Breast Changes

WHEN TO SEE YOUR DOCTOR

* You discover an unusual lump.

* You have a spontaneous nipple discharge, rough skin with enlarged pores, red patches or a bulge or dimpling in the contour of one of your breasts.

What Your Symptom Is Telling You

If women were made of marble, they would have eternally firm, smooth, symmetrical breasts like the statue of Venus. Flesh-and-blood women, however, have breasts that are constantly changing.

Gaining or losing weight causes changes in the breasts. So do a woman's hormones. Prior to each menstrual period, the surge in estrogen and progesterone stimulates fluid retention and growth in breast tissue. Breasts may swell an entire bra size every month and also become tender and lumpy. Then when menopause arrives, breasts may lose their firmness.

All these breast changes are normal and shouldn't be cause for alarm, according to Kathleen Mayzel, M.D., director of the Faulkner Breast Centre in Boston. "The time for concern is if you notice any sudden or unusual changes in the shape, texture or feel of the breasts," says Dr. Mayzel.

A dimpling of the breast skin or nipple could be from the loss of elasticity in the supporting ligaments as you age. But dimpling may also be a sign that a tumor buried in the tissues is pulling on the skin or nipples. In the case of a tumor, dimpling might show up long before a lump becomes large enough to feel.

Symptom Relief

Here are some hints to help you spot changes in your breasts that should be brought to your doctor's attention.

Use your eyes to look at all sides. Strip to your waist and stand in front of the mirror with your hands on your hips. Slowly turning from side to side, look to see if one breast has become bigger than the other. Check also for any puffiness or bulging, red or discolored patches of skin, thickened areas with big pores or clear, bloody, sticky or yellow nipple discharge.

Raise your arms behind your head. This stretches the breast tissue and makes swelling, dimpling or puckering more prominent, according to Susan Love, M.D., director of the Breast Center at the University of California in Los Angeles and author of Dr. Susan Love's Breast Book. You can also get a good look when you put your hands on your hips and press your shoulders forward, she adds.

Feel the entire breast. Gliding your hands over a wet, soapy breast is a quick way to check for changes, says Dr. Mayzel. Just make sure you feel the entire breast from your collarbone over to your armpit, she says. For more details on doing a breast self-exam, see Breast Lumps on page 77.

Report any unusual findings. If you've found something unusual that isn't in the other breast or you are unsure of your findings, contact your doctor. He or she will help you better learn what's normal or not and set your mind at ease, says Dr. Mayzel.

See also Breastfeeding Problems; Breast Lumps; Breast Tenderness; Nipple Discharge