How do you check for dimpling in your breast?

You're probably aware that one of the most common signs of breast cancer is a lump. But breast cancer can manifest in a number of ways, and a woman in the U.K. is hoping to raise awareness about one lesser-known symptom: breast dimpling.

Sherrie Rhodes posted a picture and caption on Facebook detailing the dimple on her breast, which was the only breast cancer symptom she had. The post has since been shared over 1,200 times.

“Yesterday I was diagnosed with breast cancer. It came as a total shock as this dimpling (in the pic) is the only symptom I had,” she wrote. Rhodes says she noticed the dimple at the end of June and flagged it for her doctor, who referred her to a breast clinic. She had a scan, which revealed a mass, followed by a mammogram and a few biopsies. “I wasn't too worried as there was no lump or anything,” she said. “Unfortunately it came back as breast cancer. Please check your breast regularly and don't ignore anything that is different. If I hadn't seen a post like this previously I wouldn't have known that this dimpling was a sign of cancer. Please share and raise awareness.”

The most common symptom of breast cancer is a new lump or mass, according to the American Cancer Society, but breast dimpling can also be a symptom, as well as swelling of all or part of the breast, breast or nipple pain, nipple retraction, redness or thickening of the nipple or breast skin, and nipple discharge other than breast milk.

“That’s very rare as the only sign of breast cancer, but it’s not uncommon to see dimpling associated with other symptoms, like an underlying mass,” Therese Bartholomew Bevers, M.D., F.A.A.F.P., medical director of the Cancer Prevention Center and prevention outreach programs at MD Anderson Cancer Center in Houston, tells SELF. Dimpling can happen when a tumor is growing in the tissue underneath the skin and pulling it inward, she says. Nipple retraction, when a person’s nipple suddenly turns in, is another form of this, she adds.

Dimpling can happen with several forms of breast cancer, but there’s one in particular that it might point to.

That’s known as lobular carcinoma, which is the second most common type of breast cancer, according to the Mayo Clinic. Lobular carcinoma doesn’t usually form a lump—rather, it creates sheets of cancer cells that can cause dimpling, Dr. Bevers says.

Dimpling can also be a sign of a rare form of breast cancer known as inflammatory breast cancer. With this form of breast cancer, tumor cells obstruct or block the lymphatic channels that run through the breast and cause the breast skin to look dimpled, similar to the appearance of the skin of an orange, Susan Hoover, M.D., F.A.C.S., a surgical oncologist in the Breast Oncology Program at Moffitt Cancer Center in Tampa, Florida, tells SELF.

If someone has breast dimpling and it’s not related to inflammatory breast cancer, there is often a mass associated with it that doctors can see on imaging—either a mammogram, ultrasound, or MRI, Dr. Bevers says. In rare cases, doctors may not find anything, but it’s important to continue to monitor the patient to see if anything develops over time. A small percentage of breast cancers are not seen on a mammogram and sometimes they’re too small to feel. So breast dimpling “may be the first sign of something growing in the breast,” Richard J. Bleicher, M.D., F.A.C.S., a professor in the Department of Surgical Oncology at the Fox Chase Cancer Center, tells SELF.

It’s also possible to have breast dimpling and not have have breast cancer.

So, if you develop it, don’t panic and automatically assume you have breast cancer. Breast dimpling can also be caused by a scar that pulls the breast tissue inward or a breast condition known as fat necrosis, which is damaged or dead fatty tissue in the breast, Dr. Bevers says. Fat necrosis is usually caused by some kind of trauma to the breast, like from a seatbelt, she says. Years after the trauma, a person can start to see dimpling. Still, it's a good idea to get any new breast changes checked out, especially breast dimpling.

If you notice dimpling in your breast, talk to your doctor about getting screened with a mammogram or ultrasound. “This is not something that should be written off,” Richard Reitherman, M.D., Ph.D., medical director of breast imaging at MemorialCare Breast Center at Orange Coast Memorial Medical Center in Fountain Valley, California, tells SELF. If you don’t get any answers from those scans, see a breast specialist and make sure they continue to monitor you. “A patient should not be satisfied until they get a good report or symptoms resolve,” Dr. Reitherman says. “Personal advocacy, iterated as many times as necessary, is empowerment.”

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