Breast problems

Breast problems include changes in how a breast or nipple feels or looks. You may notice pain, tenderness, a lump, swelling, nipple discharge, or a change in the skin. The change may affect one or both breasts.

Most breast changes are not caused by cancer. Hormonal changes, fluid-filled cysts, skin conditions, and pain from the muscles or ribs are common explanations. However, it is important to have a new or persistent change checked rather than trying to identify the cause yourself.

People of any sex or gender can develop breast problems. Changes can also happen during pregnancy, breastfeeding, menopause, or treatment with medicines that affect hormones.

A breast problem may involve:

• An area of soreness, burning, heaviness, or tenderness
• A lump, thickened area, or swelling in the breast or armpit
• Red, warm, itchy, scaly, puckered, or dimpled skin
• A nipple that becomes pulled inward or changes shape
• Clear, milky, yellow, green, or blood-stained nipple discharge
• A change in breast size, shape, or firmness

Pain may come and go with your menstrual cycle. It can also be focused in one spot or worsen when you move, press on the ribs, or use your shoulder.

Breasts naturally have some uneven or lumpy tissue. What matters is whether a change is new for you, persists, or is getting worse.

Hormonal changes can cause tenderness, swelling, or lumpiness, especially before a menstrual period. Pregnancy, menopause, and some hormonal medicines may also affect breast tissue.

Non-cancerous lumps include cysts, which are sacs filled with fluid, and fibroadenomas, which are solid, usually smooth lumps. These cannot be reliably identified by touch alone.

Chest-wall pain comes from the muscles, joints, or ribs beneath the breast. It may follow exercise, lifting, coughing, or a minor injury. The discomfort often changes with movement or pressure.

Skin irritation may result from rubbing, sweat, eczema, an allergic reaction, or an infection under the breast. A poorly fitting bra can add pressure but does not explain every new pain or lump.

Breastfeeding-related changes include fullness, blocked milk flow, and mastitis. Mastitis is inflammation of the breast that can cause a painful, hot, swollen area. A bacterial infection may sometimes develop.

Less common causes include a breast abscess, widening or inflammation of milk ducts, scar tissue after an injury or procedure, and growths within a milk duct.

Breast cancer is one possible cause of a persistent lump, nipple change, discharge, or skin change. Pain by itself is less suggestive, but any ongoing or unusual change still deserves assessment.

Arrange a routine appointment if you notice:

• A new breast or armpit lump
• Pain that persists, worsens, or keeps returning in one place
• Unexplained nipple discharge, especially from one breast
• A nipple newly turning inward
• Dimpling, puckering, persistent redness, or a scaly nipple rash
• A change in breast size or shape that is new for you

Seek same-day medical care for a breast that becomes red, hot, swollen, and painful, especially if you have a fever or feel unwell. Also seek prompt care for a tender swelling that may contain pus, or symptoms that worsen despite treatment for mastitis.

Call emergency services if breast or upper chest discomfort comes with chest pressure, severe shortness of breath, fainting, confusion, or heavy sweating. These symptoms may come from the heart or lungs rather than the breast. Rapid deterioration with a serious infection also needs emergency help.

A clinician will ask when the change began, whether it follows your menstrual cycle, and whether you are pregnant or breastfeeding. Mention any recent injury, surgery, medicines, hormone treatment, and family history of breast or ovarian cancer.

They may examine both breasts, nipples, armpits, and the chest wall. Depending on the finding, you may be offered an ultrasound or mammogram. Ultrasound uses sound waves, while a mammogram is a low-dose breast X-ray.

A sample of fluid or tissue may sometimes be needed. A tissue sample is called a biopsy. Being referred for imaging or a biopsy does not mean that you have cancer; these tests help identify the cause.

Treatment depends on the cause. A well-fitting, supportive bra may reduce movement-related discomfort. A warm or cool pack can also help; protect your skin with a cloth.

If you can safely take an over-the-counter pain reliever, follow the package directions. Ask a pharmacist for advice if you have other health conditions, take regular medicines, are pregnant, or are breastfeeding.

Avoid repeatedly squeezing a lump or nipple, as this can cause irritation and may encourage discharge. For irritated skin, keep the area dry and avoid fragranced products until you know what is causing the reaction.

If you are breastfeeding, continue feeding in a comfortable way or express enough milk for comfort unless a healthcare professional advises otherwise. Avoid forceful massage of a painful area. Mastitis may require antibiotics like amoxicillin or doxycycline, and an abscess may need drainage.

Cysts can sometimes be drained if they are painful. Other lumps may only need monitoring, while some need removal or specialist treatment.

Hormone-related tenderness often settles after a menstrual period. Chest-wall pain and minor irritation may improve over days or weeks. Infections should begin improving with suitable treatment, although swelling can take longer to disappear.

A lump or skin change that remains should be reviewed even if it is painless. If tests are reassuring but the change grows, returns, or feels different, arrange another assessment.

Can breast pain mean cancer?

Breast pain has many non-cancerous causes and, by itself, is less likely to indicate cancer. Persistent pain in one area, or pain with a lump, discharge, or skin change, should be checked.

Should I examine my breasts regularly?

You do not need to use a complicated technique. It can help to know how your breasts normally look and feel so you can notice a new change.

Is nipple discharge always abnormal?

Milky discharge can occur during pregnancy or breastfeeding. Discharge may also follow nipple stimulation or certain medicines. Spontaneous, blood-stained, clear, or one-sided discharge needs medical assessment.

Can men develop breast problems?

Yes. Men can develop tenderness, enlarged breast tissue, infection, non-cancerous lumps, and breast cancer. A new lump or nipple change should be checked.