Most adults cannot recognise the lesser-known symptoms of breast cancer - despite them potentially showing up before you can feel a lump, a study has suggested.
These symptoms include an inverted nipple, breast puckering, loss of feeling in part of the breast, thick or pitted skin on the breast and nipple discharge.
More than nine in 10 people know a lump can be a sign of breast cancer, research by Ohio State University found.
But when it comes to other symptoms, the majority of people are unable to identify them.
Experts said this was very concerning as most breast cancers do not present with a lump that can be detected by touch - and if they do, it often indicates a fast-growing or advanced cancer that is less treatable.
Symptoms not often recognised
Just 31% of survey respondents recognised a retracted, inverted or downward-pointing nipple as a symptom of breast cancer.
This can be caused by a tumour growing within the breast, tugging the breast tissue towards it and making the nipple turn inwards.
Just over one-third of people recognised breast puckering as a symptom.
Puckering on the surface of the breast can suggest a tumour beneath the surface that is causing the ligaments in the breast to shorten, pulling the tissue and skin inwards.
Loss of feeling in the breast was correctly identified as a symptom by 41% of respondents.
Just under half (45%) of people recognised pitting or thickening of the breast skin as a possible cancer symptom.
In some cases the skin resembles an orange peel, which can signal inflammatory breast cancer, a rare and aggressive form of cancer.
51% of respondents in the survey recognised nipple discharge as a symptom.
Some women may have milky discharge that is not a cause for concern, but spontaneously producing nipple discharge can be a breast cancer symptom. If the fluid is clear or bloody, it is particularly concerning.
The study was conducted on behalf of The Ohio State University Wexner Medical Centre through the SSRS Opinion Omnibus Platform, a US nationwide probability-based survey.
The data was collected among a sample of 1,004 respondents and was weighted to represent the target population of US adults, ages 18 or older.
Other common symptoms
Other common - but not always understood - symptoms include scaly, dry skin around the nipple, which can be a sign of a type of breast cancer called Paget's disease, and a new and noticeable size difference in your breasts.
However it is also important to note these symptoms do not necessarily indicate cancer, and are often a sign of something else happening with the breast.
The NHS advises anyone who notices a symptom of breast cancer to see their GP as soon as possible.
Breast cancer is the most common cancer in the UK, with 55,000 women and 400 men diagnosed every year.
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