Breast tumours comprise a spectrum ranging from benign fibro-epithelial lesions to invasive malignancies. Symptom expression reflects histological subtype, anatomical location, and biological behaviour. Early recognition allows accurate triage between conservative follow-up and definitive oncological therapy.

1. Painless palpable mass
   Most tumours present as a discrete, firm nodule with variable mobility. Benign lesions (fibroadenoma) are smooth and slippery; malignant masses display irregular, spiculated borders and may fix to pectoral fascia or skin.
2. Nipple-areolar changes
   Recent inversion, persistent eczema-like scaling, or spontaneous serosanguinous/bloody discharge suggests underlying malignancy. Ulceration and malodour indicate locally advanced disease.
3. Skin alterations
   Dimpling along Cooper ligaments, peau d’orange from lymphatic obstruction, and diffuse erythematous induration (inflammatory carcinoma) are pathognomonic for malignancy. Benign tumours do not alter overlying skin.
4. Axillary and supraclavicular lymphadenopathy
   Firm, matted, non-tender nodes ≥1 cm imply regional metastatic spread; fixation to deep structures signals extra-nodal extension.
5. Cyclical vs. progressive pain
   Benign proliferations often produce cyclical mastalgia; persistent, progressive pain without relation to menses raises concern for malignancy or phyllodes tumour.
6. Multifocality and bilateral disease
   Multiple synchronous masses may represent fibroadenomatosis or multifocal carcinoma; contralateral involvement suggests genetic predisposition (e.g., BRCA1/2).
7. Rapid growth or sudden change
   Size increase >20 % within 6 weeks, new skin tethering, or appearance of satellite nodules mandates core biopsy to exclude high-grade malignancy or sarcomatoid transformation.
8. Systemic and metastatic features
   Unintentional weight loss, persistent fatigue, bone pain, pleuritic cough, or neurological deficits indicate advanced malignant disease with distant organ involvement.