Common breast conditions

Painful breasts (mastalgia)

Breast pain is a common breast symptom. The real cause is not known, but it’s often linked to the menstrual cycle in younger women. You may also have breast pain before and after menopause, but the pain is usually on one side and not related to the menstrual cycle.

The contraceptive pill and menopausal hormone therapy (MHT) can also cause breast discomfort in some women.

You may be able to relieve breast tenderness or pain by:

• applying cool packs or heat packs to the affected area
• taking a warm shower or bath
• wearing a comfortable, supportive bra – or no bra
• trying different relaxation techniques
• taking pain-relief medicine.

Your doctor may suggest you take 1,000 mg of evening primrose oil up to three times a day (with food) for a few months to help with breast pain. Painful breasts are not normally a symptom of breast cancer, but if the pain doesn’t go away, see your doctor.

Breast lumps

Normal breast tissue is lumpy. You may notice lumps in the upper area of the breast. It’s normal for your breasts to feel lumpy before your period and less lumpy after your period.

Fibroadenomas (fibrous lump)

Fibroadenomas are painless, benign breast lumps made up of glands and fibrous tissue. These lumps feel quite smooth and firm and can be moved within the breast tissue.

Fibroadenomas are more common in women between the ages of 15 and 30, but they can occur in older women. A recent study suggests that 10% of women have fibroadenoma at least once in their lifetime.

Most lumps are small, but they can grow to as large as a golf ball. They can also be tender in the days before your period.

Breast cysts

A breast cyst is a fluid-filled sac in the breast tissue. Cysts can vary in size during your menstrual cycle and may disappear on their own.

Breast cysts are harmless, but they can be painful. They commonly occur in women aged 35 to 50, but they can also occur in younger women.

Benign fibrocystic disease

Some women have a combination of cysts and thickened breast tissue. This is called ‘benign fibrocystic disease’. If you have this condition, you may have lumpy breasts, and pain and tenderness that fluctuates with your menstrual cycle.

The risk of benign fibrocystic disease increases with age. It usually disappears after menopause but may persist if you take MHT.

Nipple discharge

Any fluid leaking from your nipples is referred to as ‘nipple discharge’.

When you’re pregnant or breastfeeding, it’s normal for discharge or milk to leak from your nipples. This eventually stops after you stop breastfeeding.

Depending on the cause, discharge may be milky, clear, yellow, green, brown or bloody. The consistency can be thick and sticky or thin and watery.

Discharge may be caused by hormone changes, duct problems, trauma or infection. It can also be a sign of breast cancer. It’s important to see your doctor, especially if you notice:

• discharge that is watery or blood-stained
• discharge and a lump
• a change in your nipple (e.g. a ‘tucked in’ or inverted nipple).

Inflammation of the breast (mastitis)

Mastitis causes redness, heat, lumpiness and pain in the breast tissue. You can also feel unwell with flu-like symptoms such as fever and chills. It most commonly occurs in women who are breastfeeding, due to a blocked milk duct that becomes infected.

Treatment may include:

• antibiotics for the bacterial infection
• anti-inflammatory medicine to relieve inflammation and pain
• continuing to breastfeed or express milk, as draining the breast helps clear the blocked ducts.

You need to start antibiotics straight away to prevent a build-up of pus (abscess). If an abscess forms, you may need to have a small surgical procedure to drain it.

Mastitis can also happen in women who aren’t breastfeeding. In these cases, it’s important to see a breast surgeon.

Nipple and breast itchiness

It’s common to have itchy nipples or breasts. Itchiness can be caused by:

• skin disorders, such as eczema or psoriasis
• skin infection, such as thrush (fungal) or mastitis (bacterial)
• contact dermatitis (e.g. from soap or clothing)
• dry skin
• hormonal changes.

Nipple and breast itchiness is not normally a symptom of breast cancer, but it can be, so see your doctor if you have concerns.