While most of us get a breast checkup at our yearly ob-gyn appointment (and might even do those monthly breast checks at home), the truth remains that we may not always know what breast cancer can look and feel like.

Breast cancer is incredibly common—it affects one in eight women—so it’s vital to know the signs so you can spot any breast changes ASAP. When you check for a lump (which is what many of us think we should be checking for), you might miss one of the signs of breast cancer: skin dimpling.

What are typical signs of breast cancer?

You probably already know the most common sign of breast cancer: a lump in the breast.

These lumps are often caught by physically feeling them, but cancer screening technologies are catching lumps earlier than ever. “Since many breast cancers are now detected by screening mammograms, most women do not notice any changes in the breast with early breast cancer,” says Sharon S. Lum, M.D., medical director at Loma Linda University Breast Health Center.

But lumps aren’t the only breast changes that could signal cancer. Breast cancer can also show up as changes in skin texture, changes in breast color, peeling or flaking of the nipple skin or surrounding area, changes in the size or shape of one or both breasts, changes in appearance of one or both nipples, nipple discharge (other than breast milk), swelling or tenderness of the breast or breasts, redness, or persistently irritated or itchy breasts, says dermatologist Keira L. Barr, M.D., founder of Resilient Health Institute.

What is skin dimpling, exactly?

Skin dimpling is a less common sign of breast cancer but still one that women need to be aware of. The easiest way to recognize it, according to Barr, is to think of an orange peel.

In cases of skin dimpling, “the skin of the breast is commonly red, swollen, and thickened or pitted, and often accompanied by changes in the nipple—either retraction or inversion,” says Barr. “This finding is most commonly associated with inflammatory breast cancer, which is a more rare type. In this type, the cancer cells block lymph vessels in the skin, causing the textural changes.”

How should women check for breast cancer signs?

One of the best things you can do to detect breast cancer early is to know your breasts. “Just as we recommend that people get familiar with their moles and skin so they can detect any skin cancer early, I would also recommend that women become familiar with their breasts in order to identify early breast cancer,” says Lynne Haven, M.D., a board-certified cosmetic dermatologist. “Sudden or unexplained changes in the breast tissue or surrounding skin should prompt an evaluation.”

You don’t necessarily have to perform monthly self-exams to stay up-to-date on any changes. “The American Cancer Society and other guidelines do not recommend that women perform breast self-exams on a routine basis, but they do recommend that women are aware of their breast health and how their breasts feel,” says Lum.

When it comes to how often you should get a checkup, though, that may depend on your personal health history. “Once a year at a minimum,” says Adeeti Gupta, M.D., founder of Walk in GYN Care, “and every six months or sooner if you have a strong family history, history of breast cysts, fibrocystic disease, or very dense breasts.”

What should I do if I suspect an issue?

The bottom line: If you think something is off, have your doctor check it out. “If you notice something strange or unusual, you should call your doctor ASAP to schedule an appointment,” says Gupta.

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