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Breast Problems

Topic Overview

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:

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.

Check Your Symptoms

Do you have a breast problem?
This includes symptoms like pain, nipple discharge, lumps, and other breast changes.
Yes
Breast problem
No
Breast problem
How old are you?
11 years or younger
11 years or younger
12 to 55 years
12 to 55 years
56 years or older
56 years or older
Are you male or female?
Male
Male
Female
Female
Could you be having symptoms of a heart attack?
If you're having a heart attack, there are several areas where you may feel pain or other symptoms.
Yes
Symptoms of heart attack
No
Symptoms of heart attack
Do you have symptoms of a breast infection?
Yes
Symptoms of breast infection
No
Symptoms of breast infection
Do you think you may have a fever?
Yes
Possible fever
No
Possible fever
Are there red streaks leading away from the area or pus draining from it?
Yes
Red streaks or pus
No
Red streaks or pus
Do you have diabetes or a weakened immune system?
What weakens the immune system in an adult or older child may be different than in a young child or baby.
Yes
Diabetes or immune problem
No
Diabetes or immune problem
Do you have breast pain that is not normal for you?
Many women have breast pain at a certain point in their menstrual cycle every month. This type of pain might be normal for you.
Yes
Breast pain
No
Breast pain
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
8 to 10: Severe pain
Severe pain
5 to 7: Moderate pain
Moderate pain
1 to 4: Mild pain
Mild pain
Does the breast pain come and go?
Yes
Recurrent breast pain
No
Recurrent breast pain
Have you had breast pain for more than 3 weeks?
Yes
Breast pain for more than 3 weeks
No
Breast pain for more than 3 weeks
Do you think that a medicine may be causing your breast problem?
Think about whether your breast problems started after you began using a new medicine or a higher dose of a medicine.
Yes
Medicine may be causing breast symptoms
No
Medicine may be causing breast symptoms
Does home treatment help with breast pain related to your menstrual cycle?
Yes
Home treatment helps menstrual breast pain
No
Home treatment helps menstrual breast pain
Have you noticed a lump or thickening in your breast or a change in the breast's size or shape?
Yes
Lump in breast or change in breast's size or shape
No
Lump in breast or change in breast's size or shape
Do you have other breast problems?
Yes
Other breast symptoms
No
Other breast symptoms

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines, herbal remedies, and supplements can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.
HomeTreatment
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Many prescription and nonprescription medicines can cause breast problems, such as breast tenderness or nipple discharge. A few examples are:

  • Some antidepressants.
  • Some blood pressure medicines.
  • Corticosteroids, such as prednisone.
  • Medicines that contain hormones, such as birth control pills, hormone therapy, and infertility medicines.
  • Migraine headache medicines, such as sumatriptan.

Cimetidine, such as Tagamet, may cause nipple discharge and breast enlargement in men.

Symptoms of a heart attack may include:

  • Chest pain or pressure, or a strange feeling in the chest.
  • Sweating.
  • Shortness of breath.
  • Nausea or vomiting.
  • Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
  • Lightheadedness or sudden weakness.
  • A fast or irregular heartbeat.

The more of these symptoms you have, the more likely it is that you're having a heart attack. Chest pain or pressure is the most common symptom, but some people, especially women, may not notice it as much as other symptoms. You may not have chest pain at all but instead have shortness of breath, nausea, or a strange feeling in your chest or other areas.

Other breast symptoms to pay attention to can 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.

Symptoms of a breast infection may include:

  • Increased pain, swelling, redness, or warmth around a breast.
  • Red streaks extending from a breast.
  • Drainage of pus from a breast.
  • Fever.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:

  • Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
  • Long-term alcohol and drug problems.
  • Steroid medicines, which may be used to treat a variety of conditions.
  • Chemotherapy and radiation therapy for cancer.
  • Other medicines used to treat autoimmune disease.
  • Medicines taken after organ transplant.
  • Not having a spleen.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in children are:

  • Diseases such as diabetes, cystic fibrosis, sickle cell disease, and congenital heart disease.
  • Steroid medicines, which are used to treat a variety of conditions.
  • Medicines taken after organ transplant.
  • Chemotherapy and radiation therapy for cancer.
  • Not having a spleen.

