy if she has it, she will respect her right to choose.

She admitted: “It’s her body and she has a right to decide for herself.”

Sam is now urging other women to live life to the full, saying: “Get up, put your lipstick and eyes on and thank God you have another day to live.”

CoppaFeel’s boob check video reveals how you can identify deadly breast cancer signs on the body

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Signs and Symptoms
A lump in the breast. Characteristics may include:

■ The lump is present all the time and does not get smaller or go away with the menstrual cycle

■ The lump may feel like it is attached to the skin or chest wall and cannot be moved

■ The lump may feel hard, irregular in shape and very different from the rest of the breast tissue

■ The lump may be tender, but it is usually not painful. Pain is more often a symptom of a non-cancerous (benign) condition, but should still be checked by a doctor

A lump in the armpit (axilla)

Changes in breast shape or size

Skin changes such as dimpling or puckering, redness, swelling and/or increased warmth (signs that look like an infection) may be a sign of inflammatory breast cancer as can itching of the breast or nipple and other itchiness not relieved by ointments, creams or other medications

Nipple changes such as pointed inwards, discharge or ulcers

Detection
If you suspect breast cancer ask your doctor to send you for screening which may include one or more of the following:
■ Mammogram
■ Ultrasound
■ MRI
■ Biopsy
Learn more

Claire Warner was bending over and pulling up her socks one day in June 2016 when something strange caught her eye in her bedroom mirror. It was a tiny, slight dimple in her left breast, and initially she thought nothing of it.

But remembering she had seen something like it before, she just couldn’t ignore it. Warner, of Lancashire, England, went online to find the year-old, viral post she had seen on Facebook of a woman’s dimpled breast shortly before a mastectomy for breast cancer.

Warner, then 42, compared her breast to the photo posted by fellow Briton Lisa Royle. Seeing similarities, the mother of girls, ages 10 and 3, grew worried and saw her doctor. On July 1, 2016, she learned she had breast cancer. It was aggressive, she was told, but had been caught very early and was curable.

Shocked and terrified, she was moved to educate her friends and relatives about dimpling as a less common sign of breast cancer. Inspired by Royle, Warner snapped a photo of her own dimpled breast and posted it on Facebook, where it also drew wide attention. To date, the photo has had over 65,000 shares.

“The only reason I found my cancer was because somebody else was good enough to post a picture of their dimple, and mine was even more subtle than the picture I had seen,” Warner told TODAY, in her first interview since posting the photo. “I had to do the same. It was only right that I did the same and tried to help other people find it very early.”

Claire Warner snapped this photo during her final chemotherapy treatment for breast cancer.

Warner, who recently finished treatment and has no evidence of cancer, has an indescribable gratitude for Royle, whom she has thanked in a message.

Trending stories,celebrity news and all the best of TODAY.

“She very well has probably saved my life,” Warner said, adding: “Had I not seen that Facebook post, I would not have done anything about it.”

“I was told from the start that this was curable,” Warner said, “and I don’t know that, had I waited until other symptoms came, that they still would have been saying that.”

“Blink and you’d miss it,” Warner wrote on Facebook of her dimple, urging men and women to check for the symptom.

“I hope that people realize that breast cancer isn’t just about the lump,” Warner said. “Everybody knows to check for lumps, but I couldn’t feel the lump.”

Warner is smiling today. She’s cancer free about two months after her mastectomy.Claire Warner

In places like the United States and the United Kingdom, where mammography is widely available, about 70 to 80 percent of breast cancers are found through screening mammograms, and don’t present with skin changes like dimpling or palpable lumps, said Dr. Anees Chagpar, director of the Breast Center at Smilow Cancer Hospital at Yale New Haven Health.

“Screening mammography often finds cancers at an earlier stage before they cause a mass or any other physical exam findings such as dimpling,” Chagpar said.

“However, when a patient finds skin changes — whether that is a dimpling or divot in the skin, skin discoloration with redness, excoriation of the nipple, inversion of the nipple, skin thickening — if they have any of these skin changes that are new or unusual, they should have those checked out because they can be one of the signs of breast cancer.”

