Breast Problems
Topic OverviewBreast lumps or changes are a common health worry for most women.
Women may have many kinds of breast lumps and other
breast changes throughout their lives, including
changes that occur with menstrual periods, pregnancy, and aging. Most breast
lumps and breast changes are normal. Breast changes in young girlsBreast development is the first sign of puberty in young
girls. Usually, breasts begin as small, tender bumps under one or both nipples
that will get bigger over the next few years. It is not unusual for one breast
to be larger than the other or for one side to develop before the other. A girl
may worry that a lump under the nipple is abnormal or a sign of a serious
medical problem when it is a part of normal breast development. Noncancerous breast changesCommon, noncancerous (benign) breast changes
include: If a woman has breast implants, there could be changes in the implant over time. Normal activity or an injury to the breast can damage the implant, causing it to leak, deflate, or rupture. The implant may harden, develop ripples, shift position, or change shape. The implant may need to be removed and replaced if any of these changes occur. Breast changes that need follow-upMany women with breast pain or breast
lumps worry about breast cancer. There are two
common methods of early detection: - Mammogram. A mammogram is an X-ray of the breast that can often find tumors that are too small for you or your doctor to feel. Experts do not agree about when or how often women should have mammograms. Some recommend that you begin screening at age 40, and some recommend that you begin screening at age 50. Your doctor may suggest that you have a screening mammogram at a younger age if you have risk factors for breast cancer.
- Clinical breast examination (CBE).
During your routine physical exam, your doctor may do a clinical breast
exam. During a CBE, your doctor will carefully feel your breasts and
under your arms to check for lumps or other unusual changes. Talk to your doctor about whether to have a clinical breast exam.
Breast self-examination (BSE) involves checking your
breasts for lumps or changes while standing and lying in different positions
and while looking at your breasts in a mirror. Once you know what your breasts
normally look and feel like, any new lump or change in appearance should be
evaluated by a doctor. Most breast problems or changes are not caused by
cancer. But BSE should not be used in place of clinical breast examination
and mammography. Studies have not shown that BSE alone reduces the number of
deaths from breast cancer. Early breast
cancer is often seen on a
mammogram before there are any symptoms. The most
common symptom of breast cancer is a painless lump. But sometimes painful
lumps are cancerous. Other symptoms of breast cancer include: - Skin changes, such as dimpling or
puckering.
- Nipple discharge.
- Darkening of the area around
the nipple.
- A nipple being drawn inward.
- Any breast
problem that lasts more than 2 weeks.
- A breast lump in a man.
Breast changes in boysIn
men, enlargement of male breast tissue (gynecomastia) is a
noncancerous breast change. Breast buds are common in teenage boys during puberty. The buds may last up to 2 years, but they tend to go away within the first year. Breast buds develop because of rapid
changes in hormone levels. Treatment of a breast problem depends on the cause of the
problem. Check your symptoms to decide if and when
you should see a doctor. Check Your SymptomsDo you have a breast problem? This includes symptoms like pain, nipple discharge, lumps, and other breast changes. How old are you? 11 years or younger 11 years or younger 12 to 55 years 12 to 55 years 56 years or older 56 years or older Yes Symptoms of breast infection No Symptoms of breast infection Do you think you may have a fever? Are there red streaks leading away from the area or pus draining from it? Do you have diabetes or a weakened immune system? What weakens the immune system in an adult or older child may be different than in a young child or baby. Yes Diabetes or immune problem No Diabetes or immune problem Do you have breast pain that is not normal for you? Many women have breast pain at a certain point in their menstrual cycle every month. This type of pain might be normal for you. How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine? 8 to 10: Severe pain Severe pain 5 to 7: Moderate pain Moderate pain 1 to 4: Mild pain Mild pain Does the breast pain come and go? Have you had breast pain for more than 3 weeks? Yes Breast pain for more than 3 weeks No Breast pain for more than 3 weeks Do you think that a medicine may be causing your breast problem? Think about whether your breast problems started after you began using a new medicine or a higher dose of a medicine. Yes Medicine may be causing breast symptoms No Medicine may be causing breast symptoms Does home treatment help with breast pain related to your menstrual cycle? Yes Home treatment helps menstrual breast pain No Home treatment helps menstrual breast pain Have you noticed a lump or thickening in your breast or a change in the breast's size or shape? Yes Lump in breast or change in breast's size or shape No Lump in breast or change in breast's size or shape Many things can affect how your body responds to a symptom and what kind
of care you may need. These include: - Your age. Babies and older
adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
disease, you may need to pay closer attention to certain symptoms and seek care
sooner.
