It’s normal for the size, shape and texture of your breasts to fluctuate. Things like weight gain, exercise, age, pregnancy, breastfeeding and menopause can all cause “normal” breast changes. This guide will help you practice breast awareness, understand breast cancer risk factors, and gain tips to improve your breast health.
What’s Normal, What’s Not
Breasts come in different sizes, shapes, and textures. So how do you know what is “normal” and what to be concerned about? Here are some common things to look for when checking your breasts.
Lumps: When examining your breasts, feel around for something hard that doesn’t belong there. Lumpy tissue can be prevalent in fibrous breasts. However, if you find a small lump that feels like a frozen pea or lima bean, or smooth and very firm like a marble, get it checked by your doctor. Any change in your breast tissue—such as a new mass or a change in size or shape— should be examined.
Dense Breasts: Breast density refers to the appearance of the breast tissue on a mammogram. About half of all women have dense breast tissue. A common misconception is that lumpy breast tissue means it is dense. Your breasts can feel lumpy but not appear dense on a mammogram. Extreme breast density is associated with an increased risk of breast cancer. If you are notified that your breasts are dense, you should discuss your breast cancer risk factors and screening options with your doctor.
The Hewitt Center for Breast Wellness at Griffin Hospital utilizes the latest 3D technical innovations and screening protocols to allow detection of the smallest tumors. Studies show that 3D mammography, or tomosynthesis, offers such incredible detail that can detect high risk legions in dense breasts that could be missed on conventional 2D images. This technology also reduces the need for women to return for additional screenings because it increases physician confidence in the findings. Additionally, the Center offers breast ultrasound imaging for women with dense breast for even more confidence in the screening results.
Pain: Most women experience occasional breast tenderness. During menstruation and around the time of menopause, hormonal fluctuations and hormonal therapy can cause pain. If the discomfort or pain is persistent or only in one spot on the breast, your doctor may recommend diagnostic imaging.
Skin Color and Texture: Dimpling or thickening of breast skin that resembles an orange rind are symptoms often associated with inflammatory breast cancer, a rare but aggressive disease that usually does not involve a lump and may not be detected by a mammogram.
Nipple Discharge: Many women can express milky discharge from their nipples long after they’ve stopped breastfeeding, including greenish, tan, or even black discharge from multiple ducts. Occasional discharge is usually harmless, but you should check with your doctor if discharge comes out on its own (without squeezing), is bloody, or comes from a single duct on one breast. These can be signs of benign mass such as a papilloma, but can also indicate breast cancer. It’s important to consult your doctor if you experience these symptoms.
A mammogram is an X-ray of the breast and it is one of the best ways to find early signs of breast cancer because it can often detect lumps that are too small to be felt. Regular mammograms are one of the best tools doctors have to find breast cancer early and most doctors recommend an annual mammogram starting at age 40. Check with your doctor for personal recommendations based on your risk factors.
Between yearly clinical exams, doing monthly self-exams helps you check for lumps that are unusual or changes in the skin or nipple. Perform exams on the same day of each month. A good rule of thumb is to pick a day that you can remember easily, such as your birth date.
Risk Factors for Breast Cancer
Several factors can increase your risk for developing breast cancer. The most important ones are below.
Hereditary Risk Factors
- Family history of breast cancer
- Ashkenazi Jewish ancestry
- BRCA gene mutations, the most common hereditary cause of breast cancer
- Starting menstruation before age 12
- Menopause after age 55
Other Risk Factors
- Never been pregnant or first pregnancy after age 30
- Prolonged hormone therapy during menopause
- Hormonal birth control methods
- Alcohol consumption
- Poor diet
Speak with your doctor regarding your risks for breast cancer and any additional screenings that may be appropriate. It is also important to schedule a yearly mammogram, especially if you are 40-years-old or older.
Breast Health After Age 40
As you age, you'll notice physical changes in your breasts. During menopause or leading up to it, the glands that make milk shrink and they replaced with new fat tissue, so your bra-cup size may go up. Your breasts may also begin to sag.
During a woman’s menstrual cycle, estrogen stimulates the uterus and breast tissue. The more menstrual periods a woman has, the longer these tissues are exposed to estrogen, which is a risk factor of breast cancer. Your risk for breast cancer goes up as you get older and begin menopause, which is why it is so important to get regular mammograms.
Changes When You're Pregnant or Breastfeeding
During pregnancy, it's normal for your breasts to get larger, lumpier, and more tender. Your nipples will get darker and blood vessels may become more visible. Sometimes cysts (fluid-filled sacs) and other non-cancerous tumors can form or get larger during pregnancy.
Breastfeeding women may also experience sore or cracked nipples and in some cases, plugged milk ducts, which should be treated by a doctor to avoid developing mastitis, a painful
infection. Be sure to share concerns about breast changes related to pregnancy or breastfeed with your doctor.
Hormonal Birth Control
The two most common hormonal birth control options for women are birth control pills and hormone-secreting intrauterine devices (IUDs). The approaches differ, but both the pill and hormonal IUDs are similar in that each contains synthetic hormones. These contraceptives change your hormone levels, which can increase your risk for breast cancer.
However, once you stop taking the pill or remove the IUD, the risk of breast cancer begins to decrease, and over time, risk returns to that of women who have never taken the pill. It’s important to talk to your doctor about the pros and cons of birth control before starting a new method.
Healthy Eating and Lifestyle Habits
No matter your age, you can keep your breasts healthy with simple lifestyle habits. Limit alcohol to one drink a day or less, don’t smoke, and maintain a healthy weight. Eliminate processed and fried foods, and limit consumption of sugar, white flour and artificial ingredients. Eating a balanced diet of mostly vegetables, fruits, lean protein, and healthy fats is shown to prevent many forms of cancer.
Regular exercise is also a great way to reduce your risk for cancer. Strive to get at least 150 minutes of moderate exercise a week. By following these simple tips, you are already on your way to healthier breasts.
Even If You Think It's Nothing, Get Checked
Most breast changes or complaints are not caused by cancer, but it’s important to get them checked by a doctor. Never ignore a breast problem or wait to see if it goes away on its own. If it is cancer, it will be more curable the earlier it is detected. It's never too early to start thinking about how to have healthy breasts for life, or too late to make changes for the better.
To schedule your mammogram or to make an appointment regarding your breast health, call us at 203-732-7101.