Your Breasts Common Questions and Answers
Your Breasts What do I need to know about my breasts? Your breasts go through many changes over your lifetime. They change in your early teens as you go through puberty, during pregnancy, while breast-feeding, as you get older, and when you go through menopause. Changes happen when your body s hormone levels go up and down. Every woman s breasts are different. Some women have one breast larger than the other. Some women have nipples that are flat or pull in instead of standing out. Pregnant women have higher hormone levels. Their breasts are very firm and often tender. Older women have lower hormone levels. Their breasts are usually soft and less tender. It is important to know how your breasts normally look and feel so you can notice changes. 2
What is breast density? Breast density is not related to the look or feel of your breasts. It is an x-ray term which refers to the way breast tissue appears on a mammogram (breast x-ray). Breast tissue is made up of fatty and non-fatty tissue (glands, ducts, fibrous and connective tissues) and the amount of each type of tissue differs among women. Dense breasts have more nonfatty tissue. This can make it difficult to see changes or problem areas on a mammogram, but it does not mean a mammogram is not useful for detecting breast changes or concerns. Breast density usually decreases with age as non-fatty (dense) breast tissue is replaced by fatty tissue. Some women continue to have dense breasts past menopause, particularly women who are taking hormone replacement therapy (HRT). These women may be at an increased risk of developing breast cancer due to the density in their breasts. Why do some women have lumpy breasts? Breast tissue can feel very lumpy because of the different tissues that make up the breast. The fatty tissue and the non-fatty tissue give support and shape to the breast. Most of the time, lumps in a woman s breasts are part of the normal tissue that every woman has. Sometimes a woman may have cysts or fibroadenomas which cause her breasts to be lumpy. These are common and do not cause breast cancer or mean you are likely to get breast cancer. Cysts are fluid-filled lumps or sacs. They may occur in one or both breasts. They are most common in women 30 to 50 years old. They often cause tenderness and discomfort. They are often more noticeable just before your period. 3
Fibroadenomas are solid lumps of normal breast tissue. They are most common in women in their 20 s. They are not usually painful but can be tender just before your period. They usually move easily under the skin. Fibrocystic breast changes are common changes of the breast tissue which may cause breasts to feel lumpy all over. These changes may occur in women of all ages and include: an increase in the fibrous tissue of the breast, a widening of the milk ducts, or the forming of cysts. Many health care providers call these fibrocystic breasts. 4
Sometimes I have discharge or fluid from my nipple. Should I worry? When a woman s breast is squeezed by herself or her partner, or compressed by a mammogram, she may have a small amount of watery or milky discharge come from her nipple. This discharge could be green, yellow, brown, grey, or a combination of these colours. This is normal for many women and occurs most commonly before menopause. It is not recommended for women to squeeze their nipples or breasts to see if there is nipple discharge. This could stimulate hormones which, in turn, could create more discharge. The nipple discharge that is a concern and for which you should see your health care provider is one that: is new, happens without squeezing the nipple, is from only one nipple, or is bloody*. You should not ignore these types of nipple discharge. *The most common cause of bloody discharge from the nipple is a papilloma. A papilloma is a benign (not cancer) wart like growth in the milk duct near the nipple. What about breast pain? Breast pain is common and is often worse just before a period. Tell your health care provider about any breast pain that does not go away, becomes worse, or interferes with sleep or activities. It is not common for breast pain to be caused by cancer. Chest-wall pain is not true breast pain. It is pain from the ribs, cartilage or muscles underneath the breast. For more information visit www.breastcheckmb.ca/resources to view a handout on breast pain. 5
What causes breast cancer? Although it is not known what causes breast cancer, there are many things that can increase your risk of developing breast cancer. Some risk factors are related to genetics and hormones while others are related to lifestyle. To better understand your risk of breast cancer, visit www.publichealth.gc.ca/decisionaids. Do infections or injuries to the breast cause breast cancer? No, an injury or infection in the breast does not cause breast cancer. Infections in the breast, called mastitis, are most common in women who are breastfeeding. They are usually found in one area which can become red, tender, and warm or hot to the touch. Injuries such as a pinch or a blow to the breast may cause bruising which could lead to the formation of a hematoma. A hematoma is a collection of blood that may feel like a lump. Sometimes the injury may damage the fatty breast tissue forming a lump called fat necrosis. Is it safe to use hormones? There is a lot of research on hormone use, such as birth control and hormone replacement therapy, and their effect on breast cancer risk. If you are considering using hormones, it is important to talk to your health care provider about the risks and benefits. What can I do for my breast health? Be breast aware know how your breasts normally look and feel. If you or your partner find a lump, or notice a change in your breast (such as puckering of the skin, thickened hard skin, new/bloody discharge, a change in the nipple or the size/shape/colour of your breast), do not panic. Most lumps or changes are not cancer. 6
Are you due for your period? Your breasts are most lumpy just before your period starts. Check again after your period. If you are not due for your period or don t have periods anymore, check again in a few days. If the lump or change is still there, see your health care provider. He or she will examine your breasts and may arrange for further testing as needed. Follow a healthy lifestyle - maintain a healthy weight, eat well, be physically active, limit the amount of alcohol you drink, and be smoke free to help lower your risk of breast cancer. Have a screening mammogram every 2 years starting at age 50, or as suggested by your health care provider. For an appointment call BreastCheck at 1-800-903-9290. What about breast self exams and clinical breast exams? Routine breast self exams (BSE) and clinical breast exams (CBE) are not recommended for women with an average risk of developing breast cancer. Research has shown that neither BSE nor routine CBE save lives. Know your individual risk factors. If you have questions or if your risk for breast cancer is higher than average talk to your health care provider. 7
Where can I get more information? BreastCheck CancerCare Manitoba (204) 788-8000 or 1-800-903-9290 www.breastcheckmb.ca Winnipeg Regional Health Authority Breast Health Centre (204) 235-3906 or 1-888-501-5219 www.wrha.mb.ca/bhc CancerCare Manitoba Breast Cancer Centre of Hope (204) 788-8080 or 1-888-660-4866 www.cancercare.mb.ca/hope Be PINK - Adolescent Breast Health CancerCare Manitoba www.cancercare.mb.ca/bepink Public Health Agency of Canada Information on Mammography for Women Aged 40 and Older: a Decision Aid for Breast Cancer Screening in Canada www.publichealth.gc.ca/decisionaids 8