What should I know about my breasts?
In this website you will find an overview about breast, benign lesions (not cancer) and breast cancer conditions. It also includes information about screening and diagnosic techniques to solve your doubts and assure an accurate and efficient diagnosis.
During the lifetime of every woman many changes occurs in the breast, not only anatomical changes but also functional changes. Having knowledge about the breast can help you to distinguish which changes are normal and which are not.
The main part of the breast is adipose tissue interspersed with connective tissue. The breast has also glandular tissue, made up of lobes and ducts.
Each breast has between 10 and 20 sections, known as lobes, arranged in the form of the petals of a daisy. Inside each lobe are smaller structures known as lobules. At the end of each lobule are tiny bulbs that produce the milk. Thin tubes known as lactiferous ducts carry the milk from the lobules to the nipple.
Between 50-75 percent of breast cancers begin in the milk ducts, about 10-15 percent begin in the lobules and a few begin in other breast tissues. (1)
Types of breast lesions
The vast majority of the lesions that occur in the breast are benign and are far more common than malignant ones. It is therefore very important for all specialties involved in the diagnosis and treatment of breast pathologies, such as radiologists, pathologists, oncologists and breast surgeons, to recognize benign lesions and be able to distinguish these benign lesions from breast cancer.
Benign (non-cancerous) breast conditions are very common, and most women have them. Unlike breast cancer, benign breast conditions are not life threatining.
Benign breast tumors are abnormal growths, but they do not spread outside of the breast.
Fibrocystic breast changes:
It is very common to have fibrocystic breast changes. According to Mayo Clinic, more than half of women will experience fribrocystic breast changes at some point of their lives. (2) Lumpiness, thickening and swelling, fluctuations in size tend to be more common with the woman’s menstrual period.
Fluid-filled, movable lumps, round or ovoid structures, that can range from very tiny to about the size of a small egg. Cysts are more common in premenopausal women and usually don’t need treatment.
Fibroadenoma is the most common benign breast tumor. It is a solid, round, rubbery lump that moves under skin when touched. It usually occurs during early reproductive life (between the ages of 15 and 35). Usually fibroadenomas don’t need treatment, but if it is large or painful it may be removed.
Breast infections are divided into lactational and non-lactational infections (when the process is not associated with pregnancy). The most common infection is mastitis and commonly affects women who are breastfeeding. The breast will likely be red, warm, tender and lumpy.
A blow to the breast or a bruise can cause a lump.
Deposits of calcium can appear anywhere in the breast and often show up on a mammography. There are two types; macrocalcifications that look like small white dots or microcalcifications that look like tiny white specks.
Most women have one or more areas of microcalcifications of various sizes.
The majority of calcium deposits are harmless even a small percentage may be precancerous or cancer (biopsy is sometimes recommended).
A tumor is malignant (cancer) when the cells can grow into (invade) surrounding tissues or spread (metastasize) to distant areas of the body. Breast cancer occurs almost entirely in women, but men can get breast cancer too.
Breast cancer starts when normal cells begin to change, becoming abnormal and growing uncontrollably, forming a lump (tumor). When the cancer cells have not spread, it is referred to as in situ, which means “in place”. Cancer cells often spread locally or to other parts of the body, and in this case it is referred to as “invasive”.
Breast cancers can start from different parts of the breast. Most breast cancers begin in the ducts that carry milk to the nipple (ductal cancers). Some start in the glands that make breast milk (lobular cancers). There are also other types of breast cancer that are less common, like inflamatory breast cancer, sarcomas and lymphomas.
How to detect an early lesion?
Be aware about your breast
It is very important to know how your breast usually looks and feel. Breast cancer symptoms vary from one woman to another and you should know what feels normal for you. The menstrual cycle may produce texture changes and lumpy feelings under palpation.
Doing breast self-exams can help you learn how your breasts normally feel and make it easier to notice and find any changes.
Remember to carry out a breast self-exam regularly
It is very important include a breast self-exam in your routine. If you don’t know how to do it, follow the next 5 steps:
Look at your breasts in the mirror with your shoulders straight and your arms on your hips. Check that your breasts are their usual shape, size and color. Also pay attention to your nipples, if they have changed position or are inverted.
Raise your arms and look for the same changes.
Look for any signs of fluid coming out of one or both nipples.
Feel your breasts while lying down; using your right hand to feel your left breast and then viceversa. Use a firm touch keeping the fingers flat and together. Use a circular motion, about the size of a quarter.
Cover the entire breast from top to bottom, side to side — from your collarbone to the top of your abdomen, and from your armpit to your cleavage. Make sure that you cover the whole breast.
Finally, feel your breasts while you are standing or sitting using the same movements described in step 4.
Not all cancers can be found by this self-exam, but it is an important and easy way to find a lesion early.
A clinical breast exam (CBE) is also recommended; this exam is done by a doctor or nurse, who checks your breast, underarms and surrounding area for lumps or changes.
If your regular medical check-up don’t include a CBE, ask about it.
Signs and symptoms
Often there are no outward signs of breast cancer that you can see or feel. If there are outward signs, the most common ones include a lump, an area of thickening, or a dimple in the breast. Less common signs include breast swelling and redness, nipple discharge or an enlarged underarm lymph node. However, even if you have one or more of these signs, it does not necessarily mean you have breast cancer.
Remember that most breast lumps turn out to be benign (non-cancerous). That said, it is extremely important that you see your doctor if you are worried that you might have breast cancer. Having your doctor take a look will clear your mind, and if anything is found, it can be taken care of quickly.
What should I do if I find a change or lump in my breasts?
Go to see your doctor as soon as possible
If you notice a lump in one breast, check your other breast. If both breasts feel the same, it may be normal. Normal breast tissue can sometimes feel lumpy. Even that, every suspicious lesion or change is important.
Make an appointment to your health medical provider as soon as possible. When your doctor examines your breast they may feel that there is no need for further investigation, or they may refer you to a breast specialist or gynecologist for further tests.
Keep in mind that breast changes are very common and further tests might be needed to confirm whether or not it is cancer, but remember that benign lesions are far more common than malignant ones.