What Are Breast Conditions?
Adolescent females may experience a number of changes in their breasts during puberty and adolescence. Some breast changes or conditions are related to menstrual cycles, while others may happen at any time. While most breast conditions are not dangerous, it is important to be aware of the need for proper breast health. Some breast conditions people may experience include:
- Cyclical breast pain
- Cysts
- Fibroadenomas
- Fat necrosis
- Sclerosing adenosis
- Galactorrhea (nipple discharge)
- Other conditions
Cyclical Breast Pain (re-occurring breast pain)
Cyclical 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 period 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 it is extremely uncomfortable to wear tight-fitting clothing or have 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 from contraceptive methods (birth control pills).
It may be helpful for females to chart their breast pain to determine if the pain is regular or not. When the pain is tracked, a pattern may be seen between the menstrual cycle and breast pain.
Researchers continue to study the role that hormones 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 worse.
Cysts
Cysts are fluid-filled sacs that develop in the breast tissue, and typically happen in females in their 30s and 40s. The cysts often get bigger and become tender and painful just before the menstrual period and may seem to appear overnight. Some people 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 embedded in breast tissue, a cyst will feel like a hard lump because it is covered with tissue.
A healthcare provider may identify a lump as a cyst by physical examination, but many providers confirm the diagnosis by mammography or ultrasound examination. The healthcare provider 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 treats this condition, since once the cyst is drained, it collapses and disappears. Cysts can come back at a later time, in which case they are simply drained again or surgically removed.
Fibroadenomas
Fibroadenomas are solid, smooth, firm lumps that are most commonly found in women in their late teens and early 20s. They are usually benign (harmless) lumps that happen at any age. They are also seen in postmenopausal females who are taking hormone replacement therapy.
Fibroadenomas happen 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 doctors can recognize this type of lump simply by feeling it, generally the diagnosis is confirmed by mammography or ultrasound and, possibly, fine-needle aspiration (where a sample of tissue is taken from the breast). Sometimes, in very young females, the fibroadenoma is not removed. However, since sometimes these fibroadenomas enlarge with pregnancy and breastfeeding, doctors 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 people with a family history of the disease.
Fat Necrosis
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 happens in females with very large breasts or after a bruise or blow to the breast. In some cases, healthcare providers will watch the lump through several menstrual cycles and may do 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 the risk of cancer.
Sclerosing Adenosis
Sclerosing adenosis is a breast condition that involves excessive growth of tissues in the breast's lobules (glands), often resulting in breast pain. While these changes in the breast tissue are microscopic, they may show up on mammograms as calcifications (a hardening of tissue into or with deposits of calcium) and can produce lumps. Usually, a biopsy is necessary to distinguish this condition from cancer.
Galactorrhea
Galactorrhea (or experiencing a milk-like discharge from the nipple) can happen when one is not pregnant or postpartum, and in males and females alike. This is usually seen on both breasts and may be either spontaneous or can be expressed with pressure. Most often, this is due to an increased amount of a hormone called prolactin in the body. This can be caused by certain medications, frequent stimulation of the breasts, other hormonal imbalances, or a benign (harmless) mass in the brain secreting prolactin (a prolactinoma).
Other Conditions
Generalized breast lumpiness is known under many different names, such as "fibrocystic disease" and "fibroid breasts." These are misnamed since doctors and researchers believe that these are just part of the breast changes that many females have 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 (harmless) breast conditions.
Any lumpiness in the breasts may make other, possibly dangerous lumps harder to distinguish. So it is important to have regular physical examinations, including mammograms. Knowing the normal shape and feel of your own breasts is important to detect any unusual breast changes, but regular self-screening is not recommended.
Adolescent males can also experience temporary enlargement of breast tissue, especially during puberty, which can be seen on one or both sides of the chest. This is called gynecomastia. Often, this is happens because of changes in hormones during puberty and will go away with time. However, it can rarely be caused by medications, hormonal imbalances, liver disease, genetic disorders, or specific tumors affecting the production of hormones.
