Breasts Diseases

Most women experience breast changes at some time. Your age, hormone levels and medicines you take may cause lumps, bumps and discharges.

If you have a breast lump, pain, discharge or skin irritation, see your health care provider. Minor and serious breast problems have similar symptoms. Although many women fear cancer, most breast problems are not cancer.

Some common causes of breast changes are

  • Fibrocystic breast condition - lumpiness, thickening and swelling, often associated with a woman's period
  • Cysts - fluid-filled lumps
  • Fibroadenomas - solid, round, rubbery lumps that move easily when pushed, occurring most in younger women
  • Intraductal papillomas - growths similar to warts near the nipple
  • Blocked or clogged milk ducts
  • Milk production when a woman is not breastfeeding
  • Injury

Check With Your Health Care Provider About Breast Changes

Check with your health care provider if you notice that your breast looks or feels different. No change is too small to ask about. In fact, the best time to call is when you first notice a breast change.

Breast changes to see your health care provider about:

A lump (mass) or a firm feeling

  • A lump in or near your breast or under your arm
  • Thick or firm tissue in or near your breast or under your arm
  • A change in the size or shape of your breast

Lumps come in different shapes and sizes. Most lumps are not cancer.

If you notice a lump in one breast, check your other breast. If both breasts feel the same, it may be normal. Normal breast tissue can sometimes feel lumpy.

Some women do monthly breast self-exams (BSE). Doing a BSE can help you learn how your breast normally feels, and make it easier to notice and find any changes. Talk with your health care provider if you would like to learn more.

Remember—getting mammograms and having a clinical breast exam (an exam done by a health care provider) on a regular basis are the best ways to find breast cancer early in most women.
Always get a lump checked. Don't wait until your next mammogram. You may need to have tests to be sure that the lump is not cancer.

Nipple discharge or changes

  • Nipple discharge (fluid that is not breast milk)
  • Nipple changes, such as a nipple that points or faces inward (inverted) into the breast

Nipple discharge may be different colors or textures. Nipple discharge is not usually a sign of cancer. It can be caused by birth control pills, some medicines, and infections.

  • Get nipple discharge checked, especially fluid that comes out by itself or fluid that is bloody.

Breast Changes That are Not Cancer

These changes are not cancer and do not increase your risk of breast cancer. They are called benign changes.

  • Adenosis: Small, round lumps, or a lumpy feeling that are caused by enlarged breast lobules. Sometimes the lumps are too small to be felt. If there is scar-like tissue, the condition may be painful and is called sclerosing adenosis.

  • Cysts: Lumps filled with fluid. Breast cysts often get bigger and may be painful just before your menstrual period begins. Cysts are most common in premenopausal women and in women who are taking menopausal hormone therapy.

  • Fat necrosis: Round, firm lumps that usually don't hurt. The lumps most often appear after an injury to the breast, surgery, or radiation therapy.

  • Fibroadenomas: Hard, round lumps that may feel like a small marble and move around easily. They are usually painless and are most common in young women under 30 years old.
  • Intraductal papilloma: A wart-like growth in a milk duct of the breast. It's usually found close to the nipple and may cause clear, sticky, or bloody discharge from the nipple. It may also cause pain and a lump. It is most common in women 35-55 years old.

Breast Cancer

Symptoms

Common symptoms of breast cancer include:

    • A change in how the breast or nipple feels
    • A lump or thickening in or near the breast or in the underarm area
    • Nipple tenderness
    • A change in how the breast or nipple looks
    • A change in the size or shape of the breast
    • A nipple turned inward into the breast
    • The skin of the breast, areola, or nipple may be scaly, red, or swollen. It may have ridges or pitting so that it looks like the skin of an orange.

Early breast cancer usually does not cause pain. Still, a woman should see her health care provider about breast pain or any other symptom that does not go away. Most often, these symptoms are not due to cancer. Other health problems may also cause them. Any woman with these symptoms should tell her doctor so that problems can be diagnosed and treated as early as possible.

Follow-up Tests to Diagnose Breast Changes

An ultrasound exam, an MRI, a biopsy, or other follow-up tests may be needed to learn more about a breast change.
"My doctor said my mammogram found something 'abnormal.' That scared me, so I went back for more testing. It turned out that I had a benign cyst. It wasn't cancer. That was a relief."

Ultrasound

An ultrasound exam uses sound waves to make a picture of breast tissue. This picture is called a sonogram. It helps radiologists to see if a lump or mass is solid or filled with fluid. A fluid-filled lump is called a cyst.

MRI

Magnetic resonance imaging, also called MRI, uses a powerful magnet, radio waves, and a computer to take detailed pictures of areas inside the breast. Sometimes breast lumps or large lymph nodes are found during a clinical breast exam or breast self-exam that were not seen on a mammogram or ultrasound. In these cases, an MRI can be used to learn more about these changes.

Breast biopsy

A breast biopsy is a procedure to remove a sample of breast cells or tissue, or an entire lump. A pathologist then looks at the sample under a microscope to check for signs of disease. A biopsy is the only way to find out if cells are cancer.

Biopsies are usually done in an office or a clinic on an outpatient basis. This means you will go home the same day as the procedure. Local anesthesia is used for some biopsies. This means you will be awake, but you won't feel pain in your breast during the procedure. General anesthesia is often used for a surgical biopsy. This means that you will be asleep and won't wake up during the procedure.

Common types of breast biopsies:

  • Fine-needle aspiration biopsy

    A fine-needle aspiration biopsy is a simple procedure that takes only a few minutes. Your health care provider inserts a thin needle into the breast to take out fluid and cells.

  • Core biopsy

A core biopsy, also called a core needle biopsy, uses a needle to remove small pieces or cores of breast tissue. The samples are about the size of a grain of rice. You may have a bruise, but usually not a scar.

  • Vacuum-assisted biopsy

A vacuum-assisted biopsy uses a probe, connected to a vacuum device, to remove a small sample of breast tissue. The small cut made in the breast is much smaller than with surgical biopsy. This procedure causes very little scarring, and no stitches are needed.

Your doctor may use ultrasound or mammography during a breast biopsy to help locate the breast change.

  • Surgical biopsy

A surgical biopsy is an operation to remove part, or all, of a lump so it can be looked at under a microscope to check for signs of disease. Sometimes a doctor will do a surgical biopsy as the first step. Other times, a doctor may do a surgical biopsy if the results of a needle biopsy do not give enough information.

When only a sample of breast tissue is removed, it's called an incisional biopsy. When the entire lump or suspicious area is removed, it's called an excisional biopsy.

If the breast change cannot be felt, wire localization, also called needle localization, may be used to find the breast change. During wire localization, a thin, hollow needle is inserted into the breast. A mammogram is taken to make sure that the needle is in the right place. Then a fine wire is inserted through the hollow needle, to mark the area of tissue to be removed. Next, the needle is removed, and another mammogram is taken. You then go to the operating room where the surgeon removes the wire and surrounding breast tissue. The tissue is sent to the lab to be checked for signs of disease.

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