Understanding Breast Changes: A Health Guide for All Women

by National Cancer Institute

Breast Basics

The breast is a gland that produces milk in late pregnancy and after childbirth.

What are breasts made of?

• Each breast is made of lobes.
• Lobes are groups of milk glands called lobules.
• Lobules are arranged around thin tubes called ducts.
• Ducts carry the milk to the nipple.
• These lobules and ducts make up the glandular tissue.

What is the lymphatic system?

The breasts also contain lymph vessels, which carry a clear fluid called lymph.

• The lymph vessels lead to small, round organs called lymph nodes. Groups of lymph nodes are found near the breast in the underarm, above the collarbone, in the chest behind the breastbone, and in many other parts of the body.

• The lymph nodes trap bacteria, cancer cells, or other harmful substances that may be in the lymphatic system. Their job is to make sure harmful substances are safely removed from the body.

See your health care provider about a breast change when you have:

• A lump in or near your breast or under your arm
• Thick or firm tissue in or near your breast or under your arm
• Nipple discharge or tenderness
• A nipple pulled back (inverted) into the breast
• Itching or skin changes such as redness, scales, dimples, or puckers
• A change in breast size or shape

If you notice a lump in one breast, check the other breast. If both breasts feel the same, it may be normal. You should still see your health care provider for a clinical breast exam to see if more tests are needed.

Types of Breast Changes

Breast changes occur in almost all women. Most of these changes are not cancer. However, some breast changes may be signs of cancer. Breast changes that are not cancer are called benign.

Lumpiness

Most women have some type of lumpiness in their breasts. Some areas may be more dense than others and can feel lumpy in an exam. What you are feeling may be glandular breast tissue.

Breast Changes Due to Your Period

Many women have swelling, tenderness, and pain in their breasts before and sometimes during their periods. You may also feel one or more lumps during this time because of extra fluid in your breasts.

Because some lumps are caused by normal hormone changes, your health care provider may suggest watching the lump for a month or two to see if it changes or goes away.

Single Lumps

Single lumps can appear at any time and come in various types and sizes. Most lumps are not cancer, but your health care provider should always check the lump carefully. He or she may do more tests to make sure the lump is not cancer.

Check with your health care provider if you notice any kind of lump. Even if you had a lump in the past that turned out to be benign, you can't be sure that a new lump is also benign.

Nipple Discharge

Nipple discharge is common for some women. It is fluid that comes from the nipple in different colors or textures. Usually, it is not a sign of cancer. For example, birth control pills and other medicines, such as sedatives, can cause a little discharge. Certain infections also cause nipple discharge. However, for women who are going through or have passed menopause, nipple discharge can be a sign of cancer.

See your doctor if you have nipple discharge for the first time, or a change in your discharge's color or texture. He or she may send a sample of the discharge to be checked at a lab.

Finding Breast Changes

There are two ways to find breast changes:

• Clinical breast exams — a breast exam done by your health care provider
• Mammograms — an x-ray of your breasts

One way to find breast changes is with a clinical breast exam done by your health care provider. He or she will check your breasts and underarms for any lumps, nipple discharge, or other possible changes. This breast exam should be part of a routine medical check-up.

The best tool for finding breast cancer is a mammogram. A mammogram is a picture of the breast that is made by using low-dose x-rays. It is currently recommended that women over age 40 receive a mammogram every 1 to 2 years.

Some women check their own breasts for changes. If you find a change, it's important to call your health care provider for an appointment. Make sure to watch the change you found until you see your provider. But a breast self-exam and a clinical breast exam are not substitutes for mammograms. Questions to ask your health care provider about a breast change

• How can I tell the difference between my usual lumps and lumps I need to do something about?
• How will you be able to tell what kind of breast change I have?
• What should we do to watch this change over time?

Mammograms

Mammograms are used for both screening and diagnosis.

A screening mammogram is used to find breast changes in women who have no signs of breast cancer. Most women get two x-rays of each breast.

If your recent screening mammogram revealed a breast change since your last one, or if you or your health care provider noticed a change, he or she will probably recommend a diagnostic mammogram. More x-rays are taken during a diagnostic mammogram than a screening mammogram to get clearer, more detailed pictures of the breast. It is also used to rule out other breast problems.

Tip

Take your original mammogram and copy of the medical report with you if you change doctors or centers or need a second opinion.

A digital mammogram is another way to take a picture of your breasts. The procedure for having a digital mammogram is the same as a screening mammogram, except that it records the x-ray images in computer code instead of on x-ray film.

About the Author

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