| Breast Problems
		
			| Topic OverviewBreast lumps or changes are a common health worry for most women.
		Women may have many kinds of breast lumps and other
		breast changes throughout their lives, including
		changes that occur with menstrual periods, pregnancy, and aging. Most breast
		lumps and breast changes are normal. Breast changes in young girlsBreast development is the first sign of puberty in young
		girls. Usually, breasts begin as small, tender bumps under one or both nipples
		that will get bigger over the next few years. It is not unusual for one breast
		to be larger than the other or for one side to develop before the other. A girl
		may worry that a lump under the nipple is abnormal or a sign of a serious
		medical problem when it is a part of normal breast development. Noncancerous breast changesCommon, noncancerous (benign) breast changes
		include: If a woman has breast implants, there could be changes in the implant over time. Normal activity or an injury to the breast can damage the implant, causing it to leak, deflate, or rupture. The implant may harden, develop ripples, shift position, or change shape. The implant may need to be removed and replaced if any of these changes occur. Breast changes that need follow-upMany women with breast pain or breast
		lumps worry about breast cancer. There are two
		common methods of early detection: Mammogram. A mammogram is an X-ray of the breast that can often find tumors that are too small for you or your doctor to feel. Experts do not agree about when or how often women should have mammograms.  Some recommend that you begin screening at age 40, and some recommend that you begin screening at age 50. Your doctor may suggest that you have a screening mammogram at a younger age if you have risk factors for breast cancer.Clinical breast examination (CBE).
		  During your routine physical exam, your doctor may do a clinical breast
		  exam. During a CBE, your doctor will carefully feel your breasts and
		  under your arms to check for lumps or other unusual changes. Talk to your doctor about whether to have a clinical breast exam. 
 Breast self-examination (BSE) involves checking your
		breasts for lumps or changes while standing and lying in different positions
		and while looking at your breasts in a mirror. Once you know what your breasts
		normally look and feel like, any new lump or change in appearance should be
		evaluated by a doctor. Most breast problems or changes are not caused by
		cancer. But BSE should not be used in place of clinical breast examination
		and mammography. Studies have not shown that BSE alone reduces the number of
		deaths from breast cancer. Early breast
		cancer is often seen on a
		mammogram before there are any symptoms. The most
		common symptom of breast cancer is a painless lump. But sometimes painful
		lumps are cancerous. Other symptoms of breast cancer include: Skin changes, such as dimpling or
		puckering.Nipple discharge.Darkening of the area around
		the nipple.A nipple being drawn inward.Any breast
		problem that lasts more than 2 weeks.A breast lump in a man.
 Breast changes in boysIn
		men, enlargement of male breast tissue (gynecomastia) is a
		noncancerous breast change. Breast buds are common in teenage boys during puberty. The buds may last up to 2 years, but they tend to go away within the first year. Breast buds develop because of rapid
		changes in hormone levels. Treatment of a breast problem depends on the cause of the
		problem. Check your symptoms to decide if and when
		you should see a doctor.Check Your SymptomsDo you have a breast problem? This includes symptoms like pain, nipple discharge, lumps, and other breast changes.How old are you? 11 years or younger 11 years or younger12 to 55 years 12 to 55 years56 years or older 56 years or olderYes Symptoms of breast infectionNo Symptoms of breast infectionDo you think you may have a fever?Are there red streaks leading away from the area or pus draining from it?Do you have diabetes or a weakened immune system? What weakens the immune system in an adult or older child  may be different than in a young child or baby .Yes Diabetes or immune problemNo Diabetes or immune problemDo you have breast pain that is not normal for you? Many women have breast pain at a certain point in their menstrual cycle every month. This type of pain might be normal for you.How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine? 8 to 10: Severe pain Severe pain5 to 7: Moderate pain Moderate pain1 to 4: Mild pain Mild painDoes the breast pain come and go?Have you had breast pain for more than 3 weeks? Yes Breast pain for more than 3 weeksNo Breast pain for more than 3 weeksDo you think that a medicine  may be causing your breast problem?Think about whether your breast problems started after you began using a new medicine or a higher dose of a medicine. Yes Medicine may be causing breast symptomsNo Medicine may be causing breast symptomsDoes home treatment help with breast pain related to your menstrual cycle? Yes Home treatment helps menstrual breast painNo Home treatment helps menstrual breast painHave you noticed a lump or thickening in your breast or a change in the breast's size or shape? Yes Lump in breast or change in breast's size or shapeNo Lump in breast or change in breast's size or shapeMany things can affect how your body responds to a symptom and what kind
	 of care you may need. These include: Your age. Babies and older
		adults tend to get sicker quicker.Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
		disease, you may need to pay closer attention to certain symptoms and seek care
		sooner.Medicines you take. Certain
		medicines, herbal remedies, and supplements can cause symptoms or make them
		worse.Recent health events, such as surgery
		or injury. These kinds of events can cause symptoms afterwards or make them
		more serious.Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
		use, sexual history, and travel. 