- Medicines you take. Certain
medicines, herbal remedies, and supplements can cause symptoms or make them
worse.
- Recent health events, such as surgery
or injury. These kinds of events can cause symptoms afterwards or make them
more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
use, sexual history, and travel.
Try Home TreatmentYou have answered all the questions. Based on your answers, you may be
able to take care of this problem at home. - Try home treatment to relieve the
symptoms.
- Call your doctor if symptoms get worse or you have any
concerns (for example, if symptoms are not getting better as you would expect).
You may need care sooner.
Many prescription and nonprescription medicines can cause
breast problems, such as breast tenderness or nipple discharge. A few examples
are: - Some antidepressants.
- Some blood
pressure medicines.
- Corticosteroids, such as
prednisone.
- Medicines that contain hormones, such as birth control
pills, hormone therapy, and infertility
medicines.
- Migraine headache medicines, such as sumatriptan.
Cimetidine, such as Tagamet, may cause nipple discharge and
breast enlargement in men. Symptoms of a heart attack may
include: - Chest pain or pressure, or a strange feeling in the chest.
- Sweating.
- Shortness of
breath.
- Nausea or vomiting.
- Pain, pressure, or a
strange feeling in the back, neck, jaw, or upper belly, or in one or both
shoulders or arms.
- Lightheadedness or sudden
weakness.
- A fast or irregular heartbeat.
The more of these symptoms you have, the more likely it is that
you're having a heart attack. Chest pain or pressure is the most common
symptom, but some people, especially women, may not notice it as much as other
symptoms. You may not have chest pain at all but instead have shortness of breath, nausea, or a strange feeling in your chest or other areas. Other breast symptoms to
pay attention to can include: - Skin changes, such as dimpling or
puckering.
- Nipple discharge.
- Darkening of the area around
the nipple.
- A nipple being drawn inward.
- Any breast
problem that lasts more than 2 weeks.
Symptoms of a breast infection may
include: - Increased pain, swelling, redness, or warmth around
a breast.
- Red streaks extending from a breast.
- Drainage
of pus from a breast.
- Fever.
Certain health conditions and medicines weaken the immune system's ability to fight off infection and
illness. Some examples in adults are: - Diseases such as diabetes, cancer, heart disease,
and HIV/AIDS.
- Long-term alcohol and drug
problems.
- Steroid medicines, which may be used to treat a variety
of conditions.
- Chemotherapy and radiation therapy for
cancer.
- Other medicines used to treat autoimmune
disease.
- Medicines taken after organ transplant.
- Not
having a spleen.
Certain health conditions and medicines weaken the immune system's ability to fight off infection and
illness. Some examples in children are: - Diseases such as diabetes, cystic fibrosis, sickle
cell disease, and congenital heart disease.
- Steroid medicines,
which are used to treat a variety of conditions.
- Medicines taken
after organ transplant.
- Chemotherapy and radiation therapy for
cancer.
- Not having a spleen.
Pain in adults and older children - Severe pain (8 to 10): The pain
is so bad that you can't stand it for more than a few hours, can't sleep, and
can't do anything else except focus on the pain.
- Moderate pain (5 to 7): The pain is bad enough to disrupt your
normal activities and your sleep, but you can tolerate it for hours or days.
Moderate can also mean pain that comes and goes even if it's severe when it's
there.
- Mild pain (1 to 4): You notice the pain,
but it is not bad enough to disrupt your sleep or activities.
Seek Care TodayBased on your answers, you may need care soon. The
problem probably will not get better without medical care. - Call your doctor today to discuss the symptoms
and arrange for care.
- If you cannot reach your doctor or you don't
have one, seek care today.
- If it is evening, watch the symptoms and
seek care in the morning.
- If the symptoms get worse, seek care
sooner.
Call 911 NowBased on your answers, you need
emergency care. Call911or other emergency services now. Make an Appointment Based on your answers, the problem may not improve without medical
care. - Make an appointment to see your doctor in the
next 1 to 2 weeks.
- If appropriate, try home treatment while you
are waiting for the appointment.
- If symptoms get worse or you have
any concerns, call your doctor. You may need care sooner.
Seek Care NowBased on your answers, you may need care right away. The problem is likely to get worse without medical care. - Call your doctor now to discuss the symptoms and
arrange for care.
- If you cannot reach your doctor or you don't have
one, seek care in the next hour.
