Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Breast changes are common. From the time a girl begins
to develop breasts and begins menstruating and throughout life, women may
experience various kinds of breast pain and other breast changes. Some of these changes normally occur
during the menstrual cycle, during pregnancy, and with aging. Breast lumps,
tenderness, and other changes may occur. Most breast lumps and other changes are
Your breast is composed of several glands and ducts that
lead to the nipple and the surrounding colored area called the areola. The
milk-carrying ducts extend from the nipple into the underlying breast tissue
like the spokes of a wheel. Under the areola are lactiferous ducts. These fill
with milk during lactation after a woman has a baby. When a girl reaches puberty, changing
levels of hormones cause the ducts to grow and cause fat deposits in the breast
tissue to increase. The glands that produce milk (mammary glands) that are
connected to the surface of the breast by the lactiferous ducts may extend to
the armpit area (axilla).
There are no muscles in the breasts, but muscles lie under each breast and
cover the ribs. These normal structures inside the breasts can sometimes make
them feel lumpy. Such lumpiness may be especially noticeable in women who are
thin or who have small breasts.
Lumps within breast tissue are usually found unexpectedly or during a
routine monthly breast self-exam. Most lumps are not cancer but represent
changes within the breast tissue. As your breasts develop, changes occur. These
changes are influenced by normal hormonal variations.
Breast pain is a common breast problem mostly in
younger women who are still having their periods, and happens less often in
older women. Although pain is a concern, breast pain is rarely the only
breast cancer. Most
breast cancers involve a mass or lump.
Cyclic mastalgia: About
two-thirds of women with breast pain have a problem called cyclic mastalgia.
This pain typically is worse before your menstrual cycle and usually is
relieved at the time your period begins. The pain may also happen in varying
degrees throughout the cycle. Because of its relationship to the menstrual
cycle, it is believed to be caused by hormonal changes. This type of breast
pain usually happens in younger women, although the condition has been
reported in postmenopausal women who take hormone replacement therapy.
Noncyclic mastalgia: Breast pain that is not associated with the menstrual
cycle is called noncyclic mastalgia. It occurs less often than the cyclic form.
It typically occurs in women older than 40 years and is not related to the
menstrual cycle. It is sometimes linked to a fibrous mass (called a
fibroadenoma) or a cyst.
Breast pain or tenderness may also occur in a teenage boy. The condition,
called gynecomastia, is enlargement of the male breast which may occur as a
normal part of development, often during puberty.
The breast is made up of hundreds of tiny milk-producing sacs called alveoli. They are arranged in grapelike clusters throughout the
breast. Once breastfeeding begins, milk is produced in the alveoli and secreted
into tube-shaped milk ducts that empty through the nipple. Mastitis is an
infection of the tissue of the breast that occurs most frequently during the
time of breastfeeding. This infection causes pain, swelling, redness, and
increased temperature of the breast. It can occur when bacteria, often from
the baby's mouth, enter a milk duct through a crack in the nipple. This causes
an infection and painful inflammation of the breast.