Breast Problems - Topic Overview

Breast 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.
See a picture of the breast anatomy .
Common, noncancerous (benign) breast changes include:

• Sacs filled with fluids (cysts).
• Generalized breast lumpiness.
• Painless, movable, and firm round lumps (fibroadenomas).
• Damaged fatty tissue (fat necrosis).
• Growths inside the ducts (intraductal papillomas).
• Enlargement of lymph nodes in the breast.
• Breast pain (mastalgia).
• Breast infections (mastitis) or abscesses.
• Nipple discharge.
• Inflamed blood vessels (thrombophlebitis).

Breast 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.
In men, enlargement of male breast tissue (gynecomastia) is a noncancerous breast change. Breast buds are common in adolescent boys during puberty. They 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.
Many women with breast pain or breast lumps worry about breast cancer.
The earlier breast cancer is detected, the more easily and successfully it can be treated.
There are 2 methods of early detection:

• Clinical breast examination (CBE). During your routine physical examination, your doctor may do a clinical breast examination. During a CBE, your doctor will carefully feel your breasts and under your arms to check for lumps or other unusual changes.
• 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 differ in their recommendations about when or how often women should have mammograms. Some recommend you begin screening at age 40 and some recommend you begin screening at age 50. Your doctor may suggest that you have a screening mammogram at a younger age if you have any risk factors for breast cancer.

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.

Accepting the Nude You

If your self-image has been hurt by your breast cancer, you need to work at getting back a positive view of yourself.
Are you going to great lengths not to look at the scars on your chest? Your reluctance to face the scars is understandable. But experts on healing suggest it's important to get past this attitude.

Clothes cover

Fancy lingerie or nightwear may be the immediate solution to avoiding initial shock. If you want that protection, that camouflage, go for it. Indulge yourself. Plenty of women keep their clothes on in bed. Beneath clothing, a reconstructed breast or a good prosthesis feels very much like the real thing to your partner; it has the bounce, the weight, and the resilience of a natural breast.
Responding to a discriminating market, many small shops offer an excellent variety of prostheses and cleverly adapted prosthesis pockets fitted into underclothing and swimsuits. Ask your local American Cancer Society chapter for a list of shops, or look in the Yellow Pages under Lingerie.
Even for the short term, while you're deciding whether or not to go ahead with reconstruction, a breast prosthesis may allow you to feel more comfortable about your image in clothes.

Personal Quote

"You've got to make peace with your body. After my mastectomy, I'd dress and undress in the bathroom. Then we took a delayed honeymoon. My husband didn't like my hiding in the bathroom. 'Come on out—I love you,' he'd say. 'Two breasts are better, but one is okay!'" —Emily
"For a very long time (six months), I didn't really want to look straight on in the mirror. When I finally did, it wasn't that awful. It was like a patch of white fabric stitched on my chest."—Sheryl

Easing into exposure

Frilly lingerie can serve as your first step to getting back into a pattern of relaxed sexual activity, but sooner or later you need to come to terms with the changes in how you look. Dr. Leslie Schover suggests four-step "mirror therapy":

• Use a full-length mirror in a private area of your home, then dress up in your favorite clothes.
• Study yourself in the mirror for 15 minutes and pick out three things you really like about yourself.
• After that, try the exercise in lingerie.
• Finally, take 15 minutes to look at yourself in the nude, and again, search out points about yourself that please you. Focus on the positives.

You need to accept your naked body, even if you never did before, to strike a truce with yourself. And you need to let your partner look at you and come to a similar point of view. Take it little by little. Some women find it freeing to walk around their room or apartment totally naked. One woman invited close friends over for dinner and when they had finished, she showed off her new reconstructed breasts, to oohs and aahs of approval.
The final step is being totally nude for your partner. This seems to be the last stage in releasing the anxiety about your self-image. Cathy, in a new relationship, finally worked up to letting her beau see her naked chest—and he applauded: "You really did something big, letting me see you. But I told you before, it wasn't going to matter to me."
With or without breast cancer, some women just don't enjoy parading around naked. You may need to face what you look like, but you don't have to force yourself into behavior that never suited you. Besides, most sex takes place in darkened rooms. When the lights are low and you're getting it on, whether you're totally naked or not may not matter one bit