Fitness and health 27.10.2016 12:37 pm

Breast changes that should worry you

AFP/File / Mychele Daniau

AFP/File / Mychele Daniau

It is recommended that one gets a clinical breast exam every one to three years starting at the age of 20.

Pay attention to your breasts. Be informed: not all breast lumps are cancerous. It is however recommended that one gets a clinical breast exam every one to three years starting at the age of 20.

Non-Cancerous Breast Lumps

Finding a lump in your breast can be very scary. You need to know that not all lumps are cancerous. Benign breast conditions can occur in both women and men. Breast tissue changes during a woman’s entire life. It is sensitive to changing hormone levels during the menstrual cycle. Yes, if you notice any breast changes, you should go to your doctor or clinic right away to get them checked, but there is no need to panic.

Most breast lumps are benign, which means they’re not cancerous. Benign breast lumps usually have smooth edges and can move around like mice when you touch them. They are usually often found in both breasts.

There are a number of common causes of breast lumps, including normal changes in breast tissue, breast infection or injury, and medicines that may cause lumps or breast pain. Many benign breast conditions mimic the symptoms of breast cancer and need tests (and sometimes a biopsy) for diagnosis. Therefore, for any breast changes, please do see your doctor who will ask you some questions about your health history.

The doctor will perform a breast exam to feel for lumps or other changes in the breast tissue and under the arms. If there is fluid coming out of your nipple, your doctor will collect a sample and check for cancer cells. He may also do a mammogram or ultrasound to see if the lump is solid or filled with fluid.

Your doctor may order a biopsy. He will take a tiny sample of the lump with a needle or small cut and send it to a lab. A few factors can increase the risk of benign breast conditions, including menopausal hormone therapy, oral contraceptive use, a family history of breast cancer or benign breast conditions. Some lifestyle factors during the teen years may also affect the risk of benign breast conditions in adulthood.

For example, drinking alcohol and smoking during the teen years may increase the risk of benign breast conditions. Eating foods that contain carotenoids (like melons, carrots, sweet potatoes and squash), nuts and beans through the teen years may lower the risk.

How to make sure you are cancer-free Once you turn 20, your doctor may give you a breast exam in which he feels your breast tissue for changes. It is recommended that one gets a clinical breast exam every one to three years starting at 20. As you get older then it is time for regular mammograms. It’s best to talk with your doctor to decide the right time and how often, because experts disagree.

The American Cancer Society recommends getting one every year once you turn 45. Others say every two years when you turn 50 until you’re 74. If you’re at high risk for breast cancer, you should get a mammogram every year. You may start getting them at a younger age, too.

You may also get ultrasound screenings too. Breast MRI screening, in addition to mammogram, is used only if your lifetime risk of breast cancer is greater than 20%. Talk to your doctor to decide what may be best for you.

Eight common causes of breast lumps

Fibroadenomas

These are the most common benign tumours. If you push on them they are solid, round, rubbery lumps that move freely, hence they are termed breast mouse. They’re usually painless. Fibroadenomas happen when your body forms extra milk-making glands.

Women between 20 and 30 get them most often. They’re also more common in black women. They can be removed surgically.

Fibrocystic changes

These changes are often most noticeable during your 40s. They are the most common cause of benign breast lumps in women from 35 to 50.

There are normally changes that happen in a woman’s breast due to the normal monthly menstrual cycles. These are known as fibrocystic breast changes. Women with fibrocystic breasts usually get lumps in both breasts that increase in size and tenderness just before they get their period. They sometimes have nipple discharge as well. The lumps tend to subside after they get their period. These lumps are milk ducts and tissues around them that have grown and gotten wider to form cysts.

The cysts enlarge quickly in response to hormones released near your period. The lumps may be hard or rubbery and may be felt as a single (large or small) breast lump. Fibrocystic changes can also cause breast tissue to thicken. Postmenopausal women are less likely to have these types of breast changes.

That’s because they don’t have monthly changes in hormones. Fibrocystic breast changes do not require treatment, but your doctor may recommend things to help relieve monthly tenderness.

Simple cysts

Simple cysts are fluid-filled sacs that usually happen in both breasts. There can be one or many. They can vary in size. Tenderness and size often change with your menstrual cycle. Simple cysts can be treated through fine needle aspiration.

You don’t need surgery to do this. A small needle is used to suck out some cells from the breast lump. If the lump is a cyst, they can suck out the fluid and the cyst will collapse. Cysts can also go away on their own, so your doctor may choose to wait before trying to get rid of it.

Intraductal papillomas

These are small, wart-like growths in the lining of the mammary duct near the nipple. They usually affect women between 45 and 50. They can cause bleeding from the nipple. Treatment is usually surgical removal.

Traumatic fat necrosis

This happens when there is an injury to the breast, though you may not remember an injury happening. It causes fat to form in lumps that are generally round, firm, hard, and painless. You usually get one at a time.

It can be hard to tell if a lump from traumatic fat necrosis is that or something else until your doctor does a biopsy. These usually don’t need to be treated. But if the lump bothers you, it can be cut out.

Breast lumps in men

Men can have tender breast enlargement, often with a lump under the nipple. Sometimes this is in one breast, but it often happens in both. This non-cancerous condition is called gynaecomastia.

Mastitis

Sometimes a painful lump, with or without redness, is the first sign of an infection. Mastitis is an infection most common in breastfeeding moms. It’s caused by bacteria that get into the mammary ducts through the nipple. Infection happens in small pockets. You’ll feel tender, warm lumps in the breast. For relief, try a hot shower and let the warm water flow over your breasts. A warm compress can also help. Sometimes your doctor will prescribe an antibiotic.

Sclerosing adenosis

Sclerosing adenosis is made up of small breast lumps caused by enlarged lobules. A lump may be felt and may be painful. Sclerosing adenosis may be found on a mammogram. Because it has a distorted shape, it may be mistaken for breast cancer.

A biopsy may be needed to rule out breast cancer. Sclerosing adenosis does not need treatment. Sclerosing adenosis may be found with atypical hyperplasia, lobular carcinoma in situ (LCIS) or ductal carcinoma in situ (DCIS). Some studies have found sclerosing adenosis slightly increases the risk of breast cancer and others have found no increase in risk.

Breast changes that should worry you:

  • An area that is clearly different from any other area on either breast.
  • A lump or thickening in or near the breast or underarm that persists through the menstrual cycle.
  • A change in the size, shape, or contour of the breast.
  • A mass or lump that is growing bigger and bigger.
  • A marble-like area under the skin.
  • A change in the feel of the skin on the breast or nipple or how it looks. It could be dimpled, puckered, scaly or inflamed. Sometimes it can look like orange peel.
  • Clear or bloody fluid coming out of the nipple.
  • Red skin on the breast or nipple
  • Painful breast lumps.

 

Dr Dulcy Rakumakoe. Picture: Refilwe Modise

Dr Dulcy Rakumakoe. Picture: Refilwe Modise

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