The largest organ of the body—our skin—is constantly working, renewing, and sending us warning signals about various aspects of our health. Consisting of around 21 square feet, containing over eleven miles of blood vessels, and shedding about 30,000 of its 300 million skin cells every minute, our skin can tell us about our lungs, our heart health, and more. Lesions, lumps, and moles that change colors or have irregular borders are all well-known symptoms of skin cancer. But another type of skin problem can signify cancer in a part of your body that you might not expect. Read on to find out what skin symptom to be on the lookout for, and what it could signify.
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Lumps aren't the only sign of breast cancer.
The second most common type of cancer among women in the US (with skin cancer being the first), breast cancer also the leading cause of cancer deaths among women in 130 countries around the world. The most common symptom of breast cancer is a new lump or mass, as described by the American Cancer Society: "A painless, hard mass that has irregular edges is more likely to be cancer, but breast cancers can be also soft, round, tender, or even painful," they report, noting that breast lumps can also be a symptom of non-cancerous conditions, like cysts or infection. Other signs of breast cancer may include a nipple that leaks or is inverted, as well as a change in breast size or shape. But it may surprise you to learn that a rash can also signal breast cancer.
"It's important to keep in mind that most rashes found on the breast are not overly concerning," explains Shelly Beckley, APN, an oncology nurse practitioner and clinical support lead at Outcomes4Me. "I always recommend women reach out to their medical team any time they notice any change in their breasts, whether it be a new lump or a skin rash."
A rash may indicate an especially aggressive type of breast cancer.
Rashes can signify many different conditions. Infections, allergies, heatstroke, viruses, and stress can all cause rashes—and so can breast cancer.
"There are two types of rashes that may indicate breast cancer," says Beckley, who adds that these rashes may first appear to be eczema or another common type of rash, at first. "Paget's disease of the breast is a rare condition that presents with flaky, thickened skin around the nipple or areola that is red and itchy. The nipple can also become flattened or inverted," she says, noting that "typically, Paget's disease is diagnosed along with breast cancer."
"Another type of breast cancer that can manifest with a rash is inflammatory breast cancer (IBC)," says Beckley. "[IBC] is an aggressive cancer that can have a small red rash or area of irritation similar to a bug bite as a first sign of disease." Beckley warns that "this small area then can spread and become swollen, painful, and warm to the touch, and can progress further to have the appearance of an orange peel (peau d'orange)."
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Here's when to call your doctor about a rash.
"We are not sure why Paget's disease occurs and why the rash appears," says Beckley. "The breast cancer that is often found along with Paget's disease is ductal in nature—ductal carcinoma in situ or invasive ductal carcinoma—and one thought is that the cancer cells travel within the milk ducts to the nipple and surrounding areola which cause the rash," she explains. With IBC, Beckley notes that "the cancer is growing quite quickly, and spreads to the lymph system within the breast as well as the skin, which is what causes the rash."
Beckley recommends that women seek medical advice when they notice any change in their breasts, including skin rashes or lumps. "If you are seen for a skin rash on the breast and it does not improve and resolve with treatment, let your medical team know," she says. "Changes to the nipples or breast pain—as well as any new or worsening rashes—are all symptoms that women should take seriously and check out with their doctors."
Self-exams are key for breast health.
Since some symptoms of breast cancer aren't always apparent, Beckley advises screening and exams—and also being familiar with your body. "My strongest recommendation is to be self-aware of your body and perform self breast exams monthly, including looking at your breasts in a mirror," she suggests. "Knowing how your breasts feel and what they look like will allow you to notice changes over time."
In addition, be aware of your risk factors for breast cancer. "It is important to know your family history of cancer and if you might be at higher risk for breast cancer," says Beckley. The American Cancer Society offers screening guidelines; women between the ages of 40 and 44 can opt for annual mammograms, while women 45-54 should get a mammogram every year. Women older than 55 can choose to continue with annual mammograms, or decide to do so every other year.
Beckley advises women to follow their recommended guidelines, and to make healthy lifestyle choices. "Breast health also shares similarities with overall health including following a healthy diet, getting enough sleep, exercising, reducing stress, limiting alcohol intake, and not [using tobacco]," she says.