Breast problems are very common in women of all ages. Most breast problems are not caused by breast cancer but it is really important to get any breast problems or concerns checked by a doctor. You may need to be referred to a breast specialist and you may need some tests such as a mammogram and ultrasound scan to find out the cause.
What breast problems can occur?
There are may different breast problems, including:
- Breast lumps.
- Breast pain and tenderness.
- Infection may cause hardness, pain, redness and swelling in the breast (mastitis).
- Nipple discharge.
- Inverted nipples.
- Changes in the skin of the breast.
What is the structure of a normal breast?
Cross-section diagram of a breast, showing a normal breast
The breast is connected to muscles on the wall of your chest. It is made up of fatty tissue. Within the fatty tissue are lobules or milk-forming glands. Milk drains from these glands into breast ducts during breastfeeding. Milk then leaves the ducts through your nipple.
The glands and ducts can decrease or increase in number and size. This will depend on whether they are needed.
Breast lumps can involve any of these different tissues, or components, that make up your breast.
What are the causes of nipple discharge?
Nipple discharge is usually caused by benign disease (ie not breast cancer). Normal nipple discharge occurs during pregnancy and breastfeeding and may continue until up to one year after childbirth or the end of breastfeeding. Excessive breast stimulation can also cause nipple discharge.
Nipple discharge can be caused by certain gland (endocrine) problems such as a prolactinoma or if you're taking certain medicines (the combined oral contraceptive pill, cimetidine, antidepressants or metoclopramide).
Nipple discharge caused by an underlying breast problem (for example, breast cancer) is more likely to affect only one breast, the discharge may be bloodstained and there may also be an abnormal lump in the same breast.
What are the causes of inverted nipples?
An inverted nipple points into the breast instead of the normal shape of pointing outwards. Inverted nipples are often harmless with no serious underlying cause. Many women are born with nipples that naturally invert at times and then point outwards at other times. Sometimes the nipple may become inverted after breastfeeding.
If one or both nipples start to invert then it is very important to get it checked out but most cases are not due to anything serious.
The possible causes of inverted nipples include:
- Injury to the breast, or breast surgery.
- Breast cancer.
- Breast infections - for example, mastitis.
- Rapid and substantial loss of weight.
What are the causes of changes in the skin of the breast?
Skin problems can develop on or near the breast. There may be itching, scaling, dimpling, swelling, redness or other changes in skin colour. There is often no serious underlying breast problem but these skin changes may be caused by breast cancer so it's really important to get checked out straightaway in case there is a serious problem.
Further reading and references
Salzman B, Fleegle S, Tully AS; Common breast problems. Am Fam Physician. 2012 Aug 1586(4):343-9.
Goyal A; Breast pain. Clin Evid (Online). 2011 Jan 172011. pii: 0812.
Spencer JP; Management of mastitis in breastfeeding women. Am Fam Physician. 2008 Sep 1578(6):727-31.
Cheung KL, Lam TP; Approach to a lump in the breast: a regional perspective. Asian J Surg. 2005 Jan28(1):65-70.
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