I put my exhaustion down to the menopause – it turned out to be breast cancer at 48. The scariest part of it all? I didn’t have a lump

When Elaine Carrigan first noticed she felt more tired than usual, she assumed it was an early symptom of the menopause.

The then-48-year-old stepmother-of-one often found herself fatigued at the end of a long day. But what began as feeling drained and ready for bed each evening became a sensation of bone-deep tiredness that no amount of sleep could shake.

Within a few months, Elaine was having to take regular naps just to get through the week.

‘I thought that was just the menopause starting,’ she says. ‘When you’re that age, you put everything down to it. You feel exhausted, your body’s changing, and you think, that’s just what happens now.

‘It never crossed my mind that it could be something more serious.’

Today, Elaine, now 51, wishes she had taken more notice of the change in her energy levels.

Just months later, while on holiday with her husband in Tenerife, she experienced a sudden, stabbing pain in her right breast. The next day, examining the area in the mirror, she noticed a small dimple on the underside.

‘I was putting on suncream and saw my breast had changed shape,’ she says. ‘It was all pulled in, like a balloon that had been dented. I couldn’t feel a lump, just hard tissue. I thought I’d pulled something swimming.’

Without any history of cancer in her family, and unable to feel any lump or change in the tissue, Elaine was at first ready to dismiss the symptom. 

But heading down to the pool, Elaine casually mentioned the dimple to a new friend she had made in the hotel. The woman, who had recently recovered from breast cancer herself, urged Elaine to make a GP appointment as soon as she returned home.

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

Visiting her GP the day after she returned home to Glasgow, Elaine was immediately referred to a breast clinic, where an ultrasound revealed what the scanning technician said was ’99 per cent likely’ to be cancer.

After further scans and a biopsy, she was given the devastating news: the small skin puckering was being caused by a 7cm tumour, which doctors told her could have been been growing for the past two years. A cancerous lymph node was later found near her ribs. Elaine was stunned.

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

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

Experts say Elaine is not alone in her experience. More young women, aged 50 and under, than ever are being diagnosed with breast cancer in the UK – three out of four of whom have no family history of the disease.

Research shows cancers that affect younger women are more aggressive – and tend to develop faster. Hormonal changes caused by pregnancy, breastfeeding and the menopause can also lead younger women to dismiss changes in their breasts.

Women under 50 are not eligible for the NHS breast screening programme – which invites women for free breast screening mammograms every three years.

Yet fewer young women than ever are following health service advice and checking their own breasts for changes every month, surveys show.

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.’