Common breast problems

Monday 2 November, 2009

Reviewed by: Dr Meron Pitcher (Chair VCOG Breast Cancer Committee), Surgeon, Western Hospital

On this page: Breast pain | Hormonal changes Cysts Fibroadenomas Some other common ‘lumps’ Nipple discharge Inverted nipples | Sore, cracked and itchy nipples | Extra nipples  Breast and nipple infections


Breast pain

Breast pain is common and usually caused by hormonal changes during the menstrual cycle. Taking the contraceptive pill or hormone replacement therapy can also cause breast pain.

Some women experience breast pain every day, not just during the menstrual cycle. This pain is commonly associated with shoulder, neck and armpit pain and may be worse at the end of the day or after exercise.

For some women, breast pain may be severe enough to need some form of treatment.  

Tips to help relieve breast pain:

  • Try wearing a supportive bra, even in bed.
  • Try wearing no bra, or a loose-fitting bra.
  • Cut out coffee, tea and cola drinks to reduce caffeine.
  • Cut down on salt and fat in your diet.
  • Try vitamins B6 and B1: check with your doctor or pharmacist for the dose needed.
  • Evening primrose oil may help, but do not take it if you have epilepsy.
  • Try holding a hot water bottle to your breasts or having a hot bath or shower.
  • A cold shower or icepack may be more helpful for some women.
  • Try gentle relaxation techniques or gentle massage.
  • Talk to your doctor about trying anti-inflammatory medication.
  • If you are taking hormone replacement therapy, talk to your doctor about going off it for a while to see if that helps or discuss changing your prescription.

If none of these help, you may need to see a GP who will refer you to a breast specialist. Contact the Cancer Council on 13 11 20 for more information.

If you develop breast pain and it is not a usual part of your monthly cycle, have it checked by your doctor. While there's usually another explanation, sometimes unusual breast pain can be a sign of breast cancer.

Hormonal changes

These are changes that can cause swelling, lumpiness or tenderness of the breast. Many women experience such changes as hormone levels affect their breast tissue during their menstrual cycle.

They usually happen during or just before a period. Women taking hormonal treatments for contraception (such as the ‘pill') or hormone replacement therapy may also experience these changes. 

Cysts

Cysts occur when fluid becomes trapped in the breast tissue. They are very common in women aged 35 to 50. They usually disappear with menopause, but are common in women taking hormone replacement therapy. Cysts may feel soft or firm and may sometimes be painful to touch. More than one cyst may grow at the same time. They are harmless, but to make absolutely sure that it is not cancer, your doctor should check any lump that can be felt. The fluid in cysts can be drained by a fine needle. Cysts can sometimes come back after draining. 

Fibroadenomas

Fibroadenomas are harmless lumps of glandular and fibrous tissue. They usually feel firm and rubbery and have a smooth texture. Fibroadenomas are common in women aged 20 to 40. We do not know their cause. They can be painless or become tender before periods. Some grow during pregnancy. As with all lumps, you should have them checked by your doctor.

Some other common ‘lumps’

Hardened scar tissue from an injury or previous breast surgery, such as a biopsy, can cause lumps or lumpiness. Silicone injected into the breasts for cosmetic reasons can sometimes harden and create lumps. Some women can feel their ribs through their breast tissue.

When a lump is being checked it is important to make your doctor aware of your full breast history.

Nipple discharge

Discharge from the nipple is quite common and is usually not a problem. Very rarely, a nipple discharge may be due to cancer or other diseases. See your doctor if you develop nipple discharge. Further tests may be needed, particularly if you have bloodstained or watery discharge, or if the discharge comes from only one breast.

If you are breastfeeding, it is quite normal for milk to leak from your nipples in between feeds. After you have stopped breastfeeding your baby (‘weaned'), you may still have a milky discharge. This is normal. Usually the discharge will gradually stop. If it doesn't, or if the colour or thickness of the discharge changes, see your doctor. 

Sore, cracked and itchy nipples

Breastfeeding can cause sore, cracked or itchy nipples. The skin around the nipple can split and become painful. Your doctor can recommend treatments that might help. If these changes develop when you are not breastfeeding or pregnant, see your doctor.

For more information on breastfeeding and related problems, contact your local community health service or maternal and child health nurse.

Inverted nipples

Some women have a nipple or nipples that are turned in or ‘inverted'. This is normal for them. An inverted nipple can develop after you have stopped breastfeeding or while you are pregnant.

If your nipple turns in and it hasn't in the past, it should be checked by your doctor. Occasionally it is a sign of a breast cancer under the nipple.

Extra nipples

Some people are born with extra nipples. This does not mean their risk of breast cancer is increased. Extra nipples are usually only removed by a doctor if the person does not like the way they look. They can develop the same problems as normal nipples.

Breast and nipple infections

Infections in the breast do not cause breast cancer but should be treated promptly.

If you develop any inflammation or infection in your nipples, see your doctor. It could be a sign of eczema (a common skin problem) or a condition such as duct ectasia. Duct ectasia occurs when a duct fills with waste matter from cells. There may be a sticky yellow-green to brown discharge. If the discharge becomes a problem, treatment may be needed.

Mastitis is a painful inflammation of the breast due to bacterial infection. It is often associated with breastfeeding and usually develops 2 to 6 weeks after giving birth. The breast becomes red, hot, swollen and painful. Flu-like symptoms can also develop. Mastitis can be treated with hot or cold packs and sometimes with antibiotics.

Symptoms of mastitis can sometimes be found in women who are not breastfeeding, for example, in women with diabetes, or in women with poor immune systems. Recurrent mastitis is often associated with smoking.


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