What Is A Normal Breast
No breast is typical. What is normal for you may not be normal for another woman. Most women say their breasts feel lumpy or uneven. The way your breasts look and feel can be affected by getting your period, having children, losing or gaining weight, and taking certain medications. Breasts also tend to change as you age. For more information, see the National Cancer Institutes Breast Changes and Conditions.external icon
Getting Ready To See The Doctor
- If you are still having periods, make an appointment for about 3 to 5 days after your period, if possible.
- Make a list of all medications, vitamins and supplements that you take regularly.
- Keep a note of the times and days when you have pain. Download a breast pain chart.
- Note any other symptoms like skin changes in the area or nipple discharge.
- Write down any questions you would like to ask your doctor.
Causes Of Breast Pain
Many women do experience breast pain, but there are a lot of causes, Dr. Takabe says. Oftentimes, we cannot pinpoint the reason. Infection is a common source. It could be from drinking too much coffee, from being stressed out or because of age. Sometimes women will come in and say they have pain in their breast but, upon examination, its a skin lesion or boil, not pain from a gland within the breast.
There are also major muscle groups in the same physical area as breast tissue the muscles used when doing a push-up, for example and pain that feels like its in the breast could originate in those muscles due to strain or overuse. Even more frequently, especially as you age, you start to feel the pain in between your ribs, which is underneath your breast, he says.
Mammograms also can identify growths within breast tissue other than cancerous lumps or tumors: Benign tumors happen in the breast regularly. We see them all the time. A cyst might show up as a benign tumor but its just a bag of fluid and oftentimes, they will go away. Fibroadenomas are typical benign tumors that can regress with age. Unless they get bigger, we leave them alone. Cancerous tumors will invade the lymph nodes and keep spreading thats why we cant leave them alone.
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Implications For Research And Practice
Referral of women with breast pain only is not cost-effective and may cause delay for women with higher-risk symptoms. It is an apposite moment to consider more suitable pathways for those women requiring high-quality breast care advice but not a cancer diagnosis service. There is good level II evidence of the value of primary care reassurance and advice as a significant component in the care of women presenting with breast pain alone. This can be reinforced with online resources. Most breast pain is self-limiting and will settle in a matter of weeks or months. In women presenting to primary care with breast pain alone, therefore, deferring referral to secondary care for a period of time may allow spontaneous resolution, averting unnecessary medical intervention for many women without compromising care and enabling more effective use of finite resources.
The findings indicate that women with breast pain alone should be reassured that they have no higher risk of breast cancer than asymptomatic women. They deserve high-quality information and reassurance plus considered advice on how to alleviate their breast pain symptoms. Redirecting women with breast pain alone away from secondary care to more appropriate care pathways will create extra capacity within breast cancer diagnostic clinics for women with true red-flag symptoms that have a clear link to breast malignancy.
Nipple Retraction Or Inversion
Breast cancer can cause cell changes behind the nipple. These changes can result in the nipple inverting and reversing inward into the breast, or it may look different in terms of its size.
The appearance of the nipples can often alter during ovulation or other parts of the menstrual cycle, but people should see a doctor about any new nipple changes.
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Tests At The Breast Cancer Clinic
If you have suspected breast cancer you’ll be referred to a specialist breast cancer clinic for further tests. This referral will be because of your symptoms or because your mammogram has shown an abnormality,
Mammogram and breast ultrasound
If you have symptoms and have been referred to a specialist breast unit by your GP, you’ll probably be invited to have a mammogram if you are over 35 years old. This is an X-ray of your breasts. You may also need an ultrasound scan.
If your cancer was detected through the BreastCheck screening programme, you may need another mammogram or ultrasound scan.
Ultrasound uses high-frequency sound waves to produce an image of the inside of your breasts. It helps to determine the nature of a lump or of the abnormality. It may be needed to find out if a lump in your breast is solid or contains liquid.
Your breasts are made up of thousands of tiny glands that produce milk. This glandular tissue contains a higher concentration of breast cells than other breast tissue, making it denser.
Dense breast tissue can make a mammogram difficult to read. Lumps or areas of abnormal tissue are harder to spot.
Younger women tend to have denser breasts. This is why mammography is not routinely performed in women under 35 years. As you get older, the amount of glandular tissue in your breasts decreases and is replaced by fat. This means your breasts become less dense.
Expert Review And References
- American Cancer Society. Breast Cancer. 2015: .
- de Boer M, van Dijck JA, Bult P, Borm GF, Tjan-Heijnen VC. Breast cancer prognosis and occult lymph node metastases, isolated tumor cells, and micrometastases. Journal of the National Cancer Institute. Oxford University Press 2010.