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Oct. 4, 201706:42

Having done just that, Warner was ultimately diagnosed with triple negative, invasive ductal and lobular carcinoma.

Warner had a lumpectomy and a lymph node removed two weeks after her diagnosis. But doctors discovered her tumor was larger than scans showed. She had 12 rounds of chemotherapy, followed by a mastectomy and more lymph nodes removed in March.

Along the way, she had an appendectomy and was diagnosed with an underlying heart problem that will require surgery. Warner has been sharing her journey on Twitter, under the handle @OfNoSpecialType.

Pink Power TODAY: Joan Lunden talks to Hoda Kotb about breast cancer

Oct. 4, 201704:22

Now, she is feeling great, though she knows her disease could return. “I feel really, really well,” she said. “Most of the time, I’m fine. I’m still worried.”

As Warner’s photo continues to spread, she’s come to grips with the discomfort of knowing tens of thousands of people have seen her bare breast.

Warner has received thousands of messages, sometimes hundreds a day, from people thanking her for her post, asking for advice, and some even crediting her photo with helping them receive their own early diagnosis, just as Royle’s image did for her.

“When I get messages saying because of your photo, I didn’t ignore this and went to the doctor, it definitely makes the embarrassment worthwhile,” she said.

TODAY.com contributor Lisa A. Flam is a news and lifestyles reporter in New York. Follow her on Twitter and Facebook. This story was originally published in May 2017.

Breast cancer

The first symptom of breast cancer most people notice is a lump in their breast or some thickening.

Breast symptoms to look out for:

  • a new lump or thickening in your breast or armpit
  • change in size, shape or feel of your breast
  • skin changes in the breast such as puckering, dimpling, a rash or redness of the skin
  • fluid leaking from the nipple in a woman who isn’t pregnant or breast feeding
  • changes in the position of nipple
  • breast pain

These symptoms listed here are more often caused by other medical conditions. But if you have any of them it is important to see your doctor.

Breast lump

The first symptom of breast cancer for many women is a lump in their breast. Most breast lumps are not cancer (benign).

Most benign breast lumps are:

  • areas of normal lumpiness that is more obvious just before a period
  • cysts – sacs of fluid in the breast tissue, which are quite common
  • fibroadenoma – a collection of fibrous glandular tissue (these are common in younger women, for example under 30)

It is important to always get a breast lump checked by your doctor. They will arrange for you to have tests to find out whether your lump is cancerous or not.

A lump or swelling in your armpit

You can’t usually feel the lymph glands in your body. But they often become swollen when you have an infection or a cold, including the lymph nodes in the armpit.

A less common cause of swollen lymph glands or lump in the armpit is breast cancer that has spread to this area.

Change in size, shape or feel of your breast

A cancer might cause your breast to look bigger or have a different shape than usual, it might feel different.

Many healthy women find that their breasts feel lumpy and tender just before their period.

It can help to be breast aware. This means getting to know the size, shape and feel of your breasts.

Skin changes

Skin changes include puckering, dimpling, a rash, or redness of the skin of the breast. Some people have a rash or redness of the nipple and the surrounding skin.

The skin might look like orange peel or the texture might feel different. This can be caused by other breast conditions. But get your doctor to check out anything that is not normal for you.

Fluid leaking from your nipple

Fluid leaking from a nipple in a woman who isn’t pregnant or breastfeeding can be a sign of cancer. But other medical conditions can also cause this.

Change in the position of your nipple

One nipple might turn in or sink into the breast. It might look or feel different to usual.

Do see your doctor if you notice anything different or unusual with one or both nipples.

Breast pain

Breast pain is very common and it’s not normally due to cancer. You might get pain in one or both breasts for a while, which goes after a time. There might be no obvious reason for this pain, even if you have a lot of tests.

Do see your doctor if you have breast pain. They can give you advice on how to treat the pain and whether you need any tests.

Inflammatory breast cancer symptoms

A rare type of breast cancer called inflammatory breast cancer can have different symptoms to other types.

