Your breasts go through changes when you have your period, when you’re pregnant or breastfeeding, and when you go through puberty and its flip side, menopause. If you are a transgender woman, you will also have breast changes while taking hormone treatments. But outside of these times, what’s normal? And when should you check in with your doctor?
Each breast has 15 to 20 sections, or lobes, that surround the nipple like spokes on a wheel. Inside these lobes are smaller lobes called lobules. At the end of each lobule are tiny "bulbs" that make milk. These are linked together by small tubes called ducts, which carry milk to the nipples.
The nipple is in the center of a darker area of skin called the areola. The areola contains small glands called Montgomery glands, which lubricate the nipple during breastfeeding. Fat fills the spaces between the lobes and ducts.
There are no muscles in the breasts, but the pectoral or chest muscles lie under each breast and cover the ribs.
Each breast also contains blood vessels, as well as vessels that carry a fluid called lymph. Lymph travels throughout the body through a network called the lymphatic system. The lymphatic system carries cells that help the body fight infections. The lymph vessels lead to the lymph nodes (small bean-shaped glands).
Breast development and function depend on the hormones estrogen and progesterone, which are made in the ovaries. Estrogen elongates the ducts and makes them create side branches. Progesterone increases the number and size of the lobules in order to prepare the breast for feeding a baby.
After ovulation, progesterone makes the breast cells grow and blood vessels enlarge and fill with blood. At this time, the breasts often become engorged with fluid and may be tender and swollen.
Here’s what to know about breast issues that you may notice.
Lumps in Breasts
Try not to worry. But do see your doctor to find out what it is. This is especially important if you notice large lumps in your armpit or if the bumpy area doesn’t go away after 6 weeks.
Your doctor will check your breasts and will probably recommend a mammogram and possibly other tests. They may use a needle to remove a bit of the fluid from the area or take a small sample of the lump for more testing.
It’s a good idea to get to know what’s normal for your breasts. That way, if you notice something different, you can work with your doctor to find out what it is.
Breast Color and Texture Changes
If the skin around your breasts becomes dimpled, itchy, scaly, or red, you should see your doctor. They may just keep an eye on this or order a biopsy -- removing a small piece of tissue -- to make sure everything is OK.
You could have redness or irritation on your breast, or you could have a rash that's itchy, painful, scaly, or blistered. If you see or feel any of these things, you should see your doctor.
You could have something that's also common in other parts of your body, including:
- Candidiasis (a fungal infection caused by yeast)
- Cellulitis (a bacterial skin infection)
- Seborrheic dermatitis (a skin condition)
There are some rashes that you'd get only on your breast. Causes for these include:
- An abscess
- Mammary duct ectasia (when milk ducts beneath your nipple get wider)
- Mastitis (a breast tissue infection usually tied to breastfeeding)
- Nipple dermatitis
A rash on your nipple can also be a sign of a couple of different types of breast cancer. One rare form, Paget's disease of the breast, starts on the nipple and spreads to the skin around it (which your doctor may call your areola). The other, inflammatory breast cancer, makes your breast red, swollen, and tender. It happens when cancer cells block lymphatic vessels in your breast skin.
This includes any fluid that comes out of your nipple. It can happen during pregnancy and breastfeeding. It can even continue up to 2 years past the time you stop nursing. This is all normal.
A milky-white leakage from both breasts can also happen before menopause. This is due to hormones. It’s not uncommon.
But if the discharge is bloody, greenish, or clear; if it affects only one breast; if there’s a lump; or if it happens without prodding, see your doctor, whether you’re in menopause or not. The cause could be an infection, a sac filled with fluid called a cyst, other lumps that aren’t cancer (such as fibroadenomas), or cancer.
Your doctor will give you a checkup, including a physical exam of both breasts. They’ll ask about your symptoms and family medical history. You may also get a mammogram or sonogram to check inside the breast.
Your nipples are sensitive, and they can hurt for lots of reasons, from clothes that fit poorly to more serious reasons.
Skin conditions like dermatitis, contact dermatitis, and eczema can cause pain in your nipples. Pregnancy or breastfeeding can do it, too. For some, nipples that hurt can be a sign that a period is coming. Infections like mastitis and thrush can also aggravate them.
Sore nipples may make you worry about breast cancer. But while they can be a sign of breast cancer, it's hardly ever the main symptom.
Every once in a while, you might look down and see something different with your nipples.
If you notice hair on them, don't worry. That dark circle around your nipple (called an areola) has hair follicles, so it can happen occasionally. You can cut any hair there with some small scissors.
Many people develop inverted nipples. Your doctor may call them retracted. This can be a normal part of aging, can happen when you’re breastfeeding, or may happen after you've had surgery on your breast. It can be a result of a breast injury as well.
Some people are born with inverted nipples.
If your nipples are newly inverted, you should see your doctor. They could be a sign of mastitis, mammary duct ectasia, or an abscess under your areola.
If it happens suddenly to one or both nipples, nipple inversion could be a sign of breast cancer.
Soreness and Tenderness in Breasts
It could be your period. A lot of people who menstruate feel this way before or during their periods. This is normal, and usually, the pain goes away on its own. But get the pain checked out if it gets worse, if it’s in one area of your chest, or if it affects your daily routine (like working out or picking up your kids).
Things that can cause breast pain include birth control pills, a large cup size, and hormones. During your exam, your doctor may consider whether it might help to change the type of birth control pills (if you’re on them) or adjust your hormone therapy (if you take it for menopause symptoms). For some types of breast pain, it may help to cut down on caffeine.
If you're feeling pain in your armpit and aren't sure where it comes from, you should see your doctor.
While it could be something as simple as a muscle strain or swollen lymph nodes caused by a viral infection, armpit pain could also be a sign of breast cancer.
You might have no symptoms of cancer in your breast. But underarm pain and swelling could mean that cancer has spread from your breast into your lymph nodes.
Changes in Breast Size or Shape
Your breasts may change during different points in your life. For instance, this can happen when you have your period and when you’re pregnant, often enlarging due to hormones.
Once you reach menopause, you may feel like your chest sags, becoming smaller and losing its shape. This is normal.
But if you notice changes outside of this time -- if your breasts look or feel different -- check with your doctor to make sure everything is OK.