Over time, most women experience changes in their breast. As a result, there can be changes that lead to various lumps, nipple discharge or tenderness. Given the natural fear that most women have of breast cancer, the changes can be alarming. As a general rule, if you find a lump or bump in a breast, you are advised to call the clinic.
Because breast tissue is responsive to hormones, many women experience changes in their breast that can cause pain or tenderness during the second half of the menstrual cycle. Estrogen tends to cause enlargement of breast ducts especially mid-cycle. The effect of progesterone in the second half of the menstrual cycle causes growth of the milk glands. The pain and tenderness of the breast improves with menses as the estrogen and progesterone levels decrease.
With age, the breast loose fat and tissue, which causes the breast to become smaller and less full. The density of the breast decreases and increases the usefulness of mammography to evaluate the breast tissue. Mammography is more useful in women over age 35. Lumps tend to be more common as a women approaches menopause. Fortunately, the majority of these lumps are benign cysts rather than cancer.
Breast Self-exam
The best time to do a self-breast exam is about 3 – 5 days after your period starts. Your breasts are not as tender or lumpy at this time in your monthly cycle. If you have gone through menopause, do your exam on the same day every month.
Begin by lying on your back. It is easier to examine all breast tissue if you are lying down.
- Place your right hand behind your head. With the middle fingers of your left hand, gently yet firmly press down using small motions to examine the entire right breast.
- Next, sit or stand. Feel your armpit, because breast tissue goes into that area.
- Gently squeeze the nipple, checking for discharge. Repeat the process on the left breast.
- Use a pattern to search the breast to ensure you have examined all of the breast tissue
- Look at your breasts directly and in the mirror. Look for changes in skin texture, such as dimpling, puckering, indentations, or skin that looks like an orange peel.
- Also note the shape and outline of each breast.
- Check to see if the nipple turns inward.
Most women have some lumps. Your goal is to find anything new or different. If you do, call your health care provider right away.
Common Breast Conditions
Fibrocystic Changes – The breast is composed of different type of cells. Some cells contribute to the production of milk and others contribute to the structure of breast to transport the milk to nipple by forming ducts. When there is a dysfunction of the milk producing cells, pockets of fluid develop in the breast which are referred to as cyst. Likewise, dysfunction of the structure form cells results in deposit of fibrous knots within the breast. Together, these developments of fibrous knot and cyst result in fibrocystic changes. Rather than a disease or disorder, fibrocystic changes is considered a variation of normal breast tissue.
Breast cyst – a cyst is a fluid filled structure in breast tissue and will often fluctuate in size depending on hormones, diet and caffeine intake. Generally, breast cysts are benign and occasionally drained using a needle if the cyst is large, painful or persistent.
Fibroadenoma – a solid, fibrous, rubbery, benign tumor of the breast. It most cases, the lump can be easily moved when pushed. These occur more commonly in younger women.
Intraductal Papilloma – a wart-like growth near the nipple which can cause discharge or bleeding from the nipple
Galactocele – a collection of milk within the breast caused by a blocked mild duct