Detecting and Treating Breast Problems

A woman’s breasts are always changing. They change during the menstrual cycle, pregnancy, breastfeeding and menopause (when menstrual periods end). Along with these normal changes, problems can arise. Most of the problems are minor, but a few can be serious. One major problem, breast cancer, is a leading cause of cancer deaths in women.

Your Breasts
Your breasts are made up of glands, fat and fibrous (thickened) tissue. They respond to changes in levels of the hormones estrogen and progesterone during your menstrual cycle.

Your breasts also change during pregnancy, breastfeeding and menopause.

Breast Problems in Women
Most breast problems produce only minor symptoms. Because all women are at risk for breast cancer, you should be aware of how your breasts feel. Regular breast self-exams can help. Tell your doctor if you notice any changes.

Most breast problems, especially in younger women, are benign (not cancer). Common symptoms include:

  • Lumps (which may be felt in one exact place or throughout the breast)
  • Discharge from the nipple
  • Tender areas

Benign Breast Problems
The most common problem is a benign condition called fibrocystic changes. With these changes a woman’s breast may feel lumpy and tender. Symptoms of fibrocystic changes include pain, itching, swelling and tenderness. These symptoms often occur in both breasts.

Cysts also may occur. A cyst is a small sac filled with fluid. It can be almost any size. Cysts occur most often in women aged 25-50 years.

Fibroadenomas are another common type of breast change. They are solid, benign lumps. They occur most often in young women.

Breast Cancer
Breast cancer is the second leading cause of death from cancer in women. If it is found and treated early, most women can be cured.

Screening for Breast Problems
Screening tests are used to find a health problem early. Three of the common tests for breast problems include:

  1. Mammography
  2. Doctor’s exam of the breasts
  3. Breast self-exam

Mammography
Mammography is used to examine the breast tissue by X-ray. It can find tiny lumps before they can be felt.

The test is more useful in women aged 40 years and older. Older women’s breasts are less dense, so it is easier to detect lumps.

Women aged 40-49 years should have mammography done every one to two years.

The Doctor’s Exam of the Breasts
Your doctor will examine your breasts during your routine checkups. Most women should be examined at least once a year.

The Breast Self-Exam
Self-exams help you learn the normal shape and feel of your breasts. They also make it easier to notice change.

Tests
If you have found a lump in your breast or the results of your mammogram are not complete, other tests may be used to help diagnose breast problems.

Ultrasonography
In ultrasonography, sound waves are used to create pictures of the inside of body organs or tissues, such as the breast.

Aspiration
Sometimes, when the doctor thinks you have a cyst, fluid or tissue is drawn through a needle to be examined. This is called needle aspiration.

Biopsy
The only way your doctor can find out the exact nature of a lump is to study cells from it or take a sample of it. To check a solid mass or a suspicious area, your doctor may suggest a biopsy. In a fine-needle biopsy (aspiration biopsy), a small sample of cells from the mass is drawn out through a needle to be examined.

Other types of biopsy use a surgical incision (cut). Part or all of the mass may be removed.

Finally…
Most breast problems are benign, but breast cancer can occur. Check your breasts every month. Follow your doctor’s advice about routine mammography. Breast problems can be treated with success if they are found early.

This excerpt from ACOG’s Patient Education Pamphlet is provided for your information. It is not medical advice and should not be relied upon as a substitute for visiting your doctor. If you need medical care, have any questions, or wish to receive the full text of this Patient Education Pamphlet, please contact your obstetrician-gynecologist.

To ensure the information is current and accurate, ACOG titles are reviewed every 18 months.

Copyright © November 2007 The American College of Obstetricians and Gynecologists