Triple negative breast cancer (TNBC) tends to not have many symptoms in the early stages, particularly in younger people. Many symptoms of TNBC are similar to those of other types of breast cancer. Unfortunately, the lack of early symptoms can mean breast cancer isn’t diagnosed until the cancer has spread and become metastatic (stage 4).

Since TNBC can be aggressive and spread relatively quickly, it’s important to get an accurate diagnosis and start breast cancer treatment quickly. If any of these symptoms are severe or last longer than one menstrual cycle, seek medical advice.

1. Lumps in the Breast

Triple-negative breast cancer can feel like a solid lump in your breast tissue. This is generally a lump that’s new and that you haven’t felt before. These lumps usually don’t hurt or feel tender to the touch, and they may have an irregular shape. Some lumps are not felt but detectable only via mammogram.

Many people who develop TNBC notice a lump.

Many people who develop TNBC notice a lump. Triple-negative breast cancer cells may grow faster than other forms of breast cancer. If you notice any lumps or bumps in your breast tissue, it’s better to get it checked out than to wait. Early detection of TNBC is key to getting TNBC treatment and can improve your overall prognosis.

2. Changes in Breast Size or Shape

Triple-negative breast cancer can also make one or both breasts change their shape or size. Changes caused by tumors are usually relatively slow to develop, even if they’re faster with TNBC than some other forms of breast cancer.

One form of TNBC is called inflammatory breast cancer (IBC). IBC can cause significant breast swelling with inflammatory symptoms like discoloration, warm skin, and pain, and this may come on quickly. If one or both breasts suddenly feel significantly more swollen than usual and there’s no other explanation for the changes, it’s important to talk to a doctor as soon as possible.

3. New Asymmetry Between the Breasts

Some people with breast cancer notice that their breasts don’t look as close to identical anymore. This asymmetry can be caused by the growth of tumors or other symptoms listed here.

Particularly in inflammatory breast cancer, you may notice new asymmetry or other differences between the way your breasts look or feel.

Sometimes, the changes that happen due to triple-negative breast cancer can be hard to describe. For instance, with IBC, one breast can feel hotter or like it weighs more than the other. If you notice that your breasts don’t feel the same or look the same as they used to, it’s time to talk to your doctor, even if you can’t put your finger on what those changes are.

4. Changes in the Way Nipples Look

Depending on where in your breast the cancer is located, it can affect the appearance of one or both nipples. The skin on your nipple may become flaky or start peeling.

Your nipple might also retract, or pull in, rather than stick out. This is particularly common with inflammatory breast cancer. IBC can also cause the skin on your nipple to become discolored or to feel thicker than it usually does. If your nipples begin to look or feel different in any way, either from each other or from how you expect them to look, it’s time to see a healthcare provider.

5. Discharge

Unless you’re breastfeeding, it’s unusual to have any sort of discharge from your nipple. If you do, it can be a symptom of breast cancer, specifically of IBC. The discharge you see may or may not include blood. Even if it doesn’t, it’s important to get an exam as soon as you can. Nipple discharge isn’t normal and should always be investigated.

Changes to the skin of the breast, such as a rough, orange-peel texture or changes in color, may be related to TNBC.

If you're breastfeeding and you develop TNBC, it’s possible that you might notice changes to the fluid that comes out of your nipples. This can be harder to notice. However, if you see changes that persist and/or your baby responds differently to your milk, it’s time to see a doctor.

6. New Sensations in the Breast

As noted above, one or both breasts might feel different (warmth, heaviness) than usual with triple-negative breast cancer. Your breast may also start to itch, feel painful, or feel harder or more solid than it did previously. You may also experience breast tenderness that doesn’t have another explanation. These can be signs of IBC, particularly if a breast feels warm and heavy.

7. Changes to the Skin of the Breast

Inflammatory breast cancer, in particular, can cause changes to the skin of one or both breasts. Your breast may become discolored. This usually looks like redness in people with pale skin and can look purple or simply darker than normal in people with darker skin tones. In IBC, more than one-third of the breast may be a different color than usual.

The texture of the skin on your breast may also begin to resemble an orange peel (peau d’orange). It can thicken and develop small pits. It may accompany swelling and make your breasts look significantly different from each other.

If you’re breastfeeding and you have these symptoms, similar changes can also be caused by mastitis, a breast infection. Your doctor can run tests to determine the cause.

8. Swollen Lymph Nodes Under the Arm

Some people with triple-negative breast cancer experience swelling in the lymph nodes under their arms. This swelling may only be visible when your oncologist does imaging tests. Other times, people can actually feel it. This can indicate that the cancer is already spreading.

Lymph node swelling or soreness may be hard to pinpoint. If you touch or push on the area that hurts, you might be able to feel a small, roundish lump that’s particularly painful. Even if you can’t feel a particular lymph node, persistent armpit pain that doesn’t have another known cause is a reason to talk to your doctor. They may recommend a biopsy to check your lymph nodes.

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