Introduction
Monitoring the health of your whole body, including your breasts, is important.
A woman's breasts can be affected by age, hormone levels and medications. Changes may also take place during menstrual periods, pregnancy and as part of the aging process.
Usually, breast changes aren't a cause for alarm. However, some lumps may indicate breast cancer. A woman's risk of getting breast cancer at some point in her life is currently one in nine and the risk increases as she gets older.
Symptoms
Most lumps or changes in the breast are not cancer. In fact, lumpiness in the breasts is relatively common and often becomes more noticeable just before a menstrual period. It can occur in both breasts, centering around the nipple and in the upper, outer parts of the breasts.
Lumps are more prevalent in women 35 to 50 years of age, and can occur more frequently in women who take estrogens as part of hormone replacement therapy. They often disappear in menopause.
Breast lumps may also be associated with fibrocystic breast disease. This occurs when one or more lumps form as fluid-filled cysts. They can cause periodic lumpiness in one or both breasts, especially before menstruation.
A fibroadenoma is a tumour often found in the breast during self-examination. These tumours are not cancerous. They tend to be firm, round, rubbery and painless and can be moved around with ease. Fibroadenomas are most frequent in women in their late teens to early 20s and are more common in black women. Breast biopsies can be used to distinguish between a fibroadenoma and breast cancer.
Mastalgia is severe breast pain that can occur regularly with menstruation or irregularly as non-cyclical pain. It often gets worse when your hormone levels change; stress can intensify the pain. If you experience mastalgia, consult your doctor.
Only qualified medical professionals can definitively rule out a diagnosis of breast cancer; however, if lumps move easily and differ in size according to the monthly cycle, they are likely not cancerous. Cancerous tissue is usually painless, immovable and does not grow smaller. Other symptoms of breast cancer include changes in skin colour or the shape of the nipple.
Causes/Risk Factors
Changes in hormone levels that occur one to two weeks before menstruation can cause fluid-filled cysts to form in breast glands. These cysts can swell and cause pain. The hormonal imbalances associated with menstruation can also increase the number of milk-producing glands, enlarge cells and lead to scars in breast tissue.
The hormones estrogen, progesterone and prolactin often share responsibility for the formation of breast lumps, especially increases in estrogen and decreases in progesterone levels.
A deficiency in gamma-linolenic acid (GLA), which produces the hormone-like substance prostaglandin, can play a role in breast disorders. Methylxanthines, found especially in coffee but also in black tea, chocolate and colas, have also been linked to the development of breast cysts, as has a lack of iodine.
Women are more likely to develop breast problems if they are of child-bearing age, have irregular periods, are over 60, and use birth-control pills, infertility drugs, hormone replacement therapy, corticosteroids or cimetidine.
What You Can Do
Engage in 30-60 minutes of physical activity daily.
Nourish your body with healthy food choices based on Canada�s Food Guide. Avoid coffee, tea, colas and chocolate. These stimulants contain methylxanthines, which have been linked to the development of fibrocystic breast disease.
Limit your salt intake to avoid fluid retention, which can contribute to premenstrual breast tenderness.
Don't smoke and avoid secondhand smoke. If you do smoke, take steps to quit immediately.
Be aware of the normal condition of your breasts and monitor changes. Conduct monthly self-examinations. If you notice a breast lump, pain, discharge or skin irritation, contact your doctor.
To prevent breast tenderness, discomfort or pain, wear a properly fitted sports bra during exercise to prevent injury and to support the breasts. Replace them about every six months if you're using them regularly, since they stretch and become less effective over time.
A mammogram (an X-ray of the breast) is recommended once every two years for women between 50 and 69. To arrange for a mammogram, call the Alberta Screen Test Program at 1-800-667-0604.
What You Can Take
A non-prescription medicine, such as acetaminophen (Tylenol), and non-steroidal anti-inflammatory drugs (Advil or Motrin or ASA), can help to relieve mild breast pain.
Further Resources
Contact the Breast Cancer Society of Canada at www.bcsc.ca or 1-888-855-2555.
