You're in the shower, and you feel a lump in your breast. You're cooking dinner, and you suddenly feel a shooting pain in your breast. You're getting dressed, and you notice nipple discharge. You might notice these changes at any moment. They can be scary -- and they often leave you unsure of what to do next.
Whether you notice the change or it's detected by your physician at a routine exam, such as a mammogram, MRI, or ultrasound, don't ignore it. Sometimes these changes are perfectly normal, and you can simply monitor the change on your own. Other times, it could be an indicator of something more.
Breast Changes: What's Normal, What's Not
Your breasts are made up of connective tissue, glandular tissue, and fatty tissue. These different kinds of tissue feel different. Connective tissue and glandular tissue feel and appear dense. Fatty tissue, on the other hand, is a little softer.
Most women will experience changes in their breasts over time -- pain, tenderness, even lumps. Many of these changes are caused by menstruation hormones.
Breast self-exams and regular check-ups can help you monitor your breast health and catch any problems early. With any cancer, it's easier to treat earlier because it will have had less time to spread.
Here's a look at which breast changes may be completely normal -- and ones that are not.
Breast Pain and Tenderness
Catherine M. Porter. DO, physician and fellowship-trained breast surgeon at Penn Women's Specialty Center, says breast pain in young women isn't usually something to worry about.
"If it gets worse before periods and resolves right after, that's reasonable," she says. And breast tenderness is also very common. Dr. Porter says that this can be caused by a poor-fitting bra, weight gain, or exercise.
As you age, you may experience more tenderness as your breasts respond to gravity and changes in weight. The best way to combat this is to wear a good-fitting bra for more support.
Sometimes, women blame menopause for breast pain. If your routine mammograms don't show any problems, it's more likely that the pain is due to lack of support. In addition to investing in a more supportive bra, Dr. Porter says that medicine such as aspirin or ibuprofen can alleviate the pain.
However, it's important to monitor the pain. Does the pain go away after your period? Have you tried wearing more supportive bras? Does it get worse or change with activity? If the pain persists, let your physician know.
Breast Lumps and Masses
Women in their 20s and 30s may experience lumps around the time they're menstruating. "If a 20 to 30-year-old notices a lump that came up and went away after their period, that's characteristic of a cyst," Dr. Porter says. She emphasizes that young women should still mention these changes to their physician despite having a lower risk.
"It's never safe to completely ignore a mass at any age," Dr. Porter says. "Women over 40 should definitely inform their physician, and all women should monitor any lump they find."
For women of all ages, a small amount of nipple discharge from both breasts can be completely normal. "This can happen with stimulation or pressure," Dr. Porter says.
Usually, it's nothing to be concerned about. But if nipple discharge occurs spontaneously, comes from just one breast, or contains blood, tell your physician what's going on, as this can be a sign of something more serious.
Changes in Breast Shape or Texture
Your breasts may not be the same size as each other, but they should change in the same way.
With self-exams, you should know what your breasts look like. "If your breasts change in shape or there are sudden changes in size that are not symmetrical, that should be investigated," Dr. Porter says.
Women over 60 should also keep an eye on the skin of their breasts. Talk to your physician if you notice any sudden changes in your skin's texture, like puckering, dimpling, redness, or itching.
Screening Can Save Lives
Breast self-exams are one of the key ways to find lumps -- approximately 40% of breast cancers are detected by women who feel a lump on their own.
Breast screening starts with you. You should do self-exams once a month to identify and monitor any changes. As Dr. Porter says, "Any abnormality could be problematic."
Ask your physician about when to start breast self-exams. It's important to become familiar with your breasts and monitor any changes, especially if you are over age 30.
A mammogram is an X-ray picture of the breast, and it can detect breast cancer up to three years before it can be felt. It uses the minimum amount of radiation necessary to get an image, and they're completely safe when used by a medical professional.
"Every woman should have a mammogram before the age of 50," Dr. Porter says. "At Chester County Hospital, our tomosynthesis mammograms provide 3-dimensional pictures of the breast which can help evaluate dense breast tissue."
Your physician may recommend you begin mammograms earlier because of risk factors such as family or personal history of cancer. Talk to your physician to see what age works best for you.
The Bottom Line
Along with your physician, monitoring changes in your breasts is key in detecting problems early. "Pain is almost always okay, but masses should always be investigated," Dr. Porter says. "And as you age, it becomes even more important to get any masses examined."
Getting checked regularly can put your mind at ease, and finding problems early may save your life.
If you have questions about your breast health or about breast imaging services at Chester County Hospital, call 800-789-7366 (PENN).
Dr. Catherine Porter sees patients at Penn Women's Specialty Center at the Fern Hill Medical Campus in West Chester, PA and at Penn Medicine Valley Forge.
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