What are breast disorders?
Most women experience breast changes at some time. Your age, hormone levels, and medicines you take may cause lumps, bumps, and discharges (fluids that are not breast milk).
Breast disorders may be noncancerous (benign) or cancerous (malignant). Most are noncancerous and not life threatening. Often, they do not require treatment. In contrast, breast cancer can mean loss of a breast or of life. Thus, for many women, breast cancer is their worst fear. However, potential problems can be detected early when women regularly examine their breasts themselves, are examined regularly by their doctor, and have mammograms as recommended. Early detection of breast cancer is essential to successful treatment.
Some common breast disorders are:
- Fibrocystic breast changes – lumpiness, thickening and swelling, often just before 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 milk ducts
- Milk production when a woman is not breastfeeding
How common are breast disorders?
Breast disorders are common. Please discuss with your doctor for further information.
What are the symptoms of breast disorders?
The common symptoms of breast disorders are:
- Breast pain
- A discharge from the nipple
- Changes in the breast’s skin (for example, the breast’s skin may become pitted, puckered, red, thickened, or dimpled)
Breast symptoms do not necessarily mean that a woman has breast cancer or another serious disorder. For example, monthly breast tenderness that is related to hormonal changes before a menstrual period does not indicate a serious disorder.
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
You should contact your doctor if you have any of the following:
- A lump that feels distinctly different from other breast tissue
- A lump that is stuck to the skin or chest wall
- A lump that does not go away
- Swelling that does not go away
- Pitting, puckering, reddening, thickening, or dimpling in the skin of the breast
- Scaly skin around the nipple
- Changes in the shape of the breast
- Changes in the nipple, such as being pulled inward
- Discharge from the nipple, especially if it is bloody and/or occurs spontaneously (that is, without the nipple’s being squeezed or stimulated by other means)
What causes breast disorders?
The cause of a breast disorder will vary depending on the diagnosis. Some changes simply occur with age or changing hormone levels as the child matures into puberty. Others may be the result of congenital anomalies of the breast, infections, certain medications and genetic or hereditary factors.
What increases my risk for breast disorders?
Please discuss with your doctor for further information.
Diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How are breast disorders diagnosed?
A breast examination is done. With the woman sitting or lying down, the doctor inspects the breasts for irregularities in shape, a nipple that turns inward (inverted nipple), and lumps. The doctor also checks for dimpling, thickening, redness, or tightening of the skin over the breast. The nipples are squeezed to check for a discharge. The armpits are checked for enlarged lymph nodes.
The doctor may examine the breast and armpits with the woman in different positions. For example, while sitting, she may be asked to press her palms together in front of the forehead. This position makes the chest muscles contract and makes subtle changes in the breast more noticeable.
The doctor may review the technique for breast self-examination with the woman during the examination. Techniques for the doctor’s examination and self-examination are similar.
Imaging tests are used to
- Check for breast abnormalities before they are noticed (called breast cancer screening)
- Evaluate abnormalities that have been identified, such as a breast lump found during the doctor’s examination
Mammography involves taking x-rays of both breasts to check for abnormalities. A low dose of radiation is used. Only about 10 to 15% of abnormalities detected by mammography result from cancer. Mammography is more accurate in older women because as women age, the amount of fatty tissue increases, and abnormal tissue is easier to distinguish from fatty tissue than other kinds of breast tissue.
Recommendations for routine screening with mammography vary.
Screening mammography is usually recommended for all women starting at age 50, but some experts recommend starting at age 40 or 45. Mammography is then done every 1 or 2 years. Experts have different recommendations about when to start routine mammography because the benefit of screening is not as clear in women aged 40 to 49. Routine mammography may be stopped at age 75, depending on the woman’s life expectancy and her wish for continued screening.
Mammography may also be done if a woman or doctor finds a lump while examining the breasts or if a woman has breast pain or a discharge from the nipple. It can provide images of any abnormalities (such as a tumor or an abscess) and the tissues around the abnormality. It can also provide images of lymph nodes to check for abnormalities.
Ultrasonography can provide more information about abnormalities detected by mammography. For example, ultrasonography can show whether a lump is solid or is filled with fluid (a cyst). Cysts are rarely cancerous. Ultrasonography can also be used to help doctors place a biopsy needle into the abnormal tissue.
