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Breast problems: Symptoms and treatment

A woman's breasts go through many changes over a lifetime, including puberty, periods, pregnancy and generally getting older.

Most changes in breasts are natural and nothing to worry about.

However, you may experience any of several conditions that require medical attention. These include breast pain and masses or lumps.

Lumps

Breast lumps come in many forms, including cysts, adenomas and papillomas. They differ in size, shape and location, as well as in causes and treatment. About half of all women have lumpy breasts, or fibrocystic change. They are more common in the premenstrual period and usually resolve after the menopause. Most lumps are benign and do not indicate cancer. However, if at any time you find a new or unusual lump, have your doctor check it to make sure it is not cancerous or precancerous.

Cysts, which can be large or small, are benign, fluid-filled sacs. They sometimes occur cyclically, that is, changing through the menstrual cycle, and they may be painful.

With the end of menstruation at the menopause, many cystic lumps diminish or disappear. Therefore, you should immediately have your doctor check any lumps that occur after the menopause.

Fibroadenomas are the most common benign breast tumours seen in women under 25 and are occasionally seen in adolescents. Fibroadenomas are usually round, several centimetres across, and mobile. They can sometimes resolve on their own. Your doctor may recommend removal if it persists, gets larger or if you are anxious about it. Tests will be done to check for cancer when it is removed.

Nipple adenomas are tumours of the nipple area. They vary in appearance, sometimes recur after surgical removal, and are sometimes, but not usually, associated with cancer. An intraductal papilloma is a relatively uncommon small growth in the lining of the milk ducts near the nipple. Usually seen in women over 40, papillomas produce a discharge, which may be bloody.

Breast awareness

In the UK, breast specialists recommend “breast awareness” by which they simply mean getting to know your breasts and how they usually are, and keeping an eye out for changes. As part of breast awareness, you should examine your breasts every month so that you are familiar with their structure and can detect any new masses or lumps. Premenstrual changes can cause temporary thickening that disappears after the period, so it is best to check your breasts about a week after your period. If you are no longer menstruating, examine your breasts monthly. If breast self-examination makes you anxious or you have questions about how to perform it, consult your healthcare provider.

A breast self-examination is easiest in the shower, using soap to smooth your skin. Look for dimpling. Using light pressure, check for lumps near the surface. Use firm pressure to explore deeper tissues. Squeeze each nipple gently and if there is any discharge - especially if it is bloody – seek medical advice.

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