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Your breasts respond to changes in levels of the hormones estrogen and progesterone during your menstrual cycle.  Your breasts are made up of glands, fat, and fibrous (thickened) tissue. Hormones cause a change in the amount of fluid in the breasts.  This may make fibrous areas in the breasts more painful. Your breasts also change during pregnancy, breastfeeding, and menopause. You may notice changes in your breasts if you use hormonal contraception, such as birth control pills, if you use hormone replacement medicines, or if you have breast implants.

Most breast problems, especially in younger women, are benign (not cancer). Commons symptoms include lumps, nipple discharge, and tenderness. Normal breast tissue in healthy women often feels lumpy or nodular. If you detect the presence of any new breast lumps, however, or if a previously evaluated breast lump seems to have grown or otherwise changed, make an appointment with your Atrium Ob/Gyn doctor to get it checked out.

Breast Lumps

A breast lump is a growth of tissue that develops within your breast. A breast lump is often interchangeably described as a mass, growth, swelling, thickness or fullness.

A breast lump can feel distinct and have definite borders, or it could be a thickened area in your breast that is slightly more prominent or different from the surrounding breast tissue and the other breast. You may notice other breast changes accompanying a breast lump, such as skin redness, distension, dimpling or pitting. You may also note breast asymmetry or nipple inversion or experience new symptoms of breast pain or spontaneous nipple discharge.

Sometimes, a breast lump is a sign of breast cancer. That’s why you should seek prompt medical evaluation. Fortunately, however, most breast lumps result from noncancerous (benign) conditions. Evaluation by your doctor may include a breast exam, mammogram, ultrasound, and/or consultation with a breast surgeon. Make sure you follow through with your care plan, and promptly notify our office if you have any difficulties with appointments.

Fibroadenomas

These are solid, noncancerous breast tumors that most often occur in adolescent girls and women under the age of 30. A fibroadenoma is a firm, smooth, rubbery or hard lump with a well-defined shape. It moves easily under your skin when touched and is usually painless. Typically about the size of a marble, fibroadenomas can enlarge during pregnancy and breast-feeding. Fibroadenomas are one of the most common breast lumps in young women. Treatment may include careful monitoring to detect changes in the size or feel of the fibroadenoma, or surgery to remove it.

Fibroadenomas are solid breast lumps or masses that usually are round with distinct borders, easily moved, firm or rubbery, and painless. A fibroadenoma may feel like a marble within your breast when you press on it. You can have one or many fibroadenomas. The average fibroadenoma is about an inch (2.5 centimeters) in diameter. Those larger than 2 inches (5 centimeters) are called giant fibroadenomas.

The cause of fibroadenomas is unknown. However, fibroadenoma development is probably related to reproductive hormones. Fibroadenomas occur in greater frequency during your reproductive years, can increase in size during pregnancy or estrogen therapy, and tend to shrink after menopause, when estrogen stimulation decreases.

Most fibroadenomas don’t affect your risk of breast cancer. However, your breast cancer risk might increase slightly if you have a complex fibroadenoma — which may contain cysts or bits of dense, opaque tissue called calcifications.

Breast Cysts

Breast cysts are fluid-filled sacs within your breast. You can have one or many breast cysts. They’re often described as round or oval lumps with distinct edges. In texture, a breast cyst usually feels like a soft grape or a water-filled balloon, but sometimes a breast cyst feels firm. Breast cysts develop when an overgrowth of glands and connective tissue (fibrocystic changes) block milk ducts, causing them to dilate and fill with fluid. Breast cysts are common in women in their 30s and 40s.

If you have breast cysts, they usually disappear after menopause, unless you’re taking hormone therapy. Having one or many simple breast cysts doesn’t increase your risk of breast cancer. Breast cysts don’t require treatment unless a cyst is large and painful or otherwise uncomfortable. In that case, draining the fluid from a breast cyst can ease your symptoms.

