Breast Problems

Topic Overview

Breast lumps or changes are a common health worry for most women. Women may have many kinds of breast lumps and other breast changes throughout their lives, including changes that occur with menstrual periods, pregnancy, and aging. Most breast lumps and breast changes are normal.

See a picture of the breast anatomy.

Common, noncancerous (benign) breast changes include:

Breast development is the first sign of puberty in young girls. Usually, breasts begin as small, tender bumps under one or both nipples that will get bigger over the next few years. It is not unusual for one breast to be larger than the other or for one side to develop before the other. A girl may worry that a lump under the nipple is abnormal or a sign of a serious medical problem when it is a part of normal breast development.

In men, enlargement of male breast tissue (gynecomastia) is a noncancerous breast change. Breast buds are common in adolescent boys during puberty. They may last up to 2 years, but they tend to go away within the first year. Breast buds develop because of rapid changes in hormone levels.

Many women with breast pain or breast lumps worry about breast cancer.

The earlier breast cancer is detected, the more easily and successfully it can be treated.

There are 2 common methods of early detection:

  • Mammogram. A mammogram is an X-ray of the breast that can often find tumors that are too small for you or your doctor to feel. Experts differ in their recommendations about when or how often women should have mammograms. Some recommend you begin screening at age 40 and some recommend you begin screening at age 50. Your doctor may suggest that you have a screening mammogram at a younger age if you have risk factors for breast cancer.
  • Clinical breast examination (CBE). During your routine physical exam, your doctor may do a clinical breast exam. During a CBE, your doctor will carefully feel your breasts and under your arms to check for lumps or other unusual changes. Talk to your doctor about whether to have a clinical breast exam.

Breast self-examination (BSE) involves checking your breasts for lumps or changes while standing and lying in different positions and while looking at your breasts in a mirror. Once you know what your breasts normally look and feel like, any new lump or change in appearance should be evaluated by a doctor. Most breast problems or changes are not caused by cancer. But BSE should not be used in place of clinical breast examination and mammography. Studies have not shown that BSE alone reduces the number of deaths from breast cancer.

Early breast cancer is often seen on a mammogram before there are any symptoms. The most common symptom of breast cancer is a painless lump. But sometimes painful lumps are cancerous. Other symptoms of breast cancer include:

  • A lump or thickening in the breast or armpit that is new or unusual.
  • A change in the size or shape of the breast.
  • Skin changes, such as a dimple or pucker in the skin of the breast.
  • Discharge or bleeding from the nipple that comes out without squeezing the nipple (spontaneous discharge).
  • A change in the nipple.
  • Scaling or crusting of the nipple.
  • A change in the color or feel of the skin of the breast or the darker area around the nipple (areola).
  • A breast lump in a man.

Treatment of a breast problem depends on the cause of the problem.

Use the Check Your Symptoms section to decide if and when you should see a doctor.

Check Your Symptoms

Home Treatment

Breast self-exams are a simple way for you to learn what your breasts normally feel like. During a breast self-exam, you examine your own breasts to look and feel for changes from one month to the next. You will learn how your breasts feel and what is normal for you so that you can spot any changes early. For more information about how to do a breast self-exam, see the topic Breast Self-Examination.

Medicine you can buy without a prescription
Try a nonprescription medicine to help treat your fever or pain:

Talk to your child’s doctor before switching back and forth between doses of acetaminophen and ibuprofen. When you switch between two medicines, there is a chance your child will get too much medicine.
Safety tips
Be sure to follow these safety tips when you use a nonprescription medicine:
  • Carefully read and follow all directions on the medicine bottle and box.
  • Do not take more than the recommended dose.
  • Do not take a medicine if you have had an allergic reaction to it in the past.
  • If you have been told to avoid a medicine, call your doctor before you take it.
  • If you are or could be pregnant, do not take any medicine other than acetaminophen unless your doctor has told you to.
  • Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.