- Lonning PE. Breast cancer prognostication and prediction: are we making progress?. Annals of Oncology. Oxford: Oxford University Press 2007.
- Morrow M, Burstein HJ, and Harris JR. Malignant tumors of the breast. DeVita VT Jr, Lawrence TS, & Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins 2015: 79: 1117-1156.
- Tripathy D, Eskenazi LB, Goodson, WH, et al. Breast. Ko, A. H., Dollinger, M., & Rosenbaum, E. Everyone’s Guide to Cancer Therapy: How Cancer is Diagnosed, Treated and Managed Day to Day. 5th ed. Kansas City: Andrews McMeel Publishing 2008: pp. 473-514.
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Lump In Breast Hurts Or Painful Lump In Breast
Conditions whereby one develops lumps on the breast, or hard lump inside the breast are very common. This usually depends on which period a woman is experiencing these symptoms. For example, when a teenage girl begins to develop breasts, during menstrual periods and pregnancy, women usually experience numerous kinds of breast pain associated with other changes. These lumps on breast are usually painful but not always.Therefore, a lump on breast associated with a lot of pain is a common condition in women. Those lumps that occur during pregnancy are not usually painful. Also, older women rarely experience a painful lump in their breast. Although pain is usually a point of concern, breast cancer does not base on pain as the only symptom.
Common Causes Of Benign Breast Lumps
Most benign breast lumps and conditions are directly related to your menstrual cycle, to fluctuations in your hormones, and to the fluid buildup that comes with your monthly period. Other benign breast lumps and conditions may be related to plugged milk ducts, infections, or even breast injuries. The risk for benign breast conditions increases for women who have never had children and those who have a history of irregular menstrual cycles or a family history of breast cancer.
Here are some of the most common benign breast conditions.
Fibrocystic changes These changes cause a general lumpiness that can be described as ropy or granular, and affect at least half of all women. Symptoms of fibrocystic change include tender, fibrous, rubbery tissue a thickening of tissue or a round, fluid-filled cyst. These changes, which are related to hormonal fluctuation, may increase as you approach middle age and disappear with menopause. Sometimes doctors recommend limiting salt and caffeine consumption to ease fluid buildup. Birth control pills may also ease symptoms.
Mastitis An infection of the milk duct, mastitis can create a lumpy, red, and warm breast, accompanied by fever. It occurs most commonly in women who are breastfeeding, but can occur in non-breastfeeding women as well. Treatment involves warm compresses and antibiotics. Because these symptoms are similar to inflammatory breast cancer, if they occur in a non-breastfeeding woman a doctor may want to do a biopsy.
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Does Breast Pain Increase Breast Cancer Risk
Though it’s uncommon, there are some painful breast conditions that may raise your risk of developing breast cancer. Both radial scars and multiple or complex fibroadenomas increase your risk of breast cancer Many breast conditions which cause pain pose little to no increased risk of breast cancer. Duct ectasia does not increase the risk of developing breast cancer, and while simple fibroadenomas do not increase the risk of breast cancer, complex fibroadenomas only slightly increase the risk.
When To See Your Healthcare Provider
It’s important to talk to your healthcare provider if you have breast pain from any cause. Even if it’s not due to cancer, many women find that breast pain decreases their quality of life. In one study, 15% of women experienced breast pain at some time in their life that interfered with work and family activities. Make sure to talk to your healthcare provider if you are experiencing any unusual discomfort.
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Metastatic Breast Cancer Symptoms
Metastatic breast cancer symptoms depend on the part of the body to which the cancer has spread and its stage. Sometimes, metastatic disease may not cause any symptoms.
- If the breast or chest wall is affected, symptoms may include pain, nipple discharge, or a lump or thickening in the breast or underarm.
- If the bones are affected, symptoms may include pain, fractures, constipation or decreased alertness due to high calcium levels.
- If tumors form in the lungs, symptoms may include shortness of breath or difficulty breathing, coughing, chest wall pain or extreme fatigue.
- If the liver is affected, symptoms may include nausea, extreme fatigue, increased abdominal girth, swelling of the feet and hands due to fluid collection and yellowing or itchy skin.
- If breast cancer spreads to the brain or spinal cord and forms tumors, symptoms may include pain, confusion, memory loss, headache, blurred or double vision, difficulty with speech, difficulty with movement or seizures.
What Causes Breast Pain
There are a number of harmless causes for breast pain and tenderness that may primarily be related to changes in hormone levels. These can include:
- Puberty in girls and sometimes for boys, too
- Menstruation and premenstrual syndrome
- Pregnancy more often during the first trimester
- Days following childbirth as milk comes in Breastfeeding Mastitis, which is caused by a milk duct that is not properly draining and becomes infected, should be treated. It has no correlation with cancer, but it can become a serious infection if left untreated.
