Breast 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 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 changes
Common, noncancerous (benign) breast changes
include:
Many women with breast pain or breast
lumps worry about breast cancer.
The earlier breast cancer is detected,
the more easily and successfully it can be treated.
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.
Changes in the color or feel of the
breast.
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 boys
In
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.
Breast 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:
Aspirin (also a nonsteroidal
anti-inflammatory drug), such as Bayer or Bufferin
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.
Alternative medicines or supplements
may help relieve breast tenderness, discomfort, or pain (mastalgia). 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.
Evening primrose. The latest research has shown that evening primrose oil is no better than a placebo, even after 6 months of treatment for breast pain.1 For more information on studies of evening primrose and breast symptoms, see the topic
Fibrocystic Breasts.
Magnesium. Some studies have shown that
magnesium reduces mild premenstrual symptoms. For more
information, see the topic
Fibrocystic Breasts.
Symptoms to watch for during home treatment
Call your doctor if any of the following occur during home
treatment:
To 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.
Goyal A (2011). Breast pain, search date May 2010. BMJ Clinical Evidence. Available online: http://www.clinicalevidence.com.
Other 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.
Credits
By
Healthwise Staff
Primary Medical Reviewer
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
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