Nontender

• Stabbing or aching pain (10% of cases) as the first symptom

Uncommon early symptoms include:

• Nipple discharge (3% of women and 20% of men), retraction, or dimpling

• Eczema appearance of the nipple (Paget's carcinoma)

• Prominent skin edema, redness, warmth, and induration of the underlying tissue (inflammatory carcinoma)

Metastatic symptoms—tissues most commonly involved with metastases are lymph nodes (other than axillary or internal mammary), skin, bone, liver, lungs, and brain. The following symptoms of metastases will be present in about 10% of patients when they first seek treatment:

• Difficulty breathing

• Abdominal enlargement

• Mental status changes

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