- A benign cyst
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What Medical Treatments Are There For Breast Lumps And Pain
- When your breast pain is severe enough to interfere with your lifestyle and when it occurs for more than a few days each month, you may be treated with medications.
- Before treatment is begun, document the frequency and severity of your pain on a daily basis for at least one to two menstrual cycles.
- This pain diary will also help check your response to treatment.
Yes Breast Cancer Can Hurt
by Patient Advocate
The myth that breast cancer doesn’t hurt causes way too much pain! Like many myths, this one has roots in a fact. Compared to a breast cyst, which is often very tender to the touch, a cancerous lump usually doesn’t hurt when a woman or doctor feels it.
We hear many reports from women that go something like this:
I found this lump in my breast, so I went to see the doctor. It really hurt when he did the exam. He told me not to worry because breast cancer doesn’t hurt, but I am worried. Shouldn’t he have ordered a mammogram or ultrasound to see what it is?
Probably the doctor made a determination based on the shape, texture and tenderness of the lump that it was a cyst. I hope that what he said to the patient was, “Usually a painful lump like this is not breast cancer.” However, what the patient took away was the message that breast cancer doesn’t hurt. And yes, he should have ordered an ultrasound. An ultrasound is an easy, comparatively inexpensive test that can usually tell for sure whether a lump is a harmless, fluid-filled cyst.
Our community member Peglove recently wrote a describing her experience with a painful lump:
Fortunately, Paget’s is not usually an aggressive form of breast cancer, but sometimes it is associated with other tumors inside the breast. For this reason it is important to see a doctor, especially for a rash on just one side.
Love, S. and K. Lindsey.Dr. Susan Love’s Breast Book, 5th ed. Da Capo Press, 2010.
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Are There Different Types Of Breast Pain
There are two distinct types of breast pain, which are:
- Cyclic breast pain. This type of breast pain lines up with your menstrual cycle. Because of that, its more common in 20-to-50-year-old women and its particularly common in women who are on the younger end of that range. You may have breast pain in one breast or both, and it typically occurs due to natural hormonal shifts. Roughly a week before your period, you may start to feel a little pain in the upper, outer parts of your breasts. Cyclic breast pain goes away naturally once you get your period, but returns during your next menstrual cycle. Most women dont experience this type of breast pain after menopause.
- Noncyclic breast pain. This type of breast pain has nothing to do with your menstrual cycle, and is more common in 40-to-50-year-old women.
Prognosis And Survival For Breast Cancer
If you have breast cancer, you may have questions about your prognosis. A prognosis is the doctors best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type, stage and characteristics of your cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis.
A prognostic factor is an aspect of the cancer or a characteristic of the person that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together. They both play a part in deciding on a treatment plan and a prognosis.
Doctors use different prognostic and predictive factors for newly diagnosed and recurrent breast cancers.
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Facts You Should Know About Breast Lumps In Women
- Breast lumps can be caused by infections, injuries, non-cancerous growths, and cancer.
- Breast cancer usually causes no pain in the breast. The symptoms of breast cancer include painless breast lumps, nipple discharge, and inflammation of the skin of the breast.
- The chances that a particular breast lump could be cancerous depends on many factors, including past medical history, physical examination, as well as genetic and other risk factors.
- The only way to be certain that a lump is not cancerous is to have a tissue sampling . There are several ways to do the biopsy. The treatment of a breast lump depends on its cause.
Men And Breast Cancer Warning Signs
Breast cancer isnt typically associated with people who were assigned male at birth. But male breast cancer can occur in rare instances at any age, although its more common in older men.
Many people dont realize that people assigned male at birth have breast tissue too, and those cells can undergo cancerous changes. Because male breast cells are much less developed than female breast cells, breast cancer isnt as common in this part of the population.
The most common symptom of breast cancer in people assigned male at birth is a lump in the breast tissue.
Other than a lump, symptoms of male breast cancer include:
- thickening of the breast tissue
- nipple discharge
- redness or scaling of the nipple
- a nipple that retracts or turns inward
- unexplained redness, swelling, skin irritation, itchiness, or rash on the breast
Most men dont regularly check their breast tissue for signs of lumps, so male breast cancer is often diagnosed much later.
Although a lump in the breast is typically associated with breast cancer, these lumps usually arent cancer. Most are benign, or noncancerous.
Common causes of benign breast lumps include:
With fat necrosis, the mass cant be distinguished from a cancerous lump without a biopsy.
Even though the majority of breast lumps are caused by less severe conditions, new, painless lumps are still the most common symptom of breast cancer.
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