By Patrice Cleveland
Changes in the Breast
A change in breast tissue doesn’t automatically mean you have cancer. Some changes in the breast are normal for your stage of life.
If you’re concerned, of course call the doctor, but there’s probably not a reason to panic.
Probably Not Anything to Worry About
Many changes in the breast are because of fluctuating hormones, such as when a woman is about to start her menstrual cycle or when she’s pregnant. Here are some times you may notice a difference in your breasts that’s not worrisome.
Before or during your cycle. Your breasts may feel swollen or tender, and that’s normal. You may even feel a lump because of extra fluid in your breast. You should always call a doctor if you feel a lump, but the doctor may schedule a return visit when you’re not on your cycle to check the breast.
During pregnancy. Your body undergoes a lot of changes during pregnancy, and one of them may be larger and more painful breasts. They may even feel lumpy as the glands that produce milk gear up for breastfeeding. While breastfeeding, you may also get a painful condition called mastitis when a milk duct becomes blocked. Mastitis causes the affected breast to become warm and feel lumpy and painful. You can get medications from your doctor to help.
Before and after menopause. Your hormone levels are changing, and that can make your breasts feel tender and lumpy. As your levels drop off after menopause, these conditions usually stop.
If you’re taking hormones, such as menopausal hormone therapy or birth control. These hormones may cause your breasts to become more dense, making a mammogram more difficult to read. Let your provider know about these and all other medications you take.
Symptoms to be Concerned About
If you feel any change in your breast that you’re worried about, even if it’s explained by one of the above reasons, call your doctor and have it checked out. Some symptoms that should raise a red flag are:
A lump or firm feeling in your breast or under your arm. It could be a hormonal change, but it could be something more nefarious. Do regular self-exams so that you know what your breasts feel like but remember, they’re no substitute for a mammogram.
Nipple changes or discharge. This discharge can be any of several colors or textures. It could be something as simple as an infection of the side effect of medications, but it should always be checked out.
Itchy, red, dimpled or puckered skin. Again, this could just be minor irritation, but it could be something worse. Call the doctor.
How to Do a Self-Exam
You should be checking your breast for changes at least once a month, according to the National Breast Cancer Foundation and Johns Hopkins Medical Center. About 40% of diagnosed breast cancers are detected by women who feel a lump and get it checked out. Here’s how to properly conduct a self-exam.
It’s Not a Mammogram
A self-exam is useful, but remember, it’s not the same as a mammogram or other imaging that can detect cancer in its very earliest stages. For the most effective medical care, combine self-exams with regular doctor’s appointments and age- and health-appropriate cancer screenings.
Some signs to look for during your breast exam are nipple tenderness, lumps, thickening, changes in skin texture or enlargement of pores in the skin of the breast. Also examine your underarm area as the breast tissue spreads around your sides and armpits.
When lying down, your breast tissue will spread against the chest wall. Place a pillow under your shoulder and raise that arm above your head. Using the opposite hand, move the pads of your fingers around your breast, covering the entire area and armpit. Use light, medium and firm pressure. Check for nipple discharge and lumps, then repeat for the other side.
In Front of a Mirror
With your arms at your sides, look at your breasts as you raise your arms over your head. You’re looking for changes in the contour, swelling, dimpling of the skin or changes in the nipples. Rest your palms on your hips and press firmly to flex your chest muscles. Look for dimpling, puckering or changes, particularly on one side. Don’t be alarmed if your breasts aren’t symmetrical; most women’s aren’t.
In the Shower
Hold one arm up and behind your head. Using your fingertips, check the entire breast and armpit area on that side by pressing down with light, medium and firm pressure. Look for lumps, thickening, a knot or any other changes.
If you notice any changes, don’t panic. Most lumps, even, aren’t cancer. But you do need to check with your doctor for a clinical exam whenever you have concerns. Combined with regular medical care and more in-depth screening, such as mammography, self-exams are a powerful tool in the early detection and successful treatment of breast cancer.
What is a Mammogram?
Mammograms are X-ray pictures of your breast. They can detect breast cancer early, when it’s most treatable.
Regular mammograms are some of the best tests doctors have to detect breast cancer early, the Centers for Disease Control and Prevention says.
When Should I Get a Mammogram?
The American Cancer Society recommends regular, annual mammograms for women 45-54 years old. Before then, women over 40 can start to have the annual screening with mammograms if they or their health care providers choose to. Women 55 and older can switch to mammograms every two years if they want. Screening should continue as long as a woman is in good health and expected to live 10 or more years. Because of family history, genetics or other factors, some women should also get MRIs along with their mammograms.
How is a Mammogram Done?
You’ll stand in front of an X-ray machine and a technologist will place your breast on a clear plastic plate. Another plate will firmly press your breast from above. The steps are repeated for a side view. The technologist will not be able to tell you your results; that has to wait for a radiologist. It may be uncomfortable, but it will only take a few minutes. Try not to schedule your mammogram near your menstrual cycle as this can make your breasts more tender and the X-ray more uncomfortable.
Don’t wear perfume, deodorant or powder as these products can show up as white spots on the mammogram. Try to wear a top with a skirt or pants instead of a dress as you’ll need to undress from the waist up.
When Will I Get My Results?
You will usually get your results within a few weeks. If you haven’t heard within 30 days, contact your health care provider or the mammography facility. If your mammogram is normal, you should continue to get mammograms at the regular intervals. Mammograms work best when they can be compared with previous ones.
If your mammogram is abnormal, that doesn’t necessarily mean you have cancer, but you should have additional mammograms, tests or exams. You may be referred to a breast specialist or a surgeon, but again, that doesn’t mean you have cancer or need surgery. These doctors are experts in diagnosing breast problems and they can do follow-up tests.