5 Breast Cancer Skin Changes to Recognize

Texture, color, and sensation symptoms may indicate breast cancer

The first noticeable sign of breast cancer isn't always a lump. Sometimes, there are breast skin changes that may indicate cancer.

Every skin abnormality on the breast is not automatically a sign of cancer. However, it's helpful to know how the disease might manifest on the skin so you can monitor any unusual changes.

This article discusses skin changes that might indicate breast cancer and when to see a healthcare provider for a diagnosis.

A woman checking her skin and breasts

PonyWang / Getty Images

Symptoms of Breast Cancer Skin Changes

When breast cancer develops from abnormal breast cell growth, many people start to notice signs or changes in their breast. But what's not always talked about is that some of those early-stage breast cancer symptoms can include changes to the skin.

The skin is more likely to be affected by the following two forms of breast cancer:

  • Inflammatory breast cancer (or IBC) is a rare but aggressive type of breast cancer that spreads rapidly and isn’t always noticed until later stages. IBC makes up around 1% to 5% of breast cancer cases in the United States.
  • Paget's disease of the breast is another uncommon form of breast cancer that primarily affects the nipple and areola. It accounts for up to 4% of breast cancer cases, and commonly affects people around menopause (when menstrual periods have stopped for 12 straight months).

There's also a chance for another type of breast cancer tumor to locally affect the skin on the breast, or for breast cancer to metastasize (spread) to the skin on the breast.

Rash

An itchy rash that spreads along the breast can be a symptom of both IBC and Paget's disease of the breast.

One of the main skin signs of IBC is an itchy rash that appears swollen and red or dark, depending on your skin tone. Paget's disease is known for appearing with an eczema-like itchy, flaky, crusty rash around the nipple. Importantly, usually only one breast will be affected with Paget's disease.

Dimpling

Dimpling—when the skin appears uneven, like orange peel—can also be an indicator of both IBC and Paget's disease of the breast.

This happens when the breast’s lymph vessels, which help transport bodily substances to and from the area, are blocked. The skin can appear dimpled when a tumor is forming underneath.

Dimpling might cover a large part of the breast’s skin. The area may also be inflamed and look redder or darker.

Puckering

Similar to dimpling, puckering is another change in the skin’s texture. It looks like an indentation or tethering and may be more prominent when your breast is in a slightly different position. 

Puckering is often a subtle sign that a tumor is forming underneath the skin of the breast. It happens when the ligaments inside the breast are pulling the skin inward, giving it a dented appearance.

Thickening

A thickening or swelling of breast tissue is another sign of breast cancer, particularly IBC.

This is usually an indicator that the nearby lymph nodes are blocked, which can lead to the area looking swollen or thick and feeling warm. While it’s normal for breasts to appear uneven in size or fullness, any rapid thickening or swelling affecting the skin on the breast might be a red flag for IBC.

Discoloration

Changes to the skin’s color on the breast—such as redness or darkening—might be a sign of IBC or Paget’s disease.

This might be particularly relevant if you haven’t experienced a recent trauma or other change to your breast that would explain the change in skin color. Keep in mind that discoloration will look slightly different based on each person’s individual skin tone.

Ruling Out Bites, Acne, or Eczema

Skin changes that develop on the breast area can easily happen with other conditions that are not breast cancer. Knowing what common skin irritations look like may be helpful in determining whether your skin abnormality merits a call to a healthcare provider. These can include:

  • Bug bites: A rash, irritation, or red bump that may resemble a bug bite could actually be the beginning of IBC. If you haven't been exposed to insects lately, monitor the area for warmth, swelling, spreading and check with a healthcare provider to rule out anything more sinister.
  • Acne: It's not uncommon to experience acne breakouts on areas like the chest. If breakouts are rare for you, pay attention to whether the pimple-like bump comes with itching, swelling, warmth, or other symptoms—and if it doesn't clear up, it may be worth flagging.
  • Eczema: Rashes resulting from the common skin condition eczema (the most common form being atopic dermatitis) can be dry, flaky, crusty, scaly, and itchy. Keep in mind if the rash is on or close to the nipple area, it’s possible that Paget’s disease may be involved.

Sometimes, breast cancer can spread to other parts of the body—commonly the skin. This may look more like classic skin cancer and appear as a skin-colored or discolored bump (nodule or papule).

Monitoring Breast Skin Changes

Everyone’s breasts and skin are different. Because you are most familiar with your own body, it’s recommended that you perform routine self-exams to note any unusual changes. It’s particularly helpful if you have a way of tracking those changes (whether written down on paper or on your phone) so that you can let a healthcare provider know when a symptom first became noticeable.

Whom to See: Diagnostic Steps

So you’ve noticed a change to the skin on your breasts. Maybe it’s a rash around your nipple, or perhaps part of your breast skin is starting to appear puckered. As soon as you’ve discovered the change, it’s important to give a healthcare provider a call to set up an in-person medical exam. 

At the appointment, the provider will ask about your medical history, symptoms, and when you first noticed them. After physically examining the area in question, the healthcare provider may decide to obtain a biopsy (a sample of skin to be tested in a lab) to confirm or rule out a breast cancer diagnosis.

Treatment for Skin-Related Breast Cancer

The treatment plan that's recommended for breast cancer that is also affecting the skin usually depends on several factors, including the specific type of breast cancer that's diagnosed, the stage of the cancer, the exact location, whether the cancer has metastasized, and your overall health and preferences.

For aggressive forms of breast cancer like Paget's disease of the breast and inflammatory breast cancer, the typical primary treatment options include surgery. This can involve a lumpectomy (surgical procedure to remove the tumor) or a mastectomy (removal of the entire breast). Radiation therapy might follow these procedures to help destroy any remaining cancer cells.

Additional treatments used to help prevent the breast cancer from coming back (recurring) can include therapies such as:

Summary

Breast cancer doesn't always come with the signature lump or bump. Sometimes, the first signs of breast cancer are abnormal skin changes that resemble a rash, discoloration, dimpling, puckering, or swelling or thickening. Research shows this can be particularly true with two aggressive forms of breast cancer, known as inflammatory breast cancer (IBC) or Paget's disease of the breast.

Every single skin change on the breast is not a sign of breast cancer. But it's still important to keep up with your breast self-exams and visibly check the skin on your chest area and breast, if possible. Call a healthcare provider right away if you start to notice any changes that are unusual for you, seem to be worsening, or don't go away.

A Word From Verywell

No two breasts are the same. What looks normal for one person may appear abnormal for another—and how your breasts look can change throughout your lifetime. The appearance of your breasts—and the skin covering them—can be impacted by factors such as weight fluctuations, medications, pregnancy, and your menstrual cycle.

This is why it’s so important to be aware of—and monitor—your breasts throughout your life, making it easier to detect changes to the skin that may actually be cause for alarm.

Frequently Asked Questions

  • What does breast cancer look like in the beginning?

    The signs of early-stage breast cancer can look different for everyone, depending on the form of breast cancer. Sometimes, it manifests as a lump, pain, or nipple discharge that’s not breast milk. Other times, breast cancer changes might be more evident on the skin—such as a dimpled or puckered area, a scaly or itchy rash, or thickened or swollen part of the skin.

  • How common are skin changes in breast cancer patients?

    Some research estimates that breast cancer might come with skin changes in 6% to 10% of breast cancer cases. These skin changes can either be due to aggressive forms of breast cancer (like inflammatory breast cancer, or IBC), or they might be due to a case of noninflammatory breast cancer that has manifested locally on the skin.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Cristina Mutchler
Cristina Mutchler is an award-winning journalist with more than a decade of experience in national media, specializing in health and wellness content.