Women’s breasts are complex structures, changing naturally with age and hormone fluctuations from menstruation, breastfeeding, and menopause. Even different medications can affect how your breasts feel.
Some breast changes, though, are diagnosable conditions. Of course, you know to discuss changes that could be signs of cancer with your doctor, but there are others that aren’t cancerous now, but may put you at a higher risk for the disease later.
That said, most breast changes are nothing quite that serious. “In 80% of women who come in with a lump, it will be benign,” says Monique Swain, MD, an obstetrician and gynecologist in the breast division of Henry Ford Health System in Detroit.
Most breast conditions–whether they involve lumps or not–can be effectively treated.
Here’s a guide to the different conditions that can affect your breasts.
Fibrosis, sometimes known as having fibrocystic breasts, is one of the most common breast conditions a woman can have, even more common if you’re still in your childbearing years. It means you have extra tissue in your breasts that would normally be found in scars or ligaments, making your breasts feel ropy or lumpy. The extra breast tissue can also feel rubbery or firm. Some women describe the feeling “as a bag of marbles–very, very lumpy,” says Dr. Swain.
Fibrosis doesn’t raise your risk for breast cancer and, in most cases, doesn’t even need to be treated unless the symptoms are bothersome. Some women report that cutting back on caffeine improves fibrosis symptoms like pain. Over-the-counter pain relievers may also help.
Unlike fibrosis, which stays relatively stable, breast cysts can move around your breasts and tend to wax and wane with your menstrual cycle. These fluid-filled lumps may get bigger and more painful just before your period.
“Cysts are nodules. You can feel them when they’re large enough,” says Lauren S. Cassell, MD, chief of breast surgery at Lenox Hill Hospital in New York City. “You can [also] see them on a sonogram. They look like little Swiss cheese holes.”
Cysts don’t need to be treated unless they’re uncomfortable, in which case the fluid can be drained with a hollow needle. Cysts generally don’t raise the risk of breast cancer unless they’re “complex cysts,” meaning they have both a fluid and a solid component. These need to be biopsied to make sure there’s no cancer.
This is a benign breast condition that happens when the lobules (the milk-producing glands inside your breast) get enlarged and proliferate. Adenosis is usually found by accident, when doctors do a biopsy of cysts or fibrosis.
“You can’t tell by feeling,” says Dr. Cassell. “The only way is to see something on a mammogram or sonogram.” It can be difficult to tell adenosis and breast cancer apart on these imaging tests, however, so adenosis usually requires a biopsy to rule out cancer. If no malignancy shows up on the biopsy, adenosis doesn’t need to be treated, Dr. Cassell adds.
Some lobules also contain scar-like tissue. This condition, called sclerosing adenosis, can be painful.
Fibroadenomas are made up of glandular and stromal (connective) tissue, and they can be felt. They’re usually round, firm or rubbery, and can be moved around–but they’re typically not painful.
Experts don’t know what causes fibroadenomas, but estrogen may be involved. “They become enlarged when a woman is on birth control pills, menstruating, and pregnant,” says Dr. Swain. Fibroadenomas also tend to go away after menopause.
Some fibroadenomas can increase your risk of breast cancer and need to be monitored and sometimes removed.
Breastfeeding mothers, in particular, are susceptible to mastitis, an inflammation in the breast usually caused by an infection. The infection may be caused by a clogged milk duct or small lacerations in the breast that bacteria can enter.
In addition to swelling, your breasts may hurt, appear red, and feel warm to the touch if you have mastitis. Some women also have flu-like symptoms like fever and a headache.
Mastitis itself doesn’t increase your risk of breast cancer, but it can be confused with inflammatory breast cancer (IBC), a rare and aggressive form of the disease. If antibiotics don’t succeed in resolving mastitis, you may need a skin biopsy to make sure you don’t have a malignancy.
Hyperplasia is an overgrowth of extra cells in the ducts and/or milk glands in your breast. It can be called ductal hyperplasia or lobular hyperplasia depending not so much on where the cells are growing but on what they look like under the microscope. Hyperplasia isn’t cancer per se, but certain types can raise your risk for cancer.
If you have cells that look relatively normal (called “usual hyperplasia”), your risk for breast cancer is not elevated. “Atypical hyperplasia” is when the cells look abnormal under a microscope. This can raise your risk as much as fivefold.
