Breast changes are almost always normal, as women and men experience various breast-related transformations throughout their lives. Women’s breasts change during puberty, pregnancy, and weight loss or gain, while men may notice changes due to hormonal and weight fluctuations. While most of these changes are perfectly normal and harmless, some may signal underlying health concerns, such as breast cancer.
When should you check in with a doctor? Read on for a comprehensive guide to normal versus alarming breast changes.
Understanding the Female Breast Structure
Each breast has 15 to 20 sections, known as lobes, arranged around the nipple. Within these lobes are smaller structures called lobules, which comprise tiny milk-producing “bulbs” at their ends. Slender tubes called ducts, responsible for transporting milk to the nipples, connect these lobules.
Areola and Surrounding Tissues
A darker area of skin (areola) encircles the nipple, which is situated at the center of each breast. Within the areola are small glands known as Montgomery glands, which secrete lubricating fluid to aid breastfeeding. Fat fills the interstitial spaces between the lobes and ducts, providing structural support.
Musculature and Vascular Network
While the breasts themselves lack muscular tissue, the pectoral or chest muscles are beneath each breast, overlaying the ribs. The breasts also contain an intricate network of blood vessels and lymphatic vessels. The lymphatic system, which transports lymphatic fluid containing infection-fighting cells throughout the body, includes lymph vessels that lead to small bean-shaped glands called lymph nodes.
Hormonal Influence and Breast Function
Hormones like estrogen and progesterone influence breast development and function. Estrogen promotes the development of side branches along the ducts, enhancing the complexity of the breast’s internal structure. Meanwhile, progesterone stimulates the growth and enlargement of lobules in preparation for breastfeeding.
FYI: Estrogen is deemed the female hormone, and testosterone is the male hormone. Still, both hormones are present in both sexes.
Male Breast Anatomy
The male breast is almost identical to the female breast, except that the male breast tissue has undeveloped milk ducts and no glandular tissue. Nonetheless, they still have ducts and adipose tissue (fat). Hormonal imbalances or conditions like gynecomastia, where male breast glands grow or swell, can lead to abnormal breast development in men.
Normal Breast Changes
Male and female breast structures undergo changes as people go through different life stages. These transformations often include alterations in size, texture, and sensitivity. Knowing what to expect can alleviate unnecessary panic and distress.
1. Breast Changes Due to Aging
As individuals age, the composition of breast tissue undergoes changes influenced by hormonal fluctuations and the natural aging process. As mentioned, breasts consist of various tissue types, including glandular, connective, and adipose. These tissues naturally become less elastic over time, leading to a loss of firmness and contributing to the phenomenon commonly known as saggy breasts. It affects both women and men.
In addition, estrogen plays a crucial role in the growth and development of breast tissue. During puberty and pregnancy, elevated estrogen levels contribute to breast enlargement and fullness. Conversely, as individuals age, estrogen production gradually declines and leads to changes in breast size and volume. Lower estrogen levels also impact the supportive structures within the breast, such as ligaments and connective tissue, further contributing to sagging.
These changes in breast composition and size are part of the normal aging process. However, the degree of change varies depending on genetics, lifestyle, and overall health.
2. Breast Changes Due to Puberty
During puberty, boys and girls go through physical changes due to hormonal transformations. In girls, the earliest physical change of puberty is breast development, which often begins around age 10 or 11. As estrogen levels rise, it causes breast tissue growth and the enlargement of ducts and lobules, resulting in increased breast size and changes in shape and texture.
Boys also undergo minor breast changes due to rising testosterone levels. If testosterone drops, estrogen can cause gynecomastia. About half of teenage boys between 12 and 16 have some degree of breast enlargement. Gynecomastia at puberty typically clears up as young males get older and their hormone levels stabilize.
FYI: New Hope Unlimited included puberty-related changes because breast cancer can affect teenagers. While breast cancer primarily occurs in older adults, adolescents and their parents need to understand the potential risks and be vigilant about breast health. Read Breast Cancer in Young People: Causes, Types, Consequences for more information.
3. Breast Changes Due to Menstrual Cycle
During the menstrual cycle, estrogen and progesterone levels rise and fall in a dynamic pattern. In the cycle’s initial phase, estrogen levels increase, leading to the growth and development of breast tissue. As a result, most women experience an increase in breast size and fullness during their period.
As ovulation approaches, estrogen levels peak and progesterone levels surge. These hormonal shifts can make the breasts more sensitive and tender, though more women experience swelling or discomfort in the days leading up to their period (about two weeks after ovulation).
