Patient Education

Detecting And Treating Breast Problems

The processes of puberty, menstruation, pregnancy, breastfeeding, and menopause result in unique changes in your breasts.  These changes sometimes cause problems with your breasts, although usually minor. However, properly performed monthly self breast exams and regular visits to the doctor will improve detection of problems that might not be so minor, and can save your life. This page should help you learn about potential breast problems, the tests that help determine your breast health, and how to perform self breast exams.

WHAT ARE THE BREAST PROBLEMS THAT WOMEN MAY DEVELOP?

  • Benign Breast Problems: Most growths in the breasts are benign, meaning they are not cancerous. Usually, these lumps are caused by fibrocystic changes, which often occur at times when your hormone levels are changing. Fibrocystic changes cause lumpy breasts that are tender and cystic. Cysts are small sacs filled with fluid, and occur most often between the ages of 25-50. Usually, fibrocystic changes occur before your period when hormone levels cause the fibrous tissues to swell. Also, they may occur after menopause if you start hormone replacement therapy. Some studies suggest that eliminating caffeine intake and taking birth control pills will reduce breast pain. Another benign problem in breasts are fibro adenomas, which are solid and noncancerous.
  • Breast Cancer: Breast cancer is a very serious illness that is caused by a malignant growth in one or both breasts. It is the leading cause of cancer deaths in women ages 34-50.

HOW CAN BREAST LUMPS BE FOUND?

Breast screenings are very efficient ways for women to find breast lumps. There are three different ways of breast screening that may be done by you or your doctor:

  • Self-Breast Exams: This method of breast screening is done by you in the privacy of your own home. About 90% of all breast lumps are found through self breast exams, which is why it is very important to do them every month. These exams help you learn the shape and feel of your breasts which will make it easier to notice any changes. It is most effective when done after your menstrual period when your breasts are no longer swollen. Doing a monthly self breast exam is one of the best things you can do for your health, especially if you are over the age of 30.
  • Doctor’s Exam of Breasts: During a routine check-up, your doctor will examine your breasts for any new problems or growths. During this time, he or she will check for any changes in size or shape, then for puckering, redness, or dimpling of the skin. Your doctor will also check for any discharge coming from the nipple. 
  • Mammography: Mammography is a special type of X-ray device that is used to discover breast lump tissue before it can be felt. This is especially helpful for women over the age of 40, because breasts become less dense over time. Many women may feel slight discomfort with mammograms, because the breast tissue is compressed between plastic plates in order to administer the x-ray. If your mammogram shows an abnormality, an additional mammogram, ultrasound, MRI or biopsy may be recommended for further examination.  

WHAT ARE THE FACTORS THAT INCREASE THE RISK OF BREAST CANCER?

There are several different factors that increase a woman’s risk of developing breast cancer.  The risk of breast cancer increases with age.  Over 85% of cases are found in women 40+ years old. Other risks include menarche (when a girl has her first period), late pregnancy, and late menopause. Family history of breast cancer in a patient, sibling or offspring is a substantial risk factor.  Obesity is also another factor.

However, there are several factors that decrease your risk of breast cancer. This includes maintaining a healthy lifestyle.  For instance, exercising frequently and eating a low fat diet.  Also, your risk of developing breast cancer is reduced if you had a pregnancy before the age of 30.  Women who experience an early menopause have a lower risk of estrogen-related breast cancer but have a higher risk of osteoporotic fracture.

HOW CAN I PERFORM A SELF-BREAST EXAM?

Performing a self-breast exam is a quick, easy way to maintain your health. It can be performed in a few easy steps:

  1. Stand in front of a mirror in good lighting and place arms at your side.  Look specifically for any nipple discharge, redness, dimpling, or changes in the breast shape or size.
  2. Repeat step one with your arms above your head, and again with your  hands pressed tightly on your hips.
  3. Lie on your back and place your left hand behind your head.
  4. Use your right hand to gently feel your left breast in small, circular motions, keeping fingers flat and together.
  5. Start small circles at the outer edges of your breast, and then slowly moving inward, till you have covered all areas of your breast. Also check the area above your underarm, because that also contains breast tissue.
  6. Put your right arm behind your head, and use your left hand to repeat steps 4 and 5 on your other breast.

WHAT HAPPENS IF MY DOCTOR FINDS A LUMP?

Oftentimes, benign lumps will go away by themselves, or can be treated with birth control pills that help regulate estrogen. 

If your doctor diagnoses you with breast cancer, there are several different options that may be used to treat it. These treatments depend on the type of cells found, the location of the tumor, and whether or not the cancer has spread. Usually, a removal of the lump, called a lumpectomy, will be performed, in addition to radiation treatments. Sometimes, complete removal of the breast will be necessary, which is called a mastectomy. In some cases, hormone therapy and chemotherapy are used to treat breast cancer that has spread to the lymph nodes. 

The way your doctor chooses to treat your breast cancer depends on its severity and type. Oftentimes, medications will be used along with surgery, which allows for a better chance of recovery and remission.

IN CONCLUSION

Finding a lump can be a frightening experience.  Although most lumps turn out to be benign, all of them should be checked out by your doctor to determine if they are a sign of a more serious problem.