Alternative medicines or supplements may help relieve breast tenderness, discomfort, or pain (mastalgia). As with all alternative medicines and supplements, it is important to follow the directions on the label. Do not exceed the maximum recommended dose. If you are or could be pregnant, talk with your doctor before taking any medicine or supplement.

  • Evening primrose. For more information on studies of evening primrose and breast symptoms, see the topic Fibrocystic Breasts.
  • Magnesium. Some studies have shown that magnesium reduces mild premenstrual symptoms. For more information, see the topic Fibrocystic Breasts.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate your symptoms if any of the following occur during home treatment:

  • A change in a breast develops, such as:
    • A lump or thickening in the breast or armpit that is new or unusual and does not go away after your monthly period.
    • A change in the size or shape of your breast.
    • Skin changes, such as a dimple or pucker in the skin of the breast.
    • Discharge or bleeding from the nipple that comes out without squeezing the nipple.
    • A change in the shape of a nipple (retraction or inversion of a nipple).
    • A change in the color or feel of the skin of the breast or the darker area around the nipple (areola).
  • A breast lump develops in a man.
  • Symptoms of a breast infection develop.
  • Symptoms become more severe or more frequent.

Prevention

To prevent breast tenderness, discomfort, or pain (mastalgia), follow these tips:

  • Wear a sports bra during exercise. A sports bra may prevent breast discomfort, pain, and injury during exercise or sports. It is important that the sports bra fit properly. It should keep the breasts almost motionless and allow them to move together with the chest, not separately. It is important to replace your sports bra as the material stretches and become less supportive. A sports bra may need to be replaced every 6 months if it is used regularly.
  • Limit your salt intake. High salt intake may cause fluid retention. Fluid retention may be the cause of premenstrual breast tenderness.

To prevent nipple irritation during exercise:

  • Cover your nipple with a small bandage or a dab of petroleum jelly before you exercise.
  • Wear a sports bra that fits you properly. Avoid sports bras that are lined with cotton.
  • Avoid exercising in cold temperatures.
  • Wear a vest or jacket made from fabric that blocks the wind.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

  • What symptoms do you have?
  • How long have you had your symptoms? Do your breast changes occur at the same time each month?
  • What is your age and general health?
  • Do you have menstrual periods? Are your periods regular?
  • Are you pregnant?
  • Have you had children? Did you breast-feed? Are you currently breast-feeding?
  • Have you had a breast infection (mastitis) or a blocked milk duct in the past?
  • What prescription and nonprescription medicines are you taking?
  • Have you ever been diagnosed with breast lumps or had any fluid or cysts drained from your breasts?
  • Have you ever had a mammogram or breast ultrasound?
  • Have you ever been diagnosed with breast cancer?
  • Do you have any relatives who have noncancerous (benign) breast lumps or breast cancer?
  • Do you have any health risks?

References

Other Works Consulted

  • American Cancer Society (2009). Prevention and Early Detection: American Cancer Society Guidelines for the Early Detection of Cancer. Atlanta: American Cancer Society. Available online: http://www.cancer.org/docroot/PED/content/ped_2_3X_ACS_Cancer_Detection_Guidelines_36.asp.
  • U.S. Preventive Services Task Force (2009). Screening for breast cancer. Available online: http://www.ahrq.gov/clinic/uspstf/uspsbrca.htm.

Credits

Author Jan Nissl, RN, BS
Editor Susan Van Houten, RN, BSN, MBA
Associate Editor Tracy Landauer
Primary Medical Reviewer Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer Deborah A. Penava, BA, MD, FRCSC, MPH - Obstetrics and Gynecology
Last Updated January 20, 2010

Last Updated: January 20, 2010

Author: Jan Nissl, RN, BS

Medical Review: Anne C. Poinier, MD - Internal Medicine & Deborah A. Penava, BA, MD, FRCSC, MPH - Obstetrics and Gynecology

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