Try Home TreatmentYou have answered all the questions. Based on your answers, you may be
		able to take care of this problem at home. Try home treatment to relieve the
		  symptoms. Call your doctor if symptoms get worse or you have any
		  concerns (for example, if symptoms are not getting better as you would expect).
		  You may need care sooner.
Many prescription and nonprescription medicines can cause
	 breast problems, such as breast tenderness or nipple discharge. A few examples
	 are: Some antidepressants. Some blood
		pressure medicines.Corticosteroids, such as
		prednisone.Medicines that contain hormones, such as birth control
		pills, hormone therapy, and infertility
		medicines.Migraine headache medicines, such as sumatriptan.
  Cimetidine, such as Tagamet, may cause nipple discharge and
	 breast enlargement in men.Symptoms of a heart attack may
	 include: Chest pain or pressure, or a strange feeling in the chest.Sweating.Shortness of
				  breath.Nausea or vomiting.Pain, pressure, or a
				  strange feeling in the back, neck, jaw, or upper belly, or in one or both
				  shoulders or arms.Lightheadedness or sudden
				  weakness.A fast or irregular heartbeat. 
 The more of these symptoms you have, the more likely it is that
	 you're having a heart attack. Chest pain or pressure is the most common
	 symptom, but some people, especially women, may not notice it as much as other
	 symptoms. You may not have chest pain at all but instead have shortness of breath, nausea, or a strange feeling in your chest or other areas.Other breast symptoms to
	 pay attention to can include: Skin changes, such as dimpling or
		puckering.Nipple discharge.Darkening of the area around
		the nipple.A nipple being drawn inward.Any breast
		problem that lasts more than 2 weeks.
Symptoms of a breast infection may
	 include: Increased pain, swelling, redness, or warmth around
		a breast.Red streaks extending from a breast.Drainage
		of pus from a breast.Fever.
Certain health conditions and medicines weaken the immune system's ability to fight off infection and
	 illness. Some examples in adults are: Diseases such as diabetes, cancer, heart disease,
		and HIV/AIDS.Long-term alcohol and drug
		problems.Steroid medicines, which may be used to treat a variety
		of conditions.Chemotherapy and radiation therapy for
		cancer.Other medicines used to treat autoimmune
		disease.Medicines taken after organ transplant.Not
		having a spleen.
Certain health conditions and medicines weaken the immune system's ability to fight off infection and
	 illness. Some examples in children are: Diseases such as diabetes, cystic fibrosis, sickle
		cell disease, and congenital heart disease.Steroid medicines,
		which are used to treat a variety of conditions.Medicines taken
		after organ transplant.Chemotherapy and radiation therapy for
		cancer.Not having a spleen.
Pain in adults and older children Severe pain (8 to 10): The pain
		is so bad that you can't stand it for more than a few hours, can't sleep, and
		can't do anything else except focus on the pain. Moderate pain (5 to 7): The pain is bad enough to disrupt your
		normal activities and your sleep, but you can tolerate it for hours or days.
		Moderate can also mean pain that comes and goes even if it's severe when it's
		there.Mild pain (1 to 4): You notice the pain,
		but it is not bad enough to disrupt your sleep or activities. 
Seek Care TodayBased on your answers, you may need care soon. The
		problem probably will not get better without medical care.Call your doctor today to discuss the symptoms
		  and arrange for care.If you cannot reach your doctor or you don't
		  have one, seek care today.If it is evening, watch the symptoms and
		  seek care in the morning.If the symptoms get worse, seek care
		  sooner.
Call  911  NowBased on your answers, you need
		emergency care.Call911or other emergency services now.Make an Appointment Based on your answers, the problem may not improve without medical
		care.Make an appointment to see your doctor in the
		  next 1 to 2 weeks.  If appropriate, try home treatment while you
		  are waiting for the appointment.If symptoms get worse or you have
		  any concerns, call your doctor. You may need care sooner.
Seek Care NowBased on your answers, you may need care right away. The problem is likely to get worse without medical care.Call your doctor now to discuss the symptoms and
		  arrange for care.If you cannot reach your doctor or you don't have
		  one, seek care in the next hour.You do not need to call an
		  ambulance unless: 
		  You cannot travel safely either by driving
				yourself or by having someone else drive you.You are in an area
				where heavy traffic or other problems may slow you down.
