When most of us think about breast cancer, we picture someone finding a lump during a self-exam. That image is powerful, and important, but it’s not the whole story. Breast cancer can announce itself in many different ways, and sometimes the signals are subtle. Overlooking them can delay diagnosis, which is often the difference between life and death.
This article breaks down one sign that is too often missed: skin changes on the breast.1 We’ll explain what it looks like, why it matters, and why early detection is especially urgent for Black and Brown women, who face higher risks and worse outcomes.
What Is Breast Cancer?
Breast cancer happens when cells in the breast start multiplying in abnormal ways.2 Normally, cells grow, divide, and die in an orderly process. Cancer cells, however, keep growing even when they shouldn’t.2 Over time, they can form a tumor. If not caught early, these cells may break away and travel to other parts of the body, a process called metastasis.2
Breast cancer is the most commonly diagnosed cancer among women worldwide. In the United States, about 1 in 8 women will be diagnosed in their lifetime.2 Men can also develop breast cancer, though it’s much less common.2
The good news is that breast cancer doesn’t have to be a death sentence. Thanks to better screening tools and treatments, survival rates have improved dramatically—when it’s caught early. That’s why paying attention to every possible sign matters.
The Missed Warning Sign: Changes in Skin Texture
When doing self-checks, many people focus only on lumps. But the skin of your breast can tell its own story. One important, often-overlooked sign is dimpling or puckering of the skin.1 It may look like the surface of an orange with tiny pits or grooves that weren’t there before. Doctors call this peau d’orange, which is French for “orange peel”.1
Why does this happen?
- Cancer cells can block lymphatic vessels, the channels that drain fluid from breast tissue.1
- When that drainage is blocked, fluid builds up, causing swelling and those distinct dimples.1
- Sometimes the area may feel thicker or firmer than the surrounding skin.1
This sign may be subtle. You might only notice it in certain lighting or when you raise your arms.1 But subtle does not mean harmless. If you see skin changes that don’t go away, it’s worth bringing up with a doctor right away.
Other Skin Changes to Watch For:
Alongside dimpling, the breast’s appearance can change in other ways:
- Redness or rash that looks like infection but doesn’t improve with treatment.3
- Thickening of the skin in one spot.3
- Scaly or flaky skin around the nipple.3
- Nipple pulling inward or suddenly changing direction.3
All of these can be linked to underlying cancers, even when no lump is present.
Why Early Detection Is Critical
Early detection is one of the most powerful tools we have in the fight against breast cancer.4 When the condition is caught in its earliest stages, before it has spread beyond the breast, the chances of survival are dramatically higher. In fact, the American Cancer Society reports that when breast cancer is caught before it spreads outside the breast, almost every woman—about 99 out of 100—is still alive five years later.4
But the picture changes if the cancer spreads. If it moves into the lymph nodes under the arm, the odds of living at least five more years go down. And if the cancer reaches other parts of the body, like the lungs, liver, or bones, only about 3 out of 10 women are still alive five years later.4
These numbers tell a clear story: timing matters. Recognizing something as small as a change in the skin of the breast could mean the difference between having access to a wide range of treatment options or facing a more aggressive, limited set of interventions. By the time breast cancer causes pain or grows into larger, more noticeable lumps, it may already be in an advanced stage. That’s why paying attention to subtle changes, even ones that might seem insignificant, can literally save lives.
Breast Cancer and Communities of Color
For Black and Brown women, the burden of breast cancer is especially heavy, and it isn’t because of biology alone. Research shows that Black women are about 40 percent more likely to die from breast cancer compared to white women, despite not being diagnosed more often.5
They are also more likely to face breast cancer at younger ages and to develop more aggressive forms, like triple-negative breast cancer, which is harder to treat and more likely to return. But the problem goes deeper than biology; it’s rooted in the healthcare system itself.5
Many women of color experience barriers to timely care, including limited access to mammograms (screenings) and fewer referrals for follow-up tests after an abnormal result. Delays in scheduling, insurance limitations, and living in areas without enough specialists all contribute to later diagnoses.5
These inequities are why community awareness is so important. When Black and Brown communities are equipped with knowledge, they are better prepared to advocate for themselves and one another. Recognizing the signs, insisting on follow-up care, and sharing stories within families and networks all become acts of protection and resistance. Awareness is not just about education; it’s about closing the gap in outcomes and ensuring that every woman, no matter her race or zip code, has the chance to survive.5
What You Can Do: Practical Steps for Awareness
- Look as well as feel. When checking your breasts, use a mirror. Raise your arms, put your hands on your hips, and notice if the skin looks different.6
- Get routine screenings. Talk with your doctor about when to start mammograms. For many women, that’s age 40, but for those with a family history, screening may need to start earlier.6
- Trust your instincts. If something feels or looks off, push for answers. It’s okay to ask for a second opinion.6
- Know your family history. Breast cancer risk can be higher if it runs in your family, especially if relatives were diagnosed young.6
- Talk openly. Share what you know with friends, family, and community. Awareness spreads faster when we talk about it.6
Your Body Is Speaking
Breast cancer doesn’t always begin with a lump. Sometimes, the clue is in the mirror, a patch of skin that looks dimpled, a change in texture, or something that simply doesn’t look right.
By learning to recognize these early signs, especially in communities that face the highest risks, we can change the story. Early detection saves lives. Your vigilance, your voice, and your insistence on being taken seriously could be the factor that protects your future.
At NOWINCLUDED, we believe knowledge is power, and no one should have to face health challenges alone. Come continue the conversation with us, because when we share our stories, we build the kind of community that makes health equity possible.
References
- Throckmorton, A. D. (2021). Is it breast cancer? —common dermatologic disorders found on the breast. Annals of Breast Surgery. doi:10.21037/abs-20-97
- ACS. (2021, November 19). What Is Breast Cancer? Retrieved from American Cancer Society : https://www.cancer.org/cancer/types/breast-cancer/about/what-is-breast-cancer.html
- Mutchler, C. (2024, November 04). 6 Breast Cancer Skin Changes. Retrieved from VeryWell Health: https://www.verywellhealth.com/breast-cancer-skin-changes-6831732
- ACS. (2023, December 19). American Cancer Society Recommendations for the Early Detection of Breast Cancer. Retrieved from American Cancer Society: https://www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html
- Malhotra, P. (2025). Black Women and Breast Cancer: Why Disparities Persist and How to End Them. Retrieved from The Breast Cancer Research Foundation: https://www.bcrf.org/about-breast-cancer/black-women-breast-cancer-disparities/
- National Cancer Institute. (2025, May 8). Breast Cancer Prevention (PDQ®)–Patient Version. Retrieved from National Cancer Institute: https://www.cancer.gov/types/breast/patient/breast-prevention-pdq
