Symptoms of Concern

Most lumps in the breast aren't cancer. They may be cysts or fibrous tumors caused by hormones, age or other factors. However, even noncancerous tumors must sometimes be removed. This may be:

  • Because of size
  • Because of position in the breast
  • To make sure they don’t lead to cancer

Possible Breast Cancer

The following symptoms don’t mean you have breast cancer. They should be looked at soon after they are noticed:

  • A lump in your breast or underarm area
  • Thickening, dimpling or pitting of the breast
  • Nipple discharge that is either clear yellow or bloody
  • Nipples pointing inward (inversion or retraction)
  • The breasts looking uneven
  • Redness of the breast
  • Change in the appearance of the breast or nipple
  • Itchy rash on the nipple

Noncancerous Breast Problems

Common types of noncancerous breast problems include:

  • Cysts
  • Lumps
  • Thickening
  • Breast pain
  • Discharge from the nipple
  • Breast infection

Lumps and Thickenings

If you notice a lump in your breast and are still menstruating, wait one cycle. If the lump is still present after one cycle, call your doctor. If you find a breast lump or thickening and you no longer have periods, call your doctor.

Examination: First, your doctor will look at your breasts and feel for any lumps. After studying your breasts, your doctor will decide if more tests are needed. Diagnostic tests include:

  • Mammography
  • Ultrasonography
  • Biopsy (histology)

If a biopsy is needed, it may happen in one of several ways:

  • Office core or fine needle aspiration biopsy
  • Stereotactic biopsy using a mammogram
  • Ultrasound-guided core needle biopsy
  • Surgical excisional biopsy

Depending on the procedure, these happen either in the office, the radiology department or the operating room. If the biopsy happens in the operating room, intravenous sedation is used. It usually does not need a hospital stay.

Breast Infections

Breast infections are relatively uncommon. Pain can be generalized (the whole breast hurts or throbs) or localized (the breast hurts in one area). Generalized breast pain is called "mastitis" and can be associated with:

  • Breast feeding
  • Pregnancy
  • Cancer treatment

A localized breast infection can be linked to:

  • An abscess
  • A noncontagious infection of the connective tissue beneath the skin (cellulitis)
  • Contagious inflammation or infection of one or more hair follicles of the skin (folliculitis)
  • Other skin or soft tissue damage

Breast infections can become serious and create fever or affect the whole body. You should seek treatment for a breast infection promptly.

Treatment: Breast infections are often treated with antibiotics. Heat, pain relievers, surgery and draining the site may also be needed.

Nipple Discharge

Nipple discharge can be linked with hormonal or normal aging changes (ductal ectasia). It is common for nipple discharge to occur:

  • Rarely
  • In tiny drops
  • During a breast self-exam
  • During other breast manipulation

When nipple discharge occurs on its own or you notice staining of your bra or nightclothes, talk to your doctor. See your doctor for other nipple discharge that includes:

  • Bloody discharge
  • Spontaneous clear or yellow discharge
  • Persistent one-sided discharge

Discharge that is slightly milky and coming from both breasts could be the result of pregnancy or certain supplemental hormones and medications. All nipple discharge should be looked at.

Examination: Complaints of nipple discharge are performed with breast exam and imaging studies. The doctor will try to find out:

  • Where the discharge is coming from
  • If there is blood in the discharge
  • What types of cells are in the discharge (cytology)
  • If the discharge has bacteria in it

Breast Pain

Breast pain may occur at almost any age and can have any number of causes. The pain can be:

  • One-sided
  • On both sides
  • Constant
  • Frequent
  • Occasional
  • Sharp
  • Dull
  • Aching
  • Sticking sensations

Some common reasons for breast pain are hormonal changes caused by:

  • Your period (menstruation)
  • Pregnancy
  • Perimenopause
  • Menopause
  • Muscular straining of the chest wall, upper back and shoulders

Fortunately, breast pain is rarely a sign of cancer.

Examination: A full study of the:

  • Breasts
  • Lymph nodes
  • Muscles of the chest and shoulders

The doctor will use one or more diagnostic tests such as:

  • Mammography
  • Ultrasonography
  • Needle aspiration of cysts

The doctor will also talk to you about your:

  • Caffeine intake
  • Medications
  • Hormones
  • Diuretics
  • Birth control
  • Type of support bra
  • Daily activities

Guidelines for Getting Mammograms

All women should begin getting mammograms each year starting at the age of 40. Women at an increased risk because of family or personal history should begin screening before 40. View comprehensive mammogram screening guidelines from the American Cancer Society.