Your whole breast might look red and inflamed and feel sore. The breast might feel hard and the skin might look like orange peel.

See your doctor if you have any of these symptoms.

Paget’s disease of the breast

This is a rare skin condition that is sometimes a sign of an underlying breast cancer. The symptoms are a red, scaly rash on the nipple and surrounding area. This can be itchy and looks a bit like eczema. It is sometimes mistaken for eczema at first.

See your doctor if you have any changes in the skin of your breast.

Seeing your doctor

Your symptoms may not be due to breast cancer, and they may not make you feel unwell. But it is important that any symptoms you have are checked by a doctor, even if you are feeling well.

The earlier a cancer is picked up, the easier it is to treat it and the more likely the treatment is to be successful.

8 Warning Signs of Breast Cancer

Due to the use of regular mammography screening, most breast cancers in the U.S. are found at an early stage, before symptoms appear. However, not all breast cancers are found through mammography.

The warning signs of breast cancer are not the same for all women. The most common symptoms are a change in the look or feel of the breast, a change in the look or feel of the nipple and nipple discharge. The eight warning signs of breast cancer are:

  • Lump, hard knot or thickening
  • Swelling, warmth, redness or darkening
  • Change in the size or shape of the breast
  • Dimpling or puckering of the skin
  • Itchy, scaly sore or rash on the nipple
  • Pulling in of your nipple or other parts of the breast
  • Nipple discharge that starts suddenly
  • New pain in one spot that doesn’t go away

If you have any of the symptoms described above, see a health care provider . If you do not have a provider, one of the best ways to find a good one is to get a referral from a trusted family member or friend. If that is not an option, call your health department, a clinic or a nearby hospital.

Learn more about finding a health care provider.

In most cases, these changes are not cancer. For example, breast pain is more common with benign (not cancer) breast conditions than with breast cancer. However, the only way to know for sure is to see a provider. If you have breast cancer, it is best to find it at an early stage, when the chances of survival are highest.

The first breast cancer symptom many women notice is a lump or thickened tissue in their breast, but there are other signs of the disease that many of us may not be so aware of.

That’s why mum-of-two Claire W* decided to share her experience of being diagnosed with cancer via an image of her breast on Facebook.

Credit: Facebook

‘This is a picture of my left boob,’ she wrote underneath. ‘The small purplish bruise is where I had a biopsy taken. The minuscule dimple up and to the left of it is a rare and little-known symptom of breast cancer.

‘Blink and you’d miss it. I only spotted it thanks to another post shared by an amazing friend.’

The mum of two revealed she couldn’t feel a lump, nor did she feel ill. It was just the small, almost invisible dimple that caught her attention, and in the post, which has now been shared over 26,000 times, she urged others to be vigilant.

MORE: ‘MY LINGERIE SHOOT PROVED CANCER HADN’T WON’

Dimpling of the skin can be related to breast cancer in a number of ways. First, it may occur because a tumour is growing in the tissue underneath, which is pulling the skin, or the dimpled skin could be a sign of inflammatory breast cancer, caused by a blockage of lymph vessels in the skin.

Charity CoppaFeel, which encourages women to check their breasts regularly, shared with us a handy infographic of symptoms you should look out for. Aside from changes in skin texture, such as puckering or dimpling, other common warning signs include nipple discharge, nipple inversion, swelling around the armpit or collar bone, and a constant pain in your breast or armpit.

Remember, if you notice any of these symptoms, it does not necessarily mean you have cancer (for example, 90% of breast lumps are benign). However, it’s always important to check them out with your GP as soon as possible, as they can refer you to a breast clinic where staff can reassure you and give you any necessary treatment.

Seeing your doctor early also means that if it does turn out to be cancer, you give yourself the best chance of successful treatment.

See the below video to see how to check your breasts:

For more information, visit the CoppaFeel or Cancer Research UK websites.

MORE: 6 THINGS YOU SHOULD NEVER SAY TO SOMEONE WHO HAS CANCER

*Surname has been removed to ensure Claire’s privacy

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