Common Breast Concerns
Most women, at some point in their lives, will visit their primary care doctor with a breast concern. Although breast issues can present in many different ways, some of the more common problems women may encounter are discussed here. For example, most breast lumps turn out to be normal breast tissue consisting of fibrous and fatty tissue, which can feel lumpier at different times of the menstrual cycle and with weight fluctuation.
Breast lumps may be due to cysts. Cysts are fluid-filled nodules that occur in women with fibrocystic disease. Fibrocystic disease is a benign (meaning noncancerous) condition in the breast. Although some women may develop large cysts that may be painful, these can be drained by the radiologist with a simple procedure to provide relief to the patient. Cysts may make breast self-exam and your doctor’s clinical breast examination more difficult. Your doctor may order a mammogram to see if any suspicious masses are hiding behind the cysts. Cancerous lumps may develop anywhere in the breast, including cystic areas, and be difficult to detect. In addition, the cysts make the breast tissue denser and more difficult to interpret on mammography. Breast ultrasound is an additional test frequently done when a lump is felt and in women with dense breast tissue. Ultrasound can easily identify cysts.
Cysts tend to worsen as you approach menopause, mainly if your menstrual cycles are irregular. Fortunately, after menopause, when the ovaries eventually stop hormone production, fibrocystic disease usually becomes less evident, and the breasts will become easier to examine. They may remain cystic, however, if certain medications prescribed by your doctor continue to be taken. In addition, if you are on estrogen replacement therapy, the cysts may return. Therefore, follow-up with your doctor is important if you have symptoms of persistent or new lumps.
Fibrocystic disease is most likely to occur between the ages of 40-50, but can occur at any age. Discontinuing coffee, tea, cola and chocolate can sometimes help lumps to decrease in size and reduce tenderness. Although caffeine should be stopped for at least two months to be fully effective, improvement in breast pain and lumps may happen sooner. Stopping caffeine may not get rid of fibrocystic disease, but it will likely reduce some of the breast discomfort. Other factors which may be associated with cysts are irregular menstrual cycles, hormonal therapy, soy products and increased stress.
Breast pain is a common occurrence. Most women have breast pain at one time or another, often more in one breast than the other. Sometimes the pain is only in one breast, and frequently in only one area of one breast. Breast pain is a common complaint and most likely not related to a serious concern. Sometimes pain seems to be radiating from the breast, when actually it’s really from a nearby anatomic location, such as the shoulder, neck or chest wall (usually caused by arthritis). Women may suffer from costochondritis and this may appear to be breast related pain. For this reason the mammogram is often normal when breast pain is present.
Most women feel some breast discomfort with their menstrual cycle. This is because the hormones (estrogen and progesterone) stimulate the glandular breast tissue. This may cause a small fluid accumulation in the tissue and can cause the breast tissue to be more lumpy and uncomfortable or even painful. Irregular menses are commonly associated with breast pain and swelling.
A lump can be caused by a fibroadenoma, which is a benign mass of the breast tissue and is more common in women under the age of 30. Fibroadenomas are common non cancerous tumors of the breast. Fibroadenomas are usually monitored by breast ultrasound in young women to establish that they remain stable over time or with mammography for women at the appropriate age for a yearly routine mammogram screening. If a fibroadenoma enlarges significantly or causes symptoms such as pain, surgery may be performed to remove it.
This page is intended as an educational resource only. It is not a substitute for professional care.
Please see your physician if you have any concerns about your health.