Breast Lumps

Although women often react with alarm to any change in their breasts, especially the appearance of a lump, most breast problems are benign disorders. Indeed, more than 80 percent of all breast lumps that appear before menopause are not cancerous. Fibrocystic breast syndrome is the most common cause of breast lumps. Some doctors refer to it as a disease, but most now consider it a normal variation of breast tissue that makes it appear lumpy. The condition seems to be an exaggeration of changes that normally occur in the breast each month, due to fluctuations in the female hormones. These changing hormone levels prepare the breasts for milk production by increasing fluid and blood flow. When conception does not occur, the excess fluid should be reabsorbed by the body, but often some of it accumulates in small sacs called cysts. With time, the sacs may fill with fibrous tissue, leading to permanent lumps. For unknown reasons, the breast lumpiness is often accompanied by swelling, tenderness, or pain, especially during the premenstrual week. This discomfort, which is referred to as cystic mastalgia, commonly begins when a woman is in her twenties and often continues until menopause. Some women have fibrocystic symptoms throughout their menstruating years, others find that they come and go. During pregnancy and breast feeding, fibrocystic breast discomfort stops, as a rule. Many women find that their monthly discomfort is reduced even after they discontinue breast feeding. After menopause, fibrocystic problems usually disappear, but they may in fact worsen in the months leading up to the last menstrual cycle. Contrary to popular belief, fibrocystic breastsdo not increase the risk of breast cancer, but their lumpiness can make it more difficult to detect any tumors that do develop. Fibroadenoma is the most common benign breast tumor. Although its cause is unknown, female hormones may be a factor. Most develop as a single, firm, round lump that moves freely and painlessly under the skin. These tumors normally grow very slowly, but in rare cases, they may enlarge rapidly during pregnancy. It is not uncommon for women who have had one fibroadenoma to develop a second one months or years later. These benign breast tumors do not increase the risk of breast cancer. Lipomas are benign tumors composed of fat cells. They usually lie just below the skin, and may cause dimpling similar to that of breast cancer.

Diagnostic Studies And Procedures

Any unusual or new breast lump should be examined by a doctor. Even if you have fibrocystic breasts, you should be alert to any changes in them. The first step in diagnosis usually involves inserting a hollow needle into the lump. If fluid is easily removed, the likely diagnosis is a cyst. If no fluid can be removed and the lump is solid, mammography and perhaps a biopsy should be done.

Medical Treatments

In severe cases of persistent breast pain that is not alleviated by self care, your doctor may prescribe a diuretic to prevent fluid retention. She may also have you try certain hormonal agents, such as tamoxifen (an estrogen blocker), bromocriptine (a prolactin blocker), or danazol (a synthetic androgen). These drugs are used only as a last resort because of their significant side effects, which range from cessation of menstruation and weight gain to growth of facial and body hair, elevation of blood pressure, headache, fatigue, depression, and blood clots. A fibroadenoma that is not growing or causing symptoms does not require treatment, although many doctors advocate that it be biopsied to be on the safe side. If the tumor is growing or causing other problems, it can be surgically removed under local anesthesia, usually as an outpatient procedure. Lipomas are removed as a rule because of the difficulty of distinguishing these benign tumors from cancer. This procedure, too, can be performed under local anesthesia on an outpatient basis. The removal of small tumors usually does not affect appearance.

Alternative Therapies

Herbal Medicine,A comfrey poultice has been reported to ease breast ten derness. Some herbalists also recommend taking two to four grams of evening primrose oil each day. Avoid herbal remedies that contain ginseng, which can have steroidal effects similar to estrogen; they may exacerbate fibrocystic syndrome and cystic mastitis. Nutrition Therapy, For fibrocystic syndrome, a nutrition therapist might prescribe daily supplements of 400 to 1,000 International Units of vitamin E, which may alter blood fats and indirectly influence hormone levels. In addition, 100 to 200 milligrams of vitamin B6 may help.Intake of salt should be reduced, especially in the second half of the menstrual cycle, to help reduce fluid retention and swelling. Studies indicate that reducing fat intake to less than is percent of total calories alleviates symptoms in many women. Accompanying this change should be an increased intake of complex carbohydrates and high fiber foods, such as fresh vegetables and fruits, plus whole grains.

Self Treatment

A painkiller such as aspirin, ibuprofen, or acetaminophen may be all that is needed to reduce breast discomfort. The role of methylxanthines, a substance in coffee, chocolate, tea, colas, and other caffeine containing beverages, is debatable, but some women report relief when they restrict these substances. Also, it's wise to avoid over the counter medications such as wake up pills, cold remedies, and aspirin combinations that contain caffeine.You can ease anxiety about benign breast disorders by examining your breasts regularly and learning to recognize your own pattern of breast lumpiness. For several months, practice daily breast self-examination . Make a chart for each breast, noting any lumps or discomfort. Keep track of your menstrual cycle on the same chart. Identifying patterns allows you to discern variations that could signal a new breast problem, which might warrant medical attention. Also note any effects of self care, such as reduction of caffeine, salt, or fat.

A few modest changes in lifestyle can help alleviate the discomfort of fibrocystic breasts.

• Wear a bra that fits well and gives your breasts good support. When your breasts are swollen, you may be more comfortable in a brassiere one cup size larger than normal.
• Try to sleep on your back and wear a brassiere to bed when your breasts are swollen and tender.
• Alternate applications of warm and cool compresses on the painful breasts.
• During painful times, avoid activities that jar the breasts, such as jogging and high-impact aerobics. Always wear a support bra during such activities.

Other Causes of Breast Symptoms

Breast cancer produces lumps that are sometimes difficult to distinguish from benign changes. Pregnancy also causes breast swelling and tenderness.