- You do not need to call an
ambulance unless:
- You cannot travel safely either by driving
yourself or by having someone else drive you.
- You are in an area
where heavy traffic or other problems may slow you down.
Home TreatmentBreast self-exams are a simple way
for you to learn what your breasts normally feel like. During a breast
self-exam, you examine your own breasts to look and feel for changes from one
month to the next. You will learn how your breasts feel and what is normal for
you so that you can spot any changes early. For more information about how to
do a breast self-exam, see the topic
Breast Self-Examination. If you have pain or a fever from a breast problem or injury, you can try nonprescription medicines for your symptoms. Medicine you can buy without a prescription Try a nonprescription
medicine to help treat your fever or pain: |
---|
Talk to your child's doctor before switching back and
forth between doses of acetaminophen and ibuprofen. When you switch between two
medicines, there is a chance your child will get too much medicine. | Safety tips Be sure to follow these
safety tips when you use a nonprescription medicine: |
---|
- Carefully read and follow all directions
on the medicine bottle and box.
- Do not take more than the
recommended dose.
- Do not take a medicine if you have had an
allergic reaction to it in the past.
- If
you have been told to avoid a medicine, call your doctor before you take
it.
- If you are or could be pregnant, do not take any medicine other
than acetaminophen unless your doctor has told you to.
- Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.
| Alternative medicines or supplements
may help relieve breast tenderness, discomfort, or pain (mastalgia). Some studies have shown that
magnesium reduces mild premenstrual symptoms. As with
all alternative medicines and supplements, be sure to follow the
directions on the label. Do not exceed the maximum recommended dose. If you are
or could be pregnant, talk with your doctor before taking any medicine or
supplement. For more
information, see the topic
Fibrocystic Breasts. Symptoms to watch for during home treatmentCall your doctor if any of the following occur during home
treatment: - Skin changes, such as dimpling or
puckering.
- Nipple discharge.
- Darkening of the area around
the nipple.
- A nipple being drawn inward.
- A breast lump in a man.
- Symptoms of an infection develop.
- Symptoms that become more severe or more frequent.
PreventionTo prevent breast tenderness, discomfort,
or pain (mastalgia), follow these tips: - Wear a sports bra during exercise. A sports bra may prevent breast discomfort, pain, and injury
during exercise or sports. It is important that the sports bra fit properly. It
should keep the breasts almost motionless and allow them to move together with
the chest, not separately. Be sure to replace your sports bra as the
material stretches and become less supportive. A sports bra may need to be
replaced every 6 months if it is used regularly.
- Limit your salt intake. High salt intake may cause fluid
retention. Fluid retention may be the cause of premenstrual breast
tenderness.
To prevent nipple irritation during exercise: - Cover your nipple with a small bandage or a dab
of petroleum jelly before you exercise.
- Wear a sports bra that fits
you properly. Avoid sports bras that are lined with cotton.
- Avoid
exercising in cold temperatures.
- Wear a vest or jacket made from
fabric that blocks the wind.
Preparing For Your AppointmentTo prepare for your appointment, see the topic Making the Most of Your Appointment. You can help your
doctor diagnose and treat your condition by being prepared to answer the
following questions: - What symptoms do you have?
- How long
have you had your symptoms? Do your breast changes occur at the same time each
month?
- What is your age and general health?
- Do you have
menstrual periods? Are your periods regular?
- Are you
pregnant?
- Have you had children? Did you breastfeed? Are you
currently breastfeeding?
- Have you had a
breast infection (mastitis) or a blocked milk duct in
the past?
- What prescription and nonprescription medicines are you
taking?
- Have you ever been diagnosed with breast lumps or had any
fluid or
cysts drained from your breasts?
- Have you
ever had a
mammogram or
breast ultrasound?
- Have you ever been
diagnosed with
breast cancer?
- Do you have any relatives
who have noncancerous (benign) breast lumps or breast cancer?
- Do
you have any
health risks?
ReferencesOther Works Consulted- American Cancer Society (2009). Prevention and Early Detection: American Cancer Society Guidelines for the Early Detection of Cancer. Atlanta: American Cancer Society. Available online: http://www.cancer.org/docroot/PED/content/ped_2_3X_ACS_Cancer_Detection_Guidelines_36.asp.
- U.S. Preventive Services Task Force (2009). Screening for breast cancer. Available online: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm.
CreditsByHealthwise Staff Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency Medicine Adam Husney, MD - Family Medicine Current as ofMarch 20, 2017 Current as of:
March 20, 2017 Last modified on: 8 September 2017
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