Breast lumps or changes are a common health worry for most women. Women may have many kinds of breast lumps and other breast changes throughout their lives, including changes that occur with menstrual periods, pregnancy, and aging. Most breast lumps and breast changes are normal.
Breast changes in young girls
Breast development is the first sign of puberty in young girls. Usually, breasts begin as small, tender bumps under one or both nipples that will get bigger over the next few years. It is not unusual for one breast to be larger than the other or for one side to develop before the other. A girl may worry that a lump under the nipple is abnormal or a sign of a serious medical problem when it is a part of normal breast development.
Noncancerous breast changes
Common, noncancerous (benign) breast changes include:
- Sacs filled with fluids (cysts).
- Generalized breast lumpiness.
- Painless, movable, and firm round lumps (fibroadenomas).
- Damaged fatty tissue (fat necrosis).
- Growths inside the ducts (intraductal papillomas).
- Enlargement of lymph nodes in the breast.
- Breast pain (mastalgia).
- Breast infections (mastitis) or abscesses.
- Nipple discharge.
- Inflamed blood vessels (thrombophlebitis).
If a woman has breast implants, there could be changes in the implant over time. Normal activity or an injury to the breast can damage the implant, causing it to leak, deflate, or rupture. The implant may harden, develop ripples, shift position, or change shape. The implant may need to be removed and replaced if any of these changes occur.
Breast changes that need follow-up
Many women with breast pain or breast lumps worry about breast cancer.
There are two common methods of early detection:
- Mammogram. A mammogram is an X-ray of the breast that can often find tumors that are too small for you or your doctor to feel. Experts do not agree about when or how often women should have mammograms. Some recommend that you begin screening at age 40, and some recommend that you begin screening at age 50. Your doctor may suggest that you have a screening mammogram at a younger age if you have risk factors for breast cancer.
- Clinical breast examination (CBE). During your routine physical exam, your doctor may do a clinical breast exam. During a CBE, your doctor will carefully feel your breasts and under your arms to check for lumps or other unusual changes. Talk to your doctor about whether to have a clinical breast exam.
Breast self-examination (BSE) involves checking your breasts for lumps or changes while standing and lying in different positions and while looking at your breasts in a mirror. Once you know what your breasts normally look and feel like, any new lump or change in appearance should be evaluated by a doctor. Most breast problems or changes are not caused by cancer. But BSE should not be used in place of clinical breast examination and mammography. Studies have not shown that BSE alone reduces the number of deaths from breast cancer.
Early breast cancer is often seen on a mammogram before there are any symptoms. The most common symptom of breast cancer is a painless lump. But sometimes painful lumps are cancerous. Other symptoms of breast cancer include:
- Skin changes, such as dimpling or puckering.
- Nipple discharge.
- Darkening of the area around the nipple.
- A nipple being drawn inward.
- Any breast problem that lasts more than 2 weeks.
- A breast lump in a man.
Breast changes in boys
In men, enlargement of male breast tissue (gynecomastia) is a noncancerous breast change. Breast buds are common in teenage boys during puberty. The buds may last up to 2 years, but they tend to go away within the first year. Breast buds develop because of rapid changes in hormone levels.
Treatment of a breast problem depends on the cause of the problem.
Check your symptoms to decide if and when you should see a doctor.