Signs and symptoms of breast cysts include: (1) A smooth, easily movable round or oval breast lump with distinct edges, (2) Breast pain or tenderness in the area of the breast lump, (3) Increase in breast lump size and breast tenderness just before your period, and/or (4) Decrease in breast lump size and resolution of other signs and symptoms after your period.

Fibrocystic Changes

These changes cause a woman’s breast to feel lumpy and tender. Symptoms include pain, itching, swelling, and tenderness. These symptoms often occur in both breasts. Fibrocystic breast changes don’t increase your risk of breast cancer. Having fibrocystic breasts is very common. Women with this noncancerous (benign) condition often experience lumpy, painful breasts. The cause of fibrocystic breast changes isn’t completely understood. But the condition is likely associated with hormone fluctuations during a woman’s menstrual cycle. Although it doesn’t increase your risk of breast cancer, having fibrocystic breasts may interfere with your ability to detect new breast lumps or other abnormal changes that might need to be evaluated by your doctor. It’s important to become familiar with how your breasts normally feel so that you’ll know when something just doesn’t feel right.

Breast Pain (Mastalgia)

Breast pain (mastalgia) is a common complaint among women. You might describe your breast pain as chronic tenderness, sharp burning or tightness in your breast tissue. The pain may be constant or it may occur only occasionally. Some women have severe breast pain, occurring more than five days a month. Severe breast pain may even persist throughout the menstrual cycle. Postmenopausal women sometimes have breast pain, but the symptom is more common in younger, premenopausal women and perimenopausal women.

Most times, breast pain signals a noncancerous (benign) breast condition and rarely signifies breast cancer. Still, unexplained breast pain that doesn’t go away after your next menstrual cycle or that persists after menopause needs to be evaluated by your doctor. Most cases of breast pain are classified as either cyclic or noncyclic. Each type of breast pain has distinct characteristics.

Cyclic Breast Pain

  • Clearly related to the menstrual cycle
  • Described as dull, heavy or aching
  • Often accompanied by breast swelling or lumpiness
  • Usually affects both breasts, particularly the upper, outer portions, and can radiate to the underarm
  • Intensifies during the two weeks leading up to the start of your period, then eases up afterward
  • Usually affects premenopausal women in their 20s and 30s and perimenopausal women in their 40s

Noncyclic Breast Pain

  • Unrelated to the menstrual cycle
  • Described as tight, burning or sore
  • Constant or intermittent
  • Usually affects one breast, in a localized area, but may spread more diffusely across the breast
  • Usually affects postmenopausal women

Most of the time, it’s not possible to identify the exact cause of breast pain. However, likely contributors are:

Reproductive Hormones

Cyclic breast pain appears to have a strong link to hormones and your menstrual cycle. Cyclic breast pain often decreases or disappears with pregnancy or menopause so experts theorize that hormones play a role. However, no studies have identified a particular hormonal abnormality as a contributor to cyclic breast pain.

Anatomical Factors

The cause of noncyclic breast pain is likely to be anatomical rather than hormonal, triggered by breast cysts, breast trauma, prior breast surgery or other factors localized to the breast. Noncyclic breast pain may also originate outside the breast — in the chest wall, muscles, joints or heart, for example — and radiate to the breast.

Fatty Acid Imbalance

An imbalance of fatty acids within the cells may affect the sensitivity of breast tissue to circulating hormones. This theory provides the rationale for taking evening primrose oil capsules as a remedy for breast pain. Evening primrose oil contains gamma-linolenic acid (GLA), a type of fatty acid. GLA is thought to restore the fatty acid balance and decrease the sensitivity of breast tissue to circulating hormone levels.

Medication Use

Certain hormonal medications, including some infertility treatments and oral contraceptives, may be associated with breast pain. Also, breast tenderness is a possible side effect of estrogen and progesterone hormone therapy, which could explain why some women continue to have breast pain even after menopause. There have also been reports of breast pain associated with prescribed antidepressants, including selective serotonin reuptake inhibitor (SSRI) antidepressants, such as fluoxetine (Prozac) and sertraline (Zoloft).

Some information above provided by the American College of Obstetricians & Gynecologists and the Mayo Clinic

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