Pain in adults and older children

  • Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.
  • Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.
  • Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.
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Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.
HomeTreatment
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Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.
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Home Treatment

Breast self-exams are a simple way for you to learn what your breasts normally feel like. During a breast self-exam, you examine your own breasts to look and feel for changes from one month to the next. You will learn how your breasts feel and what is normal for you so that you can spot any changes early. For more information about how to do a breast self-exam, see the topic Breast Self-Examination.

If you have pain or a fever from a breast problem or injury, you can try nonprescription medicines for your symptoms.

Medicine you can buy without a prescription

Try a nonprescription medicine to help treat your fever or pain:

Talk to your child's doctor before switching back and forth between doses of acetaminophen and ibuprofen. When you switch between two medicines, there is a chance your child will get too much medicine.
Safety tips

Be sure to follow these safety tips when you use a nonprescription medicine:

  • Carefully read and follow all directions on the medicine bottle and box.
  • Do not take more than the recommended dose.
  • Do not take a medicine if you have had an allergic reaction to it in the past.
  • If you have been told to avoid a medicine, call your doctor before you take it.
  • If you are or could be pregnant, do not take any medicine other than acetaminophen unless your doctor has told you to.
  • Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.

Alternative medicines or supplementsmay help relieve breast tenderness, discomfort, or pain (mastalgia). Some studies have shown that magnesium reduces mild premenstrual symptoms. As with all alternative medicines and supplements, be sure to follow the directions on the label. Do not exceed the maximum recommended dose. If you are or could be pregnant, talk with your doctor before taking any medicine or supplement. For more information, see the topic Fibrocystic Breasts.

Symptoms to watch for during home treatment

Call your doctor if any of the following occur during home treatment:

  • Skin changes, such as dimpling or puckering.
  • Nipple discharge.
  • Darkening of the area around the nipple.
  • A nipple being drawn inward.
  • A breast lump in a man.
  • Symptoms of an infection develop.
  • Symptoms that become more severe or more frequent.

Prevention

To prevent breast tenderness, discomfort, or pain (mastalgia), follow these tips:

  • Wear a sports bra during exercise. A sports bra may prevent breast discomfort, pain, and injury during exercise or sports. It is important that the sports bra fit properly. It should keep the breasts almost motionless and allow them to move together with the chest, not separately. Be sure to replace your sports bra as the material stretches and become less supportive. A sports bra may need to be replaced every 6 months if it is used regularly.
  • Limit your salt intake. High salt intake may cause fluid retention. Fluid retention may be the cause of premenstrual breast tenderness.

To prevent nipple irritation during exercise:

  • Cover your nipple with a small bandage or a dab of petroleum jelly before you exercise.
  • Wear a sports bra that fits you properly. Avoid sports bras that are lined with cotton.
  • Avoid exercising in cold temperatures.
  • Wear a vest or jacket made from fabric that blocks the wind.

Preparing For Your Appointment

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

  • What symptoms do you have?
  • How long have you had your symptoms? Do your breast changes occur at the same time each month?
  • What is your age and general health?
  • Do you have menstrual periods? Are your periods regular?
  • Are you pregnant?
  • Have you had children? Did you breastfeed? Are you currently breastfeeding?
  • Have you had a breast infection (mastitis) or a blocked milk duct in the past?
  • What prescription and nonprescription medicines are you taking?
  • Have you ever been diagnosed with breast lumps or had any fluid or cysts drained from your breasts?
  • Have you ever had a mammogram or breast ultrasound?
  • Have you ever been diagnosed with breast cancer?
  • Do you have any relatives who have noncancerous (benign) breast lumps or breast cancer?
  • Do you have any health risks?

References

Other Works Consulted

  • American Cancer Society (2009). Prevention and Early Detection: American Cancer Society Guidelines for the Early Detection of Cancer. Atlanta: American Cancer Society. Available online: http://www.cancer.org/docroot/PED/content/ped_2_3X_ACS_Cancer_Detection_Guidelines_36.asp.
  • U.S. Preventive Services Task Force (2009). Screening for breast cancer. Available online: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm.

Credits

ByHealthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Adam Husney, MD - Family Medicine
Kathleen Romito, MD - Family Medicine

Current as ofNovember 20, 2017

Current as of: November 20, 2017

Author: Healthwise Staff

Medical Review: William H. Blahd, Jr., MD, FACEP - Emergency Medicine & Adam Husney, MD - Family Medicine & Kathleen Romito, MD - Family Medicine