When many women think of breast disease, they think of breast cancer, but there are many other diseases and conditions of which women need to be aware. Each breast has 15 to 20 lobes, each with many smaller lobules. The lobules end in dozens of tiny bulbs that can produce milk. Lobes, lobules and bulbs are all linked by thin tubes called ducts. These ducts lead to the nipple, which is centered in a dark area of breast skin called the areola. The areola also has oil-producing glands that secrete a lubricant to make breastfeeding easier. The spaces between the lobules and ducts are filled with fat. There are no muscles in the breast, but muscles lie under each breast and cover the ribs.

These normal features can sometimes make the breasts feel lumpy. The National Cancer Institute (NCI) says this is especially true in women who are thin or who have small breasts. A woman’s breasts also change each month with her menstrual cycle and as she gets older. Common breast changes fall into several broad categories. These include generalized breast changes, solitary lumps, nipple discharge and infection and/or inflammation.

Breast lumpiness, which is sometimes described as “ropy” or “granular,” can often be felt in the area around the nipple and areola as well as in the upper/outer part of the breast. Such lumpiness may become more obvious as a woman approaches middle age and the milk-producing glandular tissue of her breasts increasingly gives way to soft, fatty tissue. Unless she is taking replacement hormones, this type of lumpiness generally disappears after menopause.

There are times when this condition becomes more noticeable. For example, during the menstrual cycle, many women experience swelling, tenderness and pain before and sometimes during their periods. At the same time, one or more lumps or a feeling of increased lumpiness may develop because of extra fluid collecting in the breast tissue. Pregnancy also can bring changes. During pregnancy, the milk-producing glands become swollen and the breasts may feel lumpier than usual. If you have any questions about how your breasts feel or look, talk to your health care provider (HCP).

NCI says that the majority of breast lumps are benign, which means they are not cancerous. Even so, it is important that any woman who notices a lump or change in her breast sees her HCP. Although benign lumps rarely, if ever, turn into cancer, according to NCI, cancerous lumps can develop near benign lumps and can be hidden on a mammogram. Even if you have had a benign lump removed in the past, you cannot be sure any new lump is also benign.

Breast Cancer

Breast cancer is a malignant or potentially life-threatening tumor that can spread throughout the breast and other areas of the body. Breast cancer usually starts to form in the milk ducts, but can also start in the lobe. Other types of cancer that can form in the breast include sarcomas and lymphomas. What many don’t know is that men can get breast cancer, though the majority of breast cancer cases are in women.

Breast Cysts

Cysts are fluid filled sacs. The National Institute of Health (NIH) says they occur most often in women ages 35 to 50, and they often enlarge and become tender and painful just before the menstrual period. They are usually found in both breasts. Some cysts are so small they cannot be felt; rarely, cysts can…

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Fat Necrosis

Fat necrosis is the name given to painless, round and firm lumps formed by damaged and disintegrating fatty tissues. According to the NIH, this condition typically occurs in obese women with very large breasts. It often develops in response to trauma, such as a bruise or blow to the breast, even though the woman may not remember the specific injury. Sometimes the skin around the lumps looks red or bruised. It is important that any woman who notices a lump or change in her breast sees her HCP.

Fibroadenomas

Fibroadenomas are solid and round benign tumors that are made up of both structural (fibro) and glandular (adenoma) tissues. Usually, these lumps are painless and found by the woman rather than a doctor. They feel rubbery and can easily be moved around. Fibroadenomas are the most common type of tumors in women in their late…

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Galactorrhea

Galactorrhea occurs when a woman’s breast makes milk even though she is not breastfeeding a baby. The American Academy of Family Physicians (AAFP) says this may occur when the breasts are touched, or it may start spontaneously. Men can have galactorrhea too, but it is much less common. Causes can include hormonal imbalance, medications such…

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Hyperplasia/Atypical Hyperplasia

Recent studies show that certain types of microscopic changes that feature excessive cell growth or hyperplasia put a woman at higher risk of developing breast cancer. Approximately five percent of benign breast biopsies reveal both excessive cell growth (hyperplasia) plus cells that are abnormal (atypical). The location of these abnormal cells can be in the…

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Intraductal Papilloma

One of the most common causes of bloody or sticky breast discharge is an intraductal papilloma, which is a small, wart-like growth that projects into breast ducts near the nipple. Any slight bump or bruise in the area of the nipple can cause the papilloma to bleed. Solitary intraductal papillomas usually affect women nearing menopause.…

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Mammary Duct Ectasia

Mammary duct ectasia is a disease of women nearing menopause. Ducts beneath the nipple become inflamed and can become blocked. Mammary duct ectasia can become painful, and it can produce a thick/sticky discharge that is gray to green in color. A woman who notices pain or discharge should see her doctor. Treatment consists of warm compresses, antibiotics and, if necessary, surgery to remove the duct.

Mastitis

Mastitis (sometimes called “postpartum mastitis”) is an infection most often seen in women who are breast-feeding. A duct may become blocked, allowing milk to pool, which causes inflammation and may lead infection by bacteria. Bacteria can also enter via cracked nipples. In its earlier stages, mastitis can be cured by antibiotics. If an abscess forms, it will need to be drained or surgically removed. It is important that a woman who notices pain or changes in her breast sees her doctor immediately.

Nipple Discharge

Nipple discharge accompanies some breast conditions. Since the breast is a gland, secretions from the nipple of a mature woman are not necessarily a sign of disease. For example, NIH says that small amounts of discharge of a milky fluid called galactorrhea commonly occur in women taking hormonal or other medications, including sedatives and tranquilizers.…

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Sclerosing Adenosis

Sclerosing adenosis is a benign condition involving the excessive growth of tissues in the breast’s lobules. It frequently causes breast pain. Usually the changes are microscopic, but adenosis can produce lumps that show up on a mammogram, often as calcifications. Short of biopsy, adenosis can be difficult to distinguish from cancer. NIH says surgical biopsy, which furnishes both diagnosis and treatment, is a common option. It is important that any woman who feels pain or notices a lump or change in her breast sees her HCP.