If fertilization does not occur after ovulation, estrogen and progesterone levels drop, and breast changes typically subside. However, women may continue to experience breast tenderness or swelling until the first few days of their period.
Understanding these cyclical changes can help women recognize normal breast changes. While mild pain and swelling are common, any persistent or unusual breast changes require a doctor’s professional opinion.
FYI: In an average 28-day menstrual cycle, ovulation occurs approximately two weeks (14 days) before the next menstrual period starts.
4. Breast Changes Due to Pregnancy
Pregnancy induces changes in the breasts, preparing them for lactation and breastfeeding.
Early in pregnancy, heightened levels of estrogen and progesterone prompt breast enlargement, often along with tenderness and sensitivity. As pregnancy progresses, the breasts continue to undergo transformations to support milk production. The development of glandular tissue and the proliferation of lobules and ducts contribute to further breast enlargement and fullness. The areolas may also darken in color, and Montgomery glands, which lubricate the nipples during breastfeeding, become more pronounced. Toward the end of pregnancy, the breasts may feel heavy and engorged as they prepare for milk production.
While these changes are normal and essential for breastfeeding, they can also bring discomfort. Breast tenderness, swelling, and leakage are common.
5. Breast Changes Due to Weight Gain or Weight Loss
Weight fluctuations can have a noticeable impact on breast size and shape, as the breasts are almost entirely fatty. When a person gains weight, excess fat can accumulate in the breasts, causing them to increase in size and become fuller. Contrarily, weight loss may lead to a reduction in breast size, as the amount of fat depletes. Rapid or significant weight loss can also result in sagging or loss of firmness in the breasts, as the skin and supporting tissues may not adapt quickly enough to accommodate the changes in volume.
FYI: These breast changes are more evident in women, but men can also experience them.
When to Worry About Breast Changes
Knowing when to consult a doctor about breast changes is crucial for maintaining breast health. While many breast changes are normal, the following symptoms might be a sign of something serious, including breast cancer:
1. Changes in Breast Size or Shape
If the breasts look or feel different and none of the above is the likely cause, check with a doctor to make sure everything is okay.
2. Breast Lumps
In case of a bulge or bump in the breast, stay calm—most are benign or noncancerous. Before or during a woman’s period, a lump in the breast can appear due to changing hormone levels. Such lumps will shrink once the monthly period ends.
However, some breast lumps appear due to a health issue, potentially breast cancer. Cancerous lumps feel hard, not soft or squishy, and may cause changes in the appearance of the skin, such as redness or dimpling. If a lump or thickened area in the breast persists beyond an individual’s menstrual cycle, they should see a doctor for a thorough evaluation.
Breast lumps are far less common in men. Most lumps are benign, but in rare cases, they may indicate male breast cancer. Men need to take a page from Bret Miller’s book and seek medical evaluation if they detect a lump or thickening that does not resolve within a few weeks. Early detection and prompt medical care are crucial for effectively managing male breast cancer.
Please read Male Breast Cancer Is Real: A Wake Up Call for more information.
3. Breast Pain
According to a study published in the Nigerian Journal of Surgery, those who experience breast pain along with other symptoms have a higher risk of breast cancer compared to individuals who only have breast pain.
If a person has persistent pain or tenderness in their breasts beyond their menstrual cycle (or in general for men), they must seek medical attention. Breast pain, particularly when accompanied by other symptoms such as lumps or nipple discharge, could indicate an infection or, in some cases, breast cancer. Consulting a doctor for a thorough evaluation is the best course of action in such situations. Early detection and diagnosis can lead to timely treatment and improved outcomes.
4. Breast Color and Texture Changes
Noticeable changes in breast skin texture, such as redness, flakiness, or orange peel-like pitting, require medical attention.
5. Breast Rash
In some cases, a rash on the breast may be a symptom of inflammatory breast cancer, a rare and aggressive form of the disease. This malignancy typically appears with symptoms including redness or swelling. Other signs may include thickening or dimpling of the skin. It occurs when cancer cells obstruct the lymphatic vessels in your breast skin.
Furthermore, a persistent rash on the nipple can be a sign of Paget’s disease of the breast. This rare form of breast cancer begins on the nipple and spreads to the areola.
6. Nipple Discharge
A yellow, milky, or green discharge from the nipples, known as physiological discharge, is no cause for concern. Harmless nipple discharge can happen because of hormonal imbalances or changes, such as during menstruation or menopause. Discharge also occurs naturally during pregnancy, breastfeeding, or when stimulated.
