Breast Diseases & Disorders

Breast Lumps

A breast lump is a swelling, protuberance, or lump in the breast.

Normal breast tissue is present in both males and females of all ages. This tissue responds to hormonal changes and, therefore, certain lumps can come and go.

Breast lumps may appear at all ages:

Infants may have breast lumps related to estrogen from the mother. The lump generally goes away on its own as the estrogen clears from the baby's body. It can happen to boys and girls.

Young girls often develop "breast buds" that appear just before the beginning of puberty. These bumps may be tender. They are common around age 9, but may happen as early as age 6.

Teenage boys may develop breast enlargement and lumps because of hormonal changes in mid-puberty. Although this may distress the teen, the lumps or enlargement generally go away on their own over a period of months.

Breast lumps in an adult woman raise concern for breast cancer, even though most lumps turn out to be not cancerous.

Lumps in a woman are often caused by fibrocystic changes, fibroadenomas, and cysts.

Fibrocystic changes can occur in either or both breasts. These changes are common in women (especially during the reproductive years), and are considered a normal variation of breast tissue. Having fibrocystic breasts does not increase your risk for breast cancer. It does, however, make it more difficult to interpret lumps that you or your doctor find on exam. Many women feel tenderness in addition to the lumps and bumps associated with fibrocystic breasts.

Fibroadenomas are noncancerous lumps that feel rubbery and are easily moveable within the breast tissue. Like fibrocystic changes, they occur most often during the reproductive years. Usually, they are not tender and, except in rare cases, do not become cancerous later. A doctor may feel fairly certain from an exam that a particular lump is a fibroadenoma. The only way to be sure, however, is to remove or biopsy it.

Cysts are fluid-filled sacs that often feel like soft grapes. These can sometimes be tender, especially just before your menstrual period. Cysts may be drained in the doctor's office. If the fluid removed is clear or greenish, and the lump disappears completely after it is drained, no further treatment is needed. If the fluid is bloody, it is sent to the lab to look for cancer cells. If the lump doesn't disappear, or recurs, it is usually removed surgically.

Breast Pain

There are many possible causes for breast pain. For example, hormone level changes related to menstruation or pregnancy are often responsible for breast tenderness. Some degree of swelling and tenderness just before your period is normal.

Although many women with pain in one or both breasts may fear breast cancer, breast pain is NOT a common symptom of cancer.

Boys and men have breast tissue. If a male has breast tissue that can be seen, the condition is called gynecomastia. Adolescent boys can have some breast swelling and tenderness as a part of normal development. This is due to hormone changes, and is similiar to breast tenderness in women.

Causes:

Some degree of breast tenderness is normal. The discomfort may be caused by hormonal changes due to:
Menopause (unless a woman is taking hormone replacement therapy)
Menstruation and premenstrual syndrome(PMS)
Pregnancy -- breast tenderness tends to be more common during the first trimester and in women who are pregnant at a young age
Puberty in both girls and boys
Soon after childbirth, your breasts may become swollen with milk. This can be very painful and is usually accompanied by swelling. If you also have an area of redness, call your health care provider. Breastfeeding itself may also cause breast pain.

Other common causes of breast pain include:

Alcoholism with liver damage
Injury
Infection of the breast tissue (mastitis)
Fibrocystic breast changes are also a common cause of breast pain. Fibrocystic breast tissue contains lumps and bumps that tend to be more tender just before your menstrual period.
Certain medications may also cause breast pain, including digitalis preparations, methyldopa (Aldomet), spironolactone (Aldactone), certain diuretics, Anadrol, and chlorpromazine.
Shingles can lead to pain felt in the breast if the painful blistering rash appears on the skin over one of your breasts.

Breast Cancer

Breast cancer affects one in eight women during their lives. Breast cancer kills more women in the United States than any cancer except lung cancer. No one knows why some women get breast cancer, but there are a number of risk factors. Risks that you cannot change include

Age - the chance of getting breast cancer rises as a woman gets older
Genes - there are two genes, BRCA1 and BRCA2, that greatly increase the risk. Women who have family members with breast or ovarian cancer may wish to be tested.
Personal factors - beginning periods before age 12 or going through menopause after age 55

Other risks include being overweight, using hormone replacement therapy, taking birth control pills, drinking alcohol, not having children or having your first child after age 35 or having dense breasts.

Symptoms of breast cancer may include a lump in the breast, a change in size or shape of the breast or discharge from a nipple. Breast self-exam and mammography can help find breast cancer early when it is most treatable. Treatment may consist of radiation, lumpectomy, mastectomy, chemotherapy and hormone therapy.

Men can have breast cancer, too, but the number of cases is small.

Obstetrical & Pregnancy

Gynecology

Natural Family Planning

Contraception