Breast Health Awareness

You know your breasts best. At times you may have noticed that they felt especially tender or swollen, or even kind of lumpy. Most of those changes were probably perfectly normal – they were caused by hormonal changes related to your menstrual cycle, pregnancy, breastfeeding or getting older.

Some changes, however, do warrant further investigation. While some doctors no longer routinely recommend monthly breast self-exams, it is still important to know what is normal for your body and to report any changes to your doctor.

What's Normal and What's Not?

Your breasts are made up of glandular, connective and fatty tissues. These tissues support the production and delivery of breast milk, so it’s no surprise they often change in sync with your hormones. “Nearly half of all women notice that their breasts seem lumpy and dense just before their period,” says Harriet Borofsky, M.D., medical director of the Mills-Peninsula Women’s Center. “Although these changes may cause discomfort, they are usually harmless.”

A single distinct lump, on the other hand, should be reported to your doctor, especially if it remains unchanged through one or two menstrual cycles. Look for any lumps in or near your breast, as well as under your arm, that feel different from the surrounding tissues, Dr. Borofsky advises.

What else should you bring to your doctor’s attention?

• Areas in the breast or under the arm that feel swollen, or thicker or firmer than normal.
• Changes in the size or shape of your breasts.
• Changes in the skin over the breast, including redness, dimpling, scaling and irritation.
• Changes in the nipple, such as any discharge that is not breast milk, and abnormalities like an inverted nipple.

If anything seems amiss, your doctor might want to take a closer look with a physical exam, mammogram, MRI, ultrasound exam or other procedure. These tests can help to determine if a lump or other abnormality is a noncancerous, fluid-filled cyst or a solid mass.

Many cysts can be left alone. If it is painful, your doctor can treat it by draining the fluid.

If a lump is found not to be a cyst, the next step may be a biopsy to see if cancerous cells are present. A noncancerous tumor will likely be left alone, but closely monitored. If it is cancerous, there are many options for treatment.

“We encourage women to know their bodies and know their breasts,” Dr. Borofsky says. “If something feels different in your breast, contact your healthcare provider. We want to know to about it.”