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Breast pathology

 Most women experience breast changes at some time. Your age, hormone levels, and medicines you take may cause lumps, bumps, and discharges (fluids that are not breast milk).

If you have a breast lump, pain, discharge or skin irritation, see your health care provider. Minor and serious breast problems have similar symptoms. Most breast problems are not cancer, but we have to consider what breast cancer affects one in eight women during their lives.
Some common breast changes are:
  •  Fibrocystic breast changes – lumpiness, thickening and swelling, often just before a woman’s period
  • Cysts – fluid-filled lumps
  • Fibroadenomas – solid, round, rubbery lumps that move easily when pushed, occurring most in younger women
  • Intraductal papillomas – growths similar to warts near the nipple
  • Blocked milk ducts
  • Milk production when a woman is not breastfeeding
No one knows why some women get breast cancer, but there are a number of risk factors. Risks that you cannot change include:
  1. Age – the chance of getting breast cancer rises as a woman gets older
  2. Genes – there are two genes, BRCA1 and BRCA2, that greatly increase the risk. Women who have family members with breast or ovarian cancer may wish to be tested.
  3.  Personal factors – beginning periods before age 12 or going through menopause after age 55

 

Other risks include being overweight, using hormone replacement therapy (also called menopausal hormone therapy), taking birth control pills, drinking alcohol, not having children or having your first child after age 35 or having dense breasts.
Symptoms of breast cancer may include a lump in the breast, a change in size or shape of the breast or discharge from a nipple. Breast self-exam and mammography can help find breast cancer early when it is most treatable. Treatment may consist of radiation, lumpectomy, mastectomy, chemotherapy and hormone therapy.
Men can have breast cancer, too, but the number of cases is small.
A mammogram is a special type of X-ray of the breasts. Mammograms can show tumors long before they are big enough for you or your health care provider to feel. They are recommended for women who have symptoms of breast cancer or who have a high risk of the disease. You and your health care provider should discuss when to start having mammograms and how often to get one.
Mammograms are quick and easy. You stand in front of an X-ray machine. The person who takes the X-rays places your breast between two plastic plates. The plates press your breast and make it flat. This may be uncomfortable, but it helps get a clear picture. You will have an X-ray of each breast. A mammogram takes only a few seconds and it can help save your life.
A breast self exam is a check-up a woman does at home to look for changes or problems in the breast tissue. Many women feel that doing this is important to their health.
The best time to do a self breast exam is about 3 – 5 days after your period starts. Your breasts are not as tender or lumpy at this time in your monthly cycle.
If you have gone through menopause, do your exam on the same day every month.
Begin by lying on your back. It is easier to examine all breast tissue if you are lying down.
Place your right hand behind your head. With the middle fingers of your left hand, gently yet firmly press down using small motions to examine the entire right breast.
Next, sit or stand. Feel your armpit, because breast tissue goes into that area.
Gently squeeze the nipple, checking for discharge. Repeat the process on the left breast.
Use one of the patterns shown in the diagram to make sure that you are covering all of the breast tissue.
Next, stand in front of a mirror with your arms by your side.
Look at your breasts directly and in the mirror. Look for changes in skin texture, such as dimpling, puckering, indentations, or skin that looks like an orange peel.
Also note the shape and outline of each breast.
Check to see if the nipple turns inward.
Do the same with your arms raised above your head.
Most women have some lumps. Your goal is to find anything new or different. If you do, call your health care provider right away.
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