Women's Health

Understanding Breast Problems -- The Basics

The female breast is an organ that changes with puberty, with the monthly menstrual cycle, and with pregnancy. It also continues to change with age.

Most changes in your breasts are perfectly normal and no cause for concern. But some changes need medical attention. Chief among these are breast pain and lumps.

Breast Lumps

Breast lumps come in many forms, including cysts, adenomas, and papillomas. They differ in size, shape, and location, as well as in causes and treatment. About half of all women have lumpy breasts, or fibrocystic change. They are more common during the premenstrual period and usually disappear after menopause. Most lumps are benign and do not signal cancer; however, any time you find a new or unusual lump, have your doctor check it to make sure it is not precancerous or cancerous.

Researchers are studying the incidence of breast lumps in women using hormone replacement therapy (HRT). In combination HRT, women take the hormones estrogen and progestin to ease the symptoms of menopause. In 2002, a study called the Women’s Health Initiative discovered that HRT resulted in more harm than good. Taking both hormones was shown to increase the risk of breast cancer and change the breast's structure, increasing breast density and making mammograms harder to read. This could make finding cancer more difficult. To put this into numbers, if 10,000 women took combined HRT for a year, this would add up to about 8 more cases of breast cancer per year than if they had not taken hormone therapy (HT). 

Cysts, which can be large or small, are harmless, fluid-filled sacs that may be painful.

After menopause, many cysts shrink or disappear. You should immediately have your doctor check any lumps that form after menopause.

Fibroadenomas are the most common benign breast tumors in women under 25 and occasionally in adolescents. These tumors are usually round, several centimeters across, and mobile. They can sometimes go away on their own. Your doctor may recommend removal if the lump persists, gets larger, or if you are anxious about it. Tests will be done to check for cancer when it is removed.

Nipple adenomas are tumors of the nipple area. They vary in appearance, sometimes come back after being removed, and are sometimes associated with cancer. An intraductal papilloma is an uncommon small growth in the lining of the milk ducts near the nipple. Usually seen in women over 40, papillomas produce a discharge, which may be bloody.

Breast Self-Exams and Mammograms

You should discuss breast self-exams with your doctor, and your doctor should go over how to perform them with you. Premenstrual changes can cause temporary thickening in breast tissue that disappears after your period, so your doctor may tell you to wait until a few days after your period to do them.