Benign Breast Conditions and Management
Breast pain, also referred to as mastalgia, can be divided into two categories; cyclical (related to menstrual cycle) and non-cyclical (not related to menstruation). Breast pain is usually not associated with breast cancer
- This is usually seen in women below the age of 40 prior to the onset of menstruation whereby the breasts may seem larger and heavier.
- Simple analgesia and well-fitting bra is advised in first instance and in some cases women will be advised to stop contraceptives as this could aggravate the breast pain.
- If the pain persists the breast specialist may recommend stronger medication, however these can have significant side-effects.
- This is pain that is not related to the menstrual cycle and suggesting that the pain could be arising from the breast tissue.
- The pain could also be musculoskeletal in nature, arising from pulling a muscle for example after heavy lifting. It is rarely associated with cancer however particularly in women above the age of 40 there have been cases where patients with breast cancer have presented with breast pain.
- The management of non-cyclical mastalgia can usually be managed with simple painkillers and a well-fitting bra.
- As with cyclical mastalgia if the pain persists, the breast specialist may recommend stronger medication, however these can have significant side-effects.
It is not unusual to have a breast lump, particularly in young age. The majority of breast lumps are benign (non-cancerous) as opposed to malignant (cancerous). If you do find a breast lump it is still important to see your doctor.
- Breast cysts
- Fibrocystis disease
- Breast cancer
When seen in the breast clinic you will be asked a number of questions which will be followed by an examination of the breasts and armpits. The specialist doctor will then decide what, if any, tests are required following this.
If a lump is found a core biopsy will be carried out whereby a small quantity of cells from the breast lump are obtained by inserting needle into the lump. This will then be sent off to the lab to be looked under the microscopy by a specialist doctor, called a pathologist.
- It is not unusual for women to have nipple discharge even when they are not breastfeeding, however in men it is abnormal. When nipple discharge occurs in women it is usually either normal or due to a minor condition. Nevertheless, it is worth seeing a doctor if this occurs, who may then refer you to a breast specialist.
- The breast specialist will decide whether further investigations are required such as sending off a sample of the discharge to the lab or arranging further imaging such as an ultrasound or a mammogram.
- If the discharge is blood-stained arising from a single milk gland duct with associated abnormalities on microscopic examination, a microdochectomy is usually performed. This is an operation to remove a single duct.
- If the nipple discharge is clear usually no further management is required unless the discharge becomes troublesome or if microscopy/imaging tests are abnormal, in which case surgery may be required to remove the ducts draining into the nipple.