Magnetic resonance imaging (MRI) is done at the same time as mammography to screen women if they have an increased risk of developing breast cancer—for example, if they have a mutation in the gene for breast cancer (the BRCA gene). After breast cancer is diagnosed, MRI is used to identify abnormal lymph nodes and to determine the size and number of tumors. This information can help doctors plan surgery or other treatments.
How are breast disorders treated?
The treatment options available depend on the type of breast disorder you have. Many types of breast disorders don’t need treatment.
Some growths or masses may be removed surgically. Cysts may be drained using a very fine needle.
Treatment for some common breast conditions:
Fibrocystic breast changes
Most women who have fibrocystic breast disease don’t require invasive treatment. Home treatment is usually sufficient to relieve associated pain and discomfort.
Over-the-counter pain relievers such as ibuprofen (Advil) and acetaminophen (Tylenol) can usually effectively relieve any pain and discomfort. You can also try wearing a well-fitting, supportive bra to reduce breast pain and tenderness. Some women find that applying warm or cold compresses relieves their symptoms. Try applying a warm cloth or ice wrapped in a cloth to your breasts to see which works best for you.
If you receive a fibroadenoma diagnosis, it doesn’t necessarily have to be removed. Depending on your physical symptoms, family history, and personal concerns, you and your doctor can decide whether to have it removed or not.
Fibroadenomas that don’t grow and are definitely not cancerous can be closely monitored with clinical breast exams and imaging tests, such as mammograms and ultrasounds.
The decision to have a fibroadenoma removed typically depends on the following:
- If it impacts the natural shape of the breast
- If it causes pain
- If you’re concerned about developing cancer
- If you have a family history of cancer
- If you receive questionable biopsy results
If a fibroadenoma is removed, it’s possible for one or more to grow in its place.
Treatment options for children are similar to those followed for adults, but the more conservative route is favored.
Some treatments remove or destroy the disease within the breast and nearby tissues, such as lymph nodes. These include:
- Surgery to remove the whole breast, called a mastectomy, or to remove just the tumor and tissues around it, called a lumpectomy or breast-conserving surgery. There are different types of mastectomies and lumpectomies.
- Radiation therapy, which uses high-energy waves to kill cancer cells.
Other treatments destroy or control cancer cells all over the body:
- Chemotherapy uses drugs to kill cancer cells. As these powerful medicines fight the disease, they also can cause side effects, like nausea, hair loss, early menopause, hot flashes, and fatigue.
- Hormone therapy uses drugs to prevent hormones, especially estrogen, from fueling the growth of breast cancer cells. Medicines include tamoxifen (Nolvadex, Soltamox) for women before and after menopause and aromatase inhibitors including anastrozole (Arimidex), exemestane (Aromasin), and letrozole (Femara) for postmenopausal women. Side effects can include hot flashes and vaginal dryness. Some types of this therapy work by stopping the ovaries from making hormones, either through surgery or medication.
- Targeted therapy such as lapatinib (Tykerb), pertuzumab (Perjeta), and trastuzumab (Herceptin). These medicines prompt the body’s immune system to destroy cancer. They target breast cancer cells that have high levels of a protein called HER2. Palbociclib (Ibrance) and ribociclib (Kisqali) work by blocking a substance that promotes cancer growth. Along with letrozole, palbociclib, and ribpciclib are for postmenopausal women with certain types of advanced cancer.
You might get chemotherapy, hormone therapy, or targeted therapy along with surgery or radiation. They can kill any cancer cells that were left behind by other treatments.
Lifestyle changes & home remedies
What are some lifestyle changes or home remedies that can help me manage health condition?
Please discuss with your doctor for further information.
If you have any questions, please consult with your doctor to better understand the best solution for you.
Overview of Breast Disorders. http://www.merckmanuals.com/home/women-s-health-issues/breast-disorders/overview-of-breast-disorders. Accessed November 7, 2017.
Breast Diseases. https://medlineplus.gov/breastdiseases.html. Accessed November 7, 2017.
Fibrocystic Breast Disease. https://www.healthline.com/health/fibrocystic-breast-disease#overview1. Accessed November 7, 2017.
Fibroadenoma of Breast. https://www.healthline.com/health/fibroadenoma-breast#overview1. Accessed November 7, 2017.
Breast Cancer Treatment. https://www.webmd.com/breast-cancer/guide/breast-cancer-treatment. Accessed November 7, 2017.
Review Date: November 7, 2017 | Last Modified: November 7, 2017