If you have a new lump, pain or irritation that doesn't go away shortly after your period ends, you must have a diagnostic breast evaluation as soon as possible. This evaluation, which allows your physician to determine whether your condition is benign or malignant, includes a physical exam, either a diagnostic mammogram and/or diagnostic ultrasound exam (depending on such factors as your age or breast density), and possibly a needle biopsy. The latter is a process in which a radiologist inserts a needle into the breast to withdraw small bits of tissue. The tissue is analyzed for the presence of breast cancer.
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Learning More About Breast Cancer
This section contains information about breast conditions that are often harmless as well as information about breast cancer. It was written by Kevin M. Kelly, MD, who invented SonoCiné and is Director of Breast Imaging at Pasadena's Huntington Memorial Hospital and Hill Breast Center. We hope it helps you make informed decisions about your healthcare.
Benign Breast Conditions: Breast Lumps, Pain and Discharge Can Be Harmless
For every cancerous breast lump, at least 10 other breast lumps are benign and completely harmless. However, cancer can cause symptoms that mimic benign breast conditions. So, if you have any of the symptoms listed below that don't fade or disappear shortly after your period, you must have a diagnostic breast evaluation as soon as possible. Remember, early detection is your best chance for a cure.
There are three kinds of breast conditions that are usually benign but should be checked by a professional health care provider:
- Pain or tenderness, which can be accompanied by swelling
- Breast lumps or lumpiness, which can be accompanied by pain or swelling
- Discharge, accompanied by pain or swelling
Four factors cause benign breast changes:
Bra Underwires
The stiff underwires found in many bras are a very common cause of breast irritation. Underwires may dig into the flesh or rub up and down when a woman moves her arms. Irritation usually occurs at one end or tip of the underwire.
Caffeine
Caffeine can stimulate fluid production within the breast, which may aggravate existing irritation.
Genetics
Just as genetics determine your hair color and height, they may cause you to have lumpy breasts, also known as fibrocystic breasts. They may also make you more susceptible to the effects of caffeine.
Hormones (those that occur naturally or any supplements you are taking)
The hormones that regulate body processes, such as menstruation, may trigger an increase in the fluid in your breast. Hormones may also trigger discharge (see A Note About Discharge).Factors Work Together
Most benign breast conditions occur when more than one causal factor is present or pronounced. For instance, a woman who drinks coffee (caffeine) and has painfully tender breasts around the time of her period (hormonal changes) may be unusually sensitive to the physical effects of caffeine (genetic predisposition).Of course, we can't do anything about our naturally occurring hormones and if you're taking supplements under a doctor's care, it's unwise to stop. We also can't change our genetic structure. However, we can do something about the bras we wear or the caffeine we consume.
How To Lessen Benign Symptoms
Moderate Your Caffeine Intake
If your breasts become painful before you begin menstruating each month, we recommend that you stop all caffeine consumption during this time until your period is over. This means no coffee, cola drinks (diet or regular), chocolate, tea, some decaffeinated coffees and teas and certain pain medications.
If you or your doctor discover that underwire bras are causing irritation, it's wise to switch to a bra without any underwire. Sports bras and others are more suitable. If lumps persist one month after menstruation, consult your healthcare provider for evaluation. If your breasts differ in size, the larger breast may get unusually irritated by the tip of the bra wire along the outside of your breast. You may need a custom made bra to fit your breasts.
A Note About Fibrocystic Breasts
Fibrocystic symptoms such as lumps or areas of thickness are not malignant and do not turn into cancer. However, see your doctor if there is any change in the lumpiness of your breasts or if new lumps do not disappear after your period.
A Note About Discharge
Nipple discharge is usually caused by fibrocystic changes, abnormal hormonal production or benign ductal ectasia. The latter is a condition, usually occurring in women who have lactated, in which liquid collects in enlarged breast ducts. These are benign conditions, but we recommend checking with your physician for further evaluation.
When discharge occurs from both breasts (bilaterally) or is clear, greenish or slightly brown, it is almost always benign. However, discharge can be a sign of cancer. If your discharge is brown or red-brown, see your doctor.