However, if the discharge is unilateral (from one breast only) and accompanied by pain, lumps, or skin rashes, a doctor’s opinion is necessary. A cloudy or yellowish discharge may suggest a possible infection, while a clear or bloody discharge may raise concerns about breast cancer. In fact, nipple discharge accounts for 2 to 5% of medical visits among women and indicates breast cancer in 5 to 12% of women.
7. Nipple Pain
Nipple pain, though usually harmless, can sometimes signal breast cancer. It’s uncommon for nipple pain to be the only symptom of breast cancer. Still, it’s important not to ignore persistent pain, especially if discharge, changes in breast size or shape, or skin abnormalities accompany it.
On the other hand, keep in mind that pregnancy or breastfeeding can cause nipple pain, too. For some, nipple pain is also a sign that a period is on the way.
8. Nipple Changes
Every now and then, individuals may notice changes in their nipples, which can understandably raise concerns. For example, it’s common for hair to grow on the nipples, particularly around the areola, as this area contains hair follicles. This is no cause for concern.
Inverted nipples, where the nipple turns inward instead of outward, are also quite common. This can happen naturally or due to factors like aging, breastfeeding, surgery, or previous breast injuries. Some individuals are also born with inverted nipples.
However, sudden and unexplained nipple inversion, especially if other symptoms accompany it, necessitates a visit to the doctor to rule out potential health issues such as mastitis, mammary duct ectasia, or an abscess beneath the areola. Moreover, sudden nipple inversion, particularly in one breast, can be a sign of breast cancer.
9. Swollen Lymph Nodes in the Armpit
Armpit pain, while often attributed to causes such as muscle strain or lymph node inflammation, can also be an indicator of underlying breast health issues, including breast cancer. The axillary region, or armpit, contains a network of lymph nodes, which play a role in filtering out toxins and fighting infection. In cases of breast cancer, cancerous cells can spread from the breast tissue to the nearby lymph nodes, causing them to enlarge and cause discomfort or pain in the armpit. Swollen lymph nodes in the underarm can also manifest as lumps or bumps.
Likewise, some types of breast cancer, such as inflammatory breast cancer, may present with symptoms including redness, warmth, and swelling, which can extend to the surrounding armpit area. This inflammatory response may contribute to armpit pain or tenderness.
Furthermore, metastatic breast cancer, where cancerous cells spread beyond the breast and nearby lymph nodes to distant parts of the body, including the lymph nodes in the armpit, can also cause discomfort or pain in this region.
Ruling Out Breast Cancer
To confirm that breast changes are not due to cancer or other health issues, a doctor will check the following:
- Age and family history: They will ask about the patient’s age and family medical history to determine their breast cancer risk.
- History of changes: The doctor will review the timeline and details of the breast changes to assess the situation better.
- Menstrual cycle and history of hormone therapy: The doctor will consider if the patient is still having periods or using Hormone Replacement Therapy (HRT), as these factors can affect breast health.
- Physical examination and tests: A thorough physical exam, along with a mammogram or ultrasound, will help detect growths within the breast.
Helpful resource: Female Versus Male Breast Cancers: What’s the Difference?
Importance of Knowing Your Breasts
No one should know your body better than you do. Regular breast self-exams help familiarize yourself with the normal look and feel of your breasts, ensuring early detection in case of irregularities. For accurate results, perform a self-exam a few days after menstrual bleeding. For men and postmenopausal women, simply check your breasts once a month.
Get Yourself Screened Today
Keeping up with medical checkups is the best way to determine whether a change in your breast is normal or not. If you have risk factors, such as breast cancer genes, routine screening ensures early diagnosis and treatment.
If you have encountered breast cancer before, you understand the importance of staying vigilant about breast changes better than anyone. As someone familiar with the journey, you recognize the need for regular self-checks and screening. Detecting breast cancer recurrence as early as possible significantly improves treatment outcomes and overall prognosis.
Refer to our ultimate guides to breast self-exams and breast cancer screening for more specific instructions.
When Confronted with Breast Cancer
If your results show that you have breast cancer, whether for the first time or due to recurrence, you can get the care you need at New Hope Unlimited. Our comprehensive approach to breast cancer treatment encompasses holistic methods tailored to your specific needs. From immunotherapy to nutritional counseling and IV therapy, our protocols empower you on your journey to wellness. Reach out to us at 480-666-1403 to schedule a consultation and discover your personalized treatment options.
