Show AllCyclical breast pain, the most common type of breast pain, is associated with the menstrual cycle and is nearly always hormonal. Some women begin to have pain a few weeks before their menses around the time of ovulation (releasing of an egg) that lasts until the beginning of their menstrual cycle. The pain can range from barely noticeable to so severe that the woman cannot wear tight-fitting clothing or tolerate close contact of any kind. The pain may be felt in only one breast or may be felt as a radiating sensation in the under-arm region. The pain may also be a result of hormones received from contraceptive methods (i.e. birth control pills).
It may be helpful for women to chart their breast pain to determine if the pain is cyclical or not. With regular documentation, the relationship between the menstrual cycle and breast pain will emerge if one exists.
Physicians continue to study the role that hormones may play in cyclical breast pain and tenderness. These hormones include those that regulate the menstrual cycle (estrogen and progesterone) as well as the one responsible for producing milk (prolactin). Stress has also been shown to alter hormones and make breast pain more severe.
Cysts are fluid-filled sacs that develop in the breast tissue, and typically occur in women in their 30s and 40s. They often enlarge and become tender and painful just before the menstrual period and may seem to appear overnight. Some women with cysts also experience nipple discharge with color ranging from green to brown. Cysts are rarely dangerous and may be caused by a blockage of breast glands.
Cysts can feel either soft or hard. When close to the surface of the breast, cysts can feel like a large blister, smooth on the outside, but fluid-filled on the inside. However, when they are deeply imbedded in breast tissue, a cyst will feel like a hard lump because it is covered with tissue.
A physician may identify a lump as a cyst by physical examination, but many physicians confirm the diagnosis by mammography or ultrasound examination. The physician may then perform a fine-needle aspiration as the next step in diagnosing the cyst. This procedure involves guiding a very fine needle into the cyst and drawing the fluid from it. This procedure also serves as the treatment for this condition, as once the cyst is drained, it collapses and disappears. Cysts can reappear at a later date, in which case they are simply drained again or surgically removed.
Fibroadenomas are solid, smooth, firm, benign lumps that are most commonly found in women in their late teens and early twenties. They are the most common benign lumps that occur in women and can occur in women of any age. They are also seen in postmenopausal women who are taking hormone replacement therapy.
Fibroadenomas occur twice as often in African-American women as in other American women. The painless lump feels rubbery, moves around freely, and very often is found by the woman herself. They vary in size and can grow anywhere in the breast tissue.
While most physicians can recognize this type of lump simply by feeling it, generally, the diagnosis is confirmed by mammography or ultrasound and fine-needle aspiration. Sometimes, in very young women, the fibroadenoma is not removed. However, since sometimes these fibroadenomas enlarge with pregnancy and breastfeeding, physicians may recommend removal.
While fibroadenomas do not lead to cancer, there is a type that has been associated with an increased risk of cancer, particularly in women with a family history of the disease.
Fat necrosis is a condition in which painless, round, firm lumps caused by damaged and disintegrating fatty tissues form in the breast tissue. Fat necrosis often occurs in women with very large breasts or in response to a bruise or blow to the breast. In some cases, physicians will watch the lump through several menstrual cycles, and may perform a mammogram before deciding whether or not to remove it. These lumps are not dangerous and there is no reason to believe that they increase a woman's risk of cancer.
Sclerosing adenosis is a breast condition that involves excessive growth of tissues in the breast's lobules, often resulting in breast pain. While these changes in the breast tissue are microscopic, they may show up on mammograms as calcifications and can produce lumps. Usually a biopsy is necessary to distinguish this condition from cancer.
Generalized breast lumpiness is known under many different names, such as "fibrocystic disease" and "fibroid breasts." These are misnamed since physicians and researchers believe that these are just part of the breast changes which many women undergo throughout the various stages of their lives.
Fibrocystic lumpiness is also described as "ropy" or "granular" and seems to become more obvious as a woman approaches middle age and the milk producing glandular tissue gives way to softer, fatty tissue. However, women with lumpy breasts may experience many other benign breast conditions.
Any lumpiness in the breasts may make other, possibly dangerous lumps harder to distinguish. Thus, it is important that women perform regular breast self-examinations and have regular physical examinations, including mammography as indicated by the National Cancer Institute guidelines. Knowing the normal shape and feel of your own breasts is important, especially when performing examinations to detect any unusual breast changes.
For additional information on this or any Health Topic, please call the Family Resource Center, 513-636-7606, or your pediatrician.
