Breast cancer arises from the terminal duct-lobular unit and may remain in-situ or invade surrounding tissue. Symptom patterns reflect tumour biology, anatomical location, and host response. Early recognition improves oncological outcome; therefore, any new, persistent breast change warrants triple assessment.

1. Painless palpable mass
   A solitary, firm-to-hard nodule with irregular or spiculated borders is most common. Fixation to pectoral fascia or skin reduces mobility and creates tethering.
2. Nipple-areolar changes
   Recent nipple inversion, persistent eczematous scaling (Paget disease), or spontaneous serosanguinous/bloody discharge indicates underlying malignancy. Ulceration or fungation denotes locally advanced disease.
3. Skin alterations
   Dimpling along Cooper ligaments, peau d’orange from lymphatic obstruction, or erythematous induration covering > one-third of the breast (inflammatory carcinoma) are pathognomonic signs.
4. Axillary and supraclavicular lymphadenopathy
   Firm, non-tender, matted nodes ≥1 cm imply regional metastasis; fixation to skin or deep structures signals extra-nodal extension.
5. Constitutional features
   Unintentional weight loss >5 % within 6 months, persistent fatigue, and low-grade night sweats reflect tumour cachexia and cytokine release.
6. Metastatic syndromes
   Bone: pathological fracture or intractable pain from lytic lesions.
   Lung: productive cough, pleuritic pain, or malignant pleural effusion.
   Liver: right-upper-quadrant discomfort, hepatomegaly, or cholestasis.
   Brain: progressive headache, focal neurological deficits, or seizures.
7. Paraneoplastic signs
   Dermatomyositis, hypertrophic osteoarthropathy, or thrombophlebitis migrans may precede overt tumour detection and mandate systemic evaluation.