Home TreatmentBreast self-exams are a simple way
		for you to learn what your breasts normally feel like. During a breast
		self-exam, you examine your own breasts to look and feel for changes from one
		month to the next. You will learn how your breasts feel and what is normal for
		you so that you can spot any changes early. For more information about how to
		do a breast self-exam, see the topic
		Breast Self-Examination. If you have pain or a fever from a breast problem or injury, you can try nonprescription medicines for your symptoms. Medicine you can buy without a prescription| Try a nonprescription
			 medicine to help treat your fever or pain: | 
|---|
 | Talk to your child's doctor before switching back and
				forth between doses of acetaminophen and ibuprofen. When you switch between two
				medicines, there is a chance your child will get too much medicine. |  Safety tips| Be sure to follow these
				safety tips when you use a nonprescription medicine: | 
|---|
 | Carefully read and follow all directions
					 on the medicine bottle and box.Do not take more than the
					 recommended dose.Do not take a medicine if you have had an
					 allergic reaction to it in the past.If
					 you have been told to avoid a medicine, call your doctor before you take
					 it.If you are or could be pregnant, do not take any medicine other
					 than acetaminophen unless your doctor has told you to.Do not give aspirin to anyone younger than age 20 unless your doctor tells you to. 
						
 |  Alternative medicines or supplements
		may help relieve breast tenderness, discomfort, or pain (mastalgia). Some studies have shown that
		  magnesium reduces mild premenstrual symptoms. As with
		all alternative medicines and supplements, be sure to follow the
		directions on the label. Do not exceed the maximum recommended dose. If you are
		or could be pregnant, talk with your doctor before taking any medicine or
		supplement. For more
		  information, see the topic
		  Fibrocystic Breasts.  Symptoms to watch for during home treatmentCall your doctor if any of the following occur during home
		  treatment: Skin changes, such as dimpling or
		puckering.Nipple discharge.Darkening of the area around
		the nipple.A nipple being drawn inward.A breast lump in a man.Symptoms of an infection develop.Symptoms that become more severe or more frequent.
PreventionTo prevent breast tenderness, discomfort,
		or pain (mastalgia), follow these tips: Wear a sports bra during exercise. A sports bra may prevent breast discomfort, pain, and injury
		  during exercise or sports. It is important that the sports bra fit properly. It
		  should keep the breasts almost motionless and allow them to move together with
		  the chest, not separately. Be sure to replace your sports bra as the
		  material stretches and become less supportive. A sports bra may need to be
		  replaced every 6 months if it is used regularly.Limit your salt intake. High salt intake may cause fluid
		  retention. Fluid retention may be the cause of premenstrual breast
		  tenderness.
 To prevent nipple irritation during exercise: Cover your nipple with a small bandage or a dab
		  of petroleum jelly before you exercise.Wear a sports bra that fits
		  you properly. Avoid sports bras that are lined with cotton.Avoid
		  exercising in cold temperatures.Wear a vest or jacket made from
		  fabric that blocks the wind.
Preparing For Your AppointmentTo prepare for your appointment, see the topic Making the Most of Your Appointment. You can help your
		doctor diagnose and treat your condition by being prepared to answer the
		following questions: What symptoms do you have?How long
		  have you had your symptoms? Do your breast changes occur at the same time each
		  month?What is your age and general health?Do you have
		  menstrual periods? Are your periods regular?Are you
		  pregnant?Have you had children? Did you breastfeed? Are you
		  currently breastfeeding?Have you had a
		  breast infection (mastitis) or a blocked milk duct in
		  the past?What prescription and nonprescription medicines are you
		  taking? Have you ever been diagnosed with breast lumps or had any
		  fluid or
		  cysts drained from your breasts?Have you
		  ever had a
		  mammogram or
		  breast ultrasound?Have you ever been
		  diagnosed with
		  breast cancer? Do you have any relatives
		  who have noncancerous (benign) breast lumps or breast cancer?Do
		  you have any
		  health risks?
ReferencesOther Works ConsultedAmerican Cancer Society (2009). Prevention and Early Detection: American Cancer Society Guidelines for the Early Detection of Cancer. Atlanta: American Cancer Society. Available online: http://www.cancer.org/docroot/PED/content/ped_2_3X_ACS_Cancer_Detection_Guidelines_36.asp.U.S. Preventive Services Task Force (2009). Screening for breast cancer. Available online: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm.
CreditsByHealthwise StaffPrimary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency Medicine
 Adam Husney, MD - Family Medicine
Current as ofMarch 20, 2017Current as of:
                March 20, 2017 Last modified on: 8 September 2017  |  |