Woman, 48, Thought Menopause Fatigue Was Breast Cancer Without a Lump

When Elaine Carrigan first began feeling unusually tired, she assumed it was an early sign of the menopause.

The 48-year-old stepmother-of-one was initially exhausted only after a long day. However, her fatigue soon deepened into a bone-weary feeling that even a full night’s sleep could not relieve.

Within months, Elaine was relying on regular naps simply to make it through the week.

‘I thought it was just the menopause beginning,’ she says. ‘When you’re that age, you blame everything on it. You feel exhausted, your body is changing, and you think, that’s just what happens now.

‘It never occurred to me that it could be something more serious.’

Now 51, Elaine wishes she had paid closer attention to the change in her energy levels.

Only a few months later, while holidaying with her husband in Tenerife, she felt a sudden, stabbing pain in her right breast. The following day, she examined the area in the mirror and noticed a small indentation underneath it.

‘I was putting on suncream when I noticed that my breast had changed shape,’ she says. ‘It looked pulled in, like a dent in a balloon. I couldn’t feel a lump, only hard tissue, so I thought I might have strained something while swimming.’

With no family history of cancer and no obvious lump or change in the breast tissue, Elaine was initially inclined to dismiss what she had seen.

But as she walked to the pool, Elaine mentioned the dimple to a new friend at the hotel. The woman, who had recently recovered from breast cancer, encouraged her to book a GP appointment as soon as she returned home.

‘I’m so glad I listened,’ Elaine says.

She saw her GP the day after returning to Glasgow and was immediately referred to a breast clinic. An ultrasound showed an abnormality the scanning technician said was ’99 per cent likely’ to be cancer.

Further scans and a biopsy confirmed the devastating diagnosis. The slight puckering of the skin had been caused by a 7cm tumour, which doctors believed may have been growing for as long as two years. A cancerous lymph node was later discovered near her ribs. Elaine was stunned.

‘My mum died at 36, but from heart problems,’ Elaine says. ‘There was no cancer in my family at all.

‘And I couldn’t feel a lump. If it hadn’t been for the pain and the change in shape, I would probably have continued blaming the menopause.’

Experts say Elaine’s experience is far from unique. More women aged 50 and under are being diagnosed with breast cancer in the UK than ever before, and three in four of them have no family history of the disease.

Research suggests breast cancers affecting younger women are more aggressive and can develop more quickly. Hormonal changes linked to pregnancy, breastfeeding and the menopause may also lead women to overlook changes in their breasts.

Women under 50 are not routinely eligible for the NHS breast screening programme, which offers free mammograms every three years.

Meanwhile, surveys show that fewer young women than ever are following health service advice to check their breasts for changes each month.

While nearly half of all women reported doing regular self-exams on their breasts in 2022, just 45 per cent owned to doing so in 2024.

The problem, say experts, is that not all women with breast cancer develop typical symptoms of the disease – like a lump – making regular self-exams essential.

Around one in six women diagnosed with symptomatic breast cancer have signs other than a distinct lump, studies show.

One such example is actress Lucy Davis, best known for her role in The Office, who revealed she has incurable breast cancer earlier this year, after finding a ‘hard spot’ on her breast.

The 53-year-old, who was diagnosed over a year ago, told fans in August that the disease had spread to her bones – making it too late for chemotherapy.

‘The initial lump that I felt wasn’t a ‘lump’ as such; rather a kind of hard spot. Really tiny. I almost didn’t bother getting it checked,’ she wrote on Instagram.

‘So I guess I’m saying don’t ignore anything – get everything checked out. I’m not scared of what comes next. I’m at peace with it. There’s a lot I have learned from [my cancer], and I’m grateful for that.’

Breast cancer can appear in a range of different ways that aren’t just a palpable lump, says breast cancer expert Dr Liz O’Riordan.

‘Dimpling or puckering can be a sign of a tumour, as well as any change in size – if one becomes more swollen than the other, for example,’ she explains.

‘Nipple inversion or bloody or watery discharge from the nipple is another sign to look out for, as is a rash around the nipple or on the breast which doesn’t clear up with antibiotics. This can create an orange peel-like effect on the skin.

‘Breast pain is very, very rarely a symptom of breast cancer on its own – however, breast pain combined with another symptom – like a skin dimple – should be a cause for concern.’

Fatigue, however, is very rarely a sign of breast cancer, she adds – unless it has already spread to other parts of the body.

‘Around five to 10 per cent of women are diagnosed with breast cancer when it is already stage 4 – because their cancer was largely asymptomatic.’

Studies show that around one in four women report feeling extreme fatigue as an initial symptom at the time of a breast cancer diagnosis, before any treatment has begun. 

Research shows this is likely due to early physiological changes, immune system activation and inflammation caused by the emerging tumour. 

Disruptions in natural hormone levels and heightened cortisol – known as the stress hormone – can also affect energy production.

Says Dr O’Riordan: ‘The key for women is to properly check their breasts every month, topless in front of a mirror – otherwise they miss the early signs of cancer.’ 

Today, after undergoing a full mastectomy, nine chemotherapy sessions and 15 sessions of radiotherapy, Elaine is cancer-free.

But she hopes raising awareness about her story will help other women seek help sooner than she did.

‘So many fellow breast cancer survivors I meet say exactly the same thing,’ says Elaine.

‘They’d put their symptoms down to the menopause. The tiredness, the changes in their bodies, all of it. They’d just assumed it was their age.

‘Hearing it again and again, I realised how common it is. Women are so used to being told their bodies are changing at that age that we don’t question it.

‘If you’re going through the perimenopause and something doesn’t feel right, don’t just assume it’s hormones. Get it checked. You don’t need a lump.’

Says Dr Liz O’Riordan: ‘If you notice a change in your breast that’s new, one-sided and doesn’t go away within a couple of weeks, go and see your GP and tell them that you’re concerned about breast cancer.

‘It’s much harder for them to dismiss it and they can refer you on to a breast clinic for further tests.

‘The majority of people seen in a breast clinic won’t have breast cancer – but the only way to tell is to go and get checked.’