Watching for early signs of breast cancer, including HER2-positive breast cancer, involves more than checking for lumps. For example, changes in skin texture or nipple appearance can also be warning signs. Knowing how your body normally looks and feels can help you catch changes early.

While a self-exam may help you notice symptoms of breast cancer, it can’t tell you what type you have. Only diagnostic testing can determine the specific type of breast cancer.

Keep reading to learn about some common early signs and symptoms of HER2-positive breast cancer.

What Is HER2-Positive Breast Cancer?

HER2-positive breast cancer is a subtype of breast cancer related to the HER2 gene. People with this type of cancer have cancer cells that make a protein called human epidermal growth factor receptor 2 (HER2). The HER2 protein helps to control how cancer grows and divides in breast cells.

HER2-positive breast cancers are aggressive types of cancer. This type of breast cancer may grow faster, metastasize (spread to other parts of the body), and recur (come back) more often than others. Because of this, it’s important to find HER2-positive breast cancer early.

According to the American Cancer Society, most symptoms of breast cancer can also be caused by conditions that aren’t cancer. However, it’s important to check with your healthcare provider as soon as you notice any new changes or symptoms.

Here are six symptoms of early-stage HER2-positive breast cancer to watch for.

1. Breast Lump

A new lump in your breast is the most common symptom of breast cancer. A hard, but painless, lump with irregular edges is most likely to be a malignant (cancerous) tumor. However, some breast cancer lumps might feel soft and round.

If you feel a lump in your breast, talk to your healthcare provider right away. They’ll likely suggest a mammogram (an X-ray test of the breast) and additional testing.

A new lump in your breast is the most common symptom of breast cancer.

Even though breast cancer isn’t the most common reason for a breast lump, your doctor can help you find the cause. Fast-growing cancers, like HER2-positive breast cancer, can result in a lump that grows quickly.

2. Breast Swelling

Swelling in part of or throughout your breast can be a symptom of breast cancer. If you have breast swelling, it may appear larger than usual. Swelling can occur in breast cancer even if you don’t feel a lump.

Breast swelling can be a symptom of inflammatory breast cancer — a rare type of invasive ductal carcinoma (invasive breast cancer). People with inflammatory breast cancer may be more likely to have HER2-positive breast cancer cells. However, you won’t know if you have HER2-positive breast cancer until after diagnosis and testing.

3. Pain in Your Breasts or Nipples

Breast cancer usually doesn’t cause pain in your breasts or nipples. Breast lumps from breast cancer are not usually painful, but in some cases, they can be.

Even though breast or nipple pain is more commonly caused by the menstrual cycle and benign (noncancerous) conditions, it’s important to tell your healthcare provider if you’re having any pain.

4. Skin Changes on Your Breasts

Changes in the texture of breast skin can be a sign of some types of breast cancer. Skin dimpling can look like pits or sunken areas in your skin. This sign is also called “peau d’orange” — French for “orange peel” — because the skin may look like the skin of an orange. Your skin may also have a thicker texture.

Skin dimpling is most often a sign of a breast infection called mastitis. However, it can also be a sign of inflammatory breast cancer.

Breast cancer can cause other changes to the skin on your breasts and nipples, such as discoloration, irritation, flaking, or dryness.

Talk to your healthcare provider as soon as possible if you notice any changes to the skin on your breasts and nipples.

5. Nipple Changes

Sometimes, breast cancer can cause changes in your nipple. The most common nipple change people see as a symptom of breast cancer is nipple retraction — when your nipple turns inward. About 20 percent of people have nipples that naturally turn inward. However, it could be a symptom of cancer if it happens suddenly or only affects one breast.

Nipple retraction could be a symptom of cancer if it happens suddenly or only affects one breast.

Nipple discharge may also be a symptom of breast cancer. Having fluid come out of your nipples isn’t normal, unless you’re breastfeeding. While changes to your nipple and discharge don’t always indicate breast cancer, talk to your healthcare provider as soon as possible if you notice anything unusual.

6. Swollen Lymph Nodes

Swollen lymph nodes can be an early sign that breast cancer has spread. Lymph nodes are small, bean-shaped structures that are part of the immune system, helping to filter out harmful substances. When breast cancer metastasizes, it often travels first to the lymph nodes, particularly those in the armpit or near the collarbone.

In some cases, swollen lymph nodes may be noticeable before a lump in the breast is detected. If you have HER2-positive breast cancer, which tends to grow and spread quickly, lymph node swelling may develop early in the disease process. While swollen lymph nodes can also be caused by infections or other conditions, it’s essential to have any unexplained swelling evaluated by a healthcare provider.

How Is Breast Cancer Diagnosed?

If you notice any of the previously mentioned symptoms of breast cancer, your healthcare provider will order follow-up tests to discover the cause of your symptoms. If these tests don’t rule out breast cancer, a breast cancer diagnosis can be made using a breast biopsy. During the biopsy, your provider will take a small sample of breast tissue to examine under a microscope.

How Do You Learn Your HER2 Status?

Several different tests can check for the HER2 protein in your cancer cells — also known as your HER2 status. Your healthcare provider can order these tests on a biopsy sample or a tumor after it’s been surgically removed.

HER2-positive breast cancer tends to grow and spread quickly. You may experience lymph node swelling as an early symptom of HER2-positive breast cancer.

There are two main tests used to determine whether your cancer is HER2-positive or HER2-negative — fluorescence in situ hybridization and immunohistochemistry tests (also called the FISH test and the IHC test).

If your breast cancer cells are HER2-positive, your cancer is more likely to grow faster and come back after treatment. About 15 percent to 20 percent of breast cancers are HER2-positive.

What Is the Best Treatment for HER2-Positive Breast Cancer?

There are several treatment options for HER2-positive breast cancer. Some of these are also used for other types of breast cancer, such as lumpectomy or mastectomy surgery, chemotherapy, radiation therapy, and hormone therapy.

Targeted therapy is a type of breast cancer treatment that works by targeting specific proteins that help cancer cells grow and divide, such as the HER2 protein. If you have HER2-positive breast cancer, you may be eligible for targeted therapy.

Examples of targeted therapies for HER2-positive breast cancer include:

• Ado-trastuzumab emtansine (Kadcyla)
• Fam-trastuzumab deruxtecan (Enhertu)
• Lapatinib (Tykerb)
• Margetuximab-cmkb (Margenza)
• Neratinib (Nerlynx)
• Pertuzumab (Perjeta)
• Trastuzumab (Herceptin)
• Trastuzumab, pertuzumab, and hyaluronidase-zzxf (Phesgo)
• Tucatinib (Tukysa)

Your cancer care team can help you find the most effective treatment, which may involve a combination of different treatments, including techniques to help manage side effects. Talk to your oncologist about your prognosis (outlook) and the right treatment plan for you.

Find Your Team

MyBCTeam is the social network for people with breast cancer and their loved ones. On MyBCTeam, more than 76,000 members come together to ask questions, give advice, and share their stories with others who understand life with breast cancer.

Which early symptoms of breast cancer did you notice? Did any symptoms prompt you to see your healthcare provider before your scheduled breast cancer screening? Share your experience in the comments below, start a conversation by posting on your Activities page, or connect with like-minded members in Groups.