October is National Breast Cancer Awareness Month. People from all over the world sport pink ribbons to spread awareness of the disease, the importance of early detection and the progress we’ve made in terms of treatment. But we still have a long way to go. About 12% of US women will develop invasive breast cancer over the course of their lifetime, and it’s the most commonly diagnosed cancer in women, aside from skin cancer.

For women over the age of 50, death rates for breast cancer are decreasing. This is believed to be because of treatment advances, increased awareness and early detection. With early identification being so important, let’s take a look at five surprising signs of breast cancer in women over 50.

  1. Lump in the breast or underarm. Lumps are typically detected in mammograms before they will be noticed, so it’s crucial to get regular screenings. However, if you notice a lump in the breast or underarm, schedule an appointment immediately.
  1. Pain or tenderness. Breast pain can be caused by a number of factors such as stress, fluctuating hormones or wearing a tight bra. But it can also be a sign of breast cancer. Don’t ignore pain in the back or chest; this could also signal a problem.
  1. Redness or itchiness. A bumpy “orange peel” texture on your breast could indicate breast cancer. Your first step may be to see the dermatologist, as it could likely be typical skin irritation. However, if the redness or itchiness doesn’t go away with a cream, schedule a doctor’s appointment.
  1. Changes in the nipple. Any changes with your nipple may be a cause for concern. Look for the following red flags: nipple retraction, rash, dimpling, itching, burning or discoloration. Also, if any discharge (aside from breast milk) is coming from the nipple, also phone your doctor. This is not normal.
  1. Swelling. Even if a lump is not apparent, swelling is usually not a good sign. Take note of other symptoms you may be experiencing such as warmness, irritation or inflammation. It may feel like you have a breast infection, but it could also be an early sign of breast cancer.

Early detection is key. While any of these symptoms can occur on their own, they could also signify breast cancer. If you happen to notice any of them, call your doctor immediately. Also be sure to get your screenings on time and to lower your risk of cancer by eating plenty of fruits and vegetables, exercising each day and not drinking alcohol.