This updated story was originally published in May 2015. We're re-sharing during Breast Cancer Awareness Month to shine a light on a symptom women may not know about.
It’s the breast cancer awareness photo seen around the world.
After receiving the terrifying news that she had stage 2 breast cancer, Lisa Royle took time before her mastectomy to help others: She posted a picture on Facebook of the dimpled skin on her left breast, the first sign that led to her diagnosis.
"Very subtle dimples underneath that could easily be missed when we're all rushing round getting ready in a morning," Royle, 44, a mother of four from Manchester, England, wrote in the caption. "Please take time to look at your boobs. It could save your life ?”
After Royle posted the photo snapped by her husband last May, it has been shared from her Facebook page more than 74,000 times.
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"I've had messages from ladies saying because of it (the photo) they checked themselves and found the same and have gone on to be diagnosed, thankfully early," Royale told TODAY via email last year. "It's so important to find it early because even though the treatment can be grueling, it doesn't last forever and it's so much better than the alternative."
Royle noticed the dimples during vacation in Egypt. She went to the doctor within weeks. “I knew something wasn't right,” she wrote. An ultrasound detected a lump.
“Hearing you have cancer is the scariest thing but it could have been a lot worse had I not spotted it as early as I have,” she wrote.
Skin changes can be a sign
Dimpling and puckering are among the skin changes that can occur with breast cancer. They happen when a tumor pulls healthy skin toward its center, said Dr. Anees Chagpar, director of the Breast Center at Smilow Cancer Hospital at Yale-New Haven Hospital.
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She estimated that 70 to 80 percent of breast cancers in countries like the U.S. and the United Kingdom are generally detected earlier through mammograms — before skin changes occur or lumps can be felt.
Awareness that redness or thickening of the skin can be a sign of cancer, “is not as high as we would like,” Chapgar said. “Women in general don’t know that often times breast cancer can present as skin changes. They may be only looking for a lump.
While the changes can also occur in people without cancer, Chagpar praised Royle for sharing the photo.
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“The more people who see this picture, who then can look in the mirror and say, ‘Gee, do I have that?’ and who could potentially catch breast cancer earlier, the better,” said Chagpar.
Today, Royale is celebrating a year since her last chemo treatment, which was followed by radiotherapy.
"I'm feeling really positive about the future and enjoying making lots of happy memories with my family," she wrote this week in an email to TODAY.
Health and wellness editor Gabrielle Frank contributed to this report. Lisa A. Flam is a news and lifestyles reporter in New York. Follow her on Twitter.