If you have hyperplasia (usually seen on a mammogram and diagnosed with a biopsy), talk to your doctor about how to manage any increased risk of breast cancer.
There are many different types of breast cancer–not to mention individual preferences for screening and treatment. “Breast cancer is not one disease. Each patient’s history is their history, and their disease is not what their friend has,” says Dr. Cassell.
At its core, breast cancer is an abnormal change to breast tissue that keeps reproducing. Some women may notice a lump while others may notice changes in the skin of their breast or their nipple.
Fortunately, an array of different treatments has emerged to treat breast cancer. “Treatment is very much tailored [to the individual],” says Dr. Cassell.
To help determine treatment, doctors look at factors including the size of the tumor, whether the cancer has spread to the lymph nodes, whether the tumor has estrogen and progesterone receptors, and if it expresses the protein HER2/neu, which can be elevated in some cancer patients.
Eczema is technically a skin condition, not a breast condition, but it can certainly affect breasts. Symptoms include dry, red, scaly skin and itchiness. The condition is chronic, meaning it never goes away. Instead, symptoms tend to reappear.
When it comes to eczema on your breasts, the most important thing is to make sure it is not a rare form of breast cancer known as Paget’s disease. This type of breast cancer and eczema “can look very similar–even to the experienced eye–and sometimes it requires biopsy of the skin and underlying tissue to determine,” says Dr. Cassell.
If it is eczema, treatment is the same as it would be on any other part of your body: smart skincare and sometimes medicated creams or ointments.
Like eczema, psoriasis is a dermatological condition that can affect any area of skin, including your breasts. Psoriasis is an autoimmune disease–when your immune system flips and starts attacking healthy cells–so it can sometimes lead to wider damage throughout your body, including heart disease and psoriatic arthritis, if it’s not controlled.
In psoriasis, the misfiring immune system causes skin cells to die at an accelerated rate. Because of that, cells accumulate on your skin, creating silvery scales and red patches that itch and may hurt. It’s chronic and often requires prescription medications.
If you had chickenpox when you were young and think you are safe from any related problems, you could be wrong: Shingles can be a later-in-life consequence of having had the childhood disease.
Shingles occurs when the varicella zoster virus, the virus that causes chickenpox, re-erupts in your body, causing a rash with blisters on one side of your body, sometimes including your breast. Other than a visible rash, the most common complaint is severe pain.
Newer vaccines can help prevent shingles, though they don’t eliminate the risk. If you do get shingles, you generally have to wait out the outbreak, although pain medications can help you get through it.
In addition to eczema, psoriasis, and breast conditions like mastitis, IBC, and Paget’s disease, you could also have rashes on the skin of your breasts from other causes. That includes yeast infections, hives, and scabies (caused by mites), as well as intertrigo, a rash that can appear anywhere skin folds. Folds of skin cause friction and trap moisture, leading to red, raw, or cracked skin and a hospitable environment for yeast, fungus, or bacteria.
Most rashes can be handled with simple skincare steps you can take at home: Don’t scratch, don’t use products with fragrances, and stop using any new products you think might have caused or contributed to the rash. Keep the area dry as much as you can.
If the rash doesn’t go away, gets worse, or comes with fever or severe pain, contact your doctor. It’s probably not breast cancer, but you definitely want to make sure.
Yes, you can get pimples on your breasts. “Most people get acne on the face, however acne can affect other parts of the body, such as the breast and chest,” says dermatologist Michele S. Green, MD, also with Lenox Hill Hospital.
Chest or breast acne can be caused or aggravated by stress, hormones, diet, and certain topical medications, Dr. Green says. Birth control pills may help if hormones are a culprit. Wearing breathable fabrics when you work out, taking a shower afterwards, and using oil-free sunscreen on your chest can also minimize outbreaks.
Follow the same skincare habits you would for acne on your face, Dr. Green adds. “Cleanse your skin using a non-comedogenic cleanser containing glycolic acid or salicylic acid,” she says. “After cleansing, towel dry with a clean towel and apply moisturizer containing salicylic acid, benzoyl peroxide, or glycolic acid. If your skin becomes too dry, alternate between a non-comedogenic moisturizer.
Tea tree oil and topical zinc have antibacterial properties that may help reduce acne on your breasts or chest, as well.
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