Frequently Asked Questions about Breast Symptoms
• Why am I getting pain in the breast?
Pain in the breast is called mastalgia and may be due to a number of causes. Most often it is related to the menstrual cycle, getting worse just before a period and easing or resolving completely after the onset of the period. This pattern is called cyclical mastalgia. In a large number of women with this pattern of pain, there is a deficiency of a fatty acid called Gamoleneic Acid (GLA). This makes the breast more sensitive to the effects of the female hormones oestrogen and progesterone. As a result, the changes in the breast are exaggerated.
It is very useful to keep a chart of the mentrual cycle and the days the breasts get painful and the days the pain resolves. Some breast units will be able to provide you with these charts to help you keep an account of your symptoms.
Breast pain is almost never a symptom of breast cancer.
• How can I get relief from the pain?
It is important to determine the cause of the pain. Where it is hormonal (cyclical mastalgia) taking Gamoleneic acid 240mgs daily, present in Oil of Evening Primrose or Starflower oil, will reduce the sensitivity and the pain. 200 to 400mg of Ibuprofen every 6 or 8 hours may be required in cases of severe pain.
It is important to wear a bra that fits perfectly. A bra that is too large or too small will make the breasts sore. Underwired bras make the pain worse and are best avoided when the breasts are painful. Support or sport bras are the best at such times.
If the pain is due to arthritis in the neck , shoulders or spine, these will need to be treated. Physiotherapy often helps.
• What is a cyst?
A cyst is fluid containing sac. They often appear suddenly as a painful lump.They may be small or large, single or multiple. Sometimes they may cause no symptoms and are detected incidentally when the breast is scanned for some other reason.
In the majority of cases cysts are benign ( not cancerous) but an ultrasound scan is necessary in all cases.
• What is Fibrocystic Disease?
Fibrocystic disease is the medical term given to a condition characterised by multiple lumps in the breast due to cysts. These cysts are associated with scarring within the breast. Generally this is referred to as ‘lumpy breasts’. It is very common in women of childbearing age and tends to largely disappear with the onset of menopause
• What is a Fibroadenoma?
A Fibroadenoma is a benign lump that presents as a smooth round lump of varying sizes. Usually it is the size of a pea or a marble but can grow to a very large size. It is often called a “breast mouse” as it moves from one part of the breast to another when felt.
• Can Fibroadenomas turn cancerous?
A fibroadenoma will rarely if ever become malignant. In such cases it will show an increase in size quite rapidly. Most remain unchanged and may even diminish in size. Some small ones may even disappear. It is not necessary to remove them unless they rapidly increase in size or cause symptoms.
• What should I do if I have a lump? What can I expect from my doctor?
In the first instance , you should see your GP.
All breast lumps should be assessed by a specialist. He/she will then ask for an ultrasound scan. If you are 40 years of age or older, a mammogram will also be done. Most units will carry out a biopsy of the lump in patients 25 years or older. This biopsy may be done with a needle and syringe ( examination of cells only and this is called cytology) or with a cutting needle fired by a gun like machine ( this is called a needle core biopsy and examines a sliver of tissue rather than cells alone).
• Does the lump need to be removed?
When the lump is confirmed by biopsy to benign, then in most instances it can be left alone. If it is malignant (cancerous) it will need treatment decided by its characteristics. If there is any doubt about the nature of the lump even after biopsy, it should be removed for microscopic examination