GynoFiles

Breast lumps that are non-cancerous typically are stimulated by the hormone estrogen. Cancerous lumps may be as well, but are much less frequently found than the non-cancerous lumps. The picture in this post shows a non-cancerous lump. For women with a breast lump that has been stable and suddenly started to grow, the question is, are you getting hormone exposure that you didn't realize? Hormonal stimulation can come from taking hormonal medications or from pregnancy, or from consuming estrogen in foods. Fortunately cancer in women who are pregnant is not common, and less than 1/1000 pregnant women are ever diagnosed with cancer during pregnancy. Plant estrogen or estrogen found in meats from hormone treated animals are both possible sources of the extra estrogen. Overall women who are diagnosed with breast cancer during pregnancy do not have higher death rates. For women diagnosed during breast feeding, their death rate actually is approximately doubled, but some think this is du...

Mammographicbreast density is also now graded along with the other characteristics of your breast reported on a mammogram . Women with dense breast tissue have 3-5 times greater risk of breast cancer than women with normal breasts, and hormone therapy can increase breast density in 30-50% of women who take it.  The National Cancer Institute Breast Cancer Surveillance site also has a lot of data on breast density at their site. They have developed a tool for health care providers to help them understand what patients are at most risk from dense breasts . Generally a physician can look at the mammogram and the amount of ‘black’ verses ‘white’ components of the x-ray. Very white means very dense. Since breast tissue is actually 3 dimensional the denseness of the breast also is based on the internal structures that the radiologist is seeing. The thought has been that too dense of a breast would then obscure the view of a cancer. In general the pictures are graded by the ‘per...

Mammography is an excellent test, and usually the best test for determining the nature of a breast complaint. However, mammography is performed with radiation, and has some cost and discomfort and certainly is not a test women can receive frequently during the year. Women, alternatively, can receive an ultrasound of breast tissue that can reveal the nature of a lump if one is felt on examination. Breast Ultrasound is also extremely useful to direct a fluid aspiration test and to follow up when breast cysts have persisted. Many organizations have guidelines covering when and how to use ultrasound, including, ACOG , AIUM , and ACR . Left Breast Sold Mass,in this case a Fibroadenoma Shown Between Arrows

Women who have painful and lumpy breasts are most likely suffering from fibrocystic breast diseas e. It's been argued that it should be called a breast condition as almost 70% of women will have breast changes consistent with this diagnosis by the time they are in their 40s. The cause is not really known, but we do know that you are about 50% less likely to get FCBD if you have use birth control pills. Women know there are certain times of the month their breasts feel more painful, and seem to be more tender to the touch, and even physically larger. So it is no surprise to learn that on a microscopic level breasts do change during a cycle. During the menstrual cycle the breasts actually cycle, in sync with what the hormones of the ovaries are doing. So that in the early part of the cycle, the estrogen dominant part of the cycle, there is growth of the breast cells. And this is why after the menstrual cycle the breasts are less painful as the estrogen levels are the lowest, and d...

The top signs and symptoms of  breast cancer Remember most early breast cancers have no symptoms at all, and pain is not usually present. Lumps plus any of the signs listed below are more likely to be cancerous.  1. Mass in the breast 2. Skin changes of the breast, particularly new dimpling 3. Sudden difference in the breast appearance, size or shape 4. Bloody nipple discharge, particularly if it comes from a single duct 5. Lymph nodes under arms or Lymph nodes above your collar bone 6. Lump in the underarm (axillary area) 7. Redness of the skin 8. Distorted feature of the breast like it now appearing asymmetrical 9. Breast Pain 10. Mass attached to the skin of the breast

Left Breast Fibroadenoma Shown Between Arrows Ultrasound is a non-invasive and non-painful way of looking at breast lumps. So if you think you feel a mass, get a clinical breast exam with your gyno provider. They may decide to order an ultrasound prior to any x ray exposure

Variation in Breast Nipple Color One Side Darker It is a good idea to check with your gyno whenever you appreciate new breast symptoms. Changes are what we ask patients to pay the most attention to. Women usually think this mostly refers to feeling a breast lump, which should indeed be reason to call. But if there are skin changes, skin color changes, a difference between the nipples that didn't exist at all or new pains or discomfort, these are reasons as well. It is important to notice skin changes. The nipple skin on one side may suddenly be a lot darker than the other side. This can be seen in women without breast discharge, but if there is also nipple discharge on one side that is another reason to get an examination. Many simple explanations can account for one nipple being darker than the other; like using sun screen on one side not the other, but it's also possible there is a medical cause and we advise our patients to come in and consult so that we can determine i...

Breast cancer and estrogen link will never be completely clear, in part because we know there are different types of genetically distinct breast cancers. Editorials and commentary from journals and medical news sites have been flying to try to explain the findings that sometimes we find that taking estrogen during menopausal therapy treatment causes breast cancer, and yet in some studies breast cancer is actually prevented by prescription menopausal estrogen use! The current thinking is that 5 years or less of hormone replacement therapy in menopause is safe. It's important to remember that for you to understand  your individual breast cancer risk multiple facts have to be considered including, your own 'risk-benefit ratio' (the risks you may have of one illness off-set by benefits of the therapy), what other hormones and medications you have taken, how long you have taken what you took previously, and how long you have been off! Your gyno also will consider what your...

Drs. Pearlman and Griffin in the September 2010 journal Obstetrics & Gynecolog y reviewed the topic of non-cancerous breast disease and present a concise picture for physicians on what to recommend for their patients who complain of a new breast mass. In an update of this topic the Division of Pediatric and Adolescent Gynecology at Mayo Clini c with researchers from Melbourne, Australia have looked at the rates of breast cancers in women 25 and under an published their article in September 2011.We know that 80% of breast cancers are in women 50 years or older based on American Cancer Societ y information. Thus a young woman with a mass can find comfort in those facts alone. Of course no one set of generalizations apply to every woman, and experts even have some variation on what they recommend. What remains firm is that a clinical examination, which is by a health care provider, is the first step to evaluation and diagnosis. Any new lump, especially one that has persisted for ov...

Sticky, Icky, and perhaps a bit yellow or brownish or tending to a bit greenish. When my patient's describe their physical complaints, we encourage being as accurate as possible. When we describe the consistency to others in the medical field, in fact, those same lay terms just creep right back into our lingo. But Dr. Nigel Bundred of Manchester in his recent writings on the subject of breast was reaching back into those 18th century metaphors when he described the discharge of Periductal Mastitis and Duct Ectasia as "toothpaste like". I did get the reference being both a avid student of the Two Fat Ladies and the daughter of a cook who could master the burn of virtually all things purported to be edible. As it was in one very popular 18th Century recipe for toothpaste were the ingredients of burnt bread. But lets not digress. If you have this sticky yellow discharge, what could it mean? It might mean fibrocystic condition, it might mean milk production, it might mean ...

Lipomas of the breast are relatively common. When they are deep in the breast they usually escape detection although they can show up quite nicely on ultrasound like this one does in the picture. They are usually painless and not cancerous although lipomas can grow quite large. It is important for your gyno to know what any mass is that is sitting around unchanged in your body so even if removal is not planned, some sort of small biopsy probably will be.

If you feel a breast lump, you should also let your gyno do what is called a clinical breast exam. Studies show that 50-70% of masses felt by the patient or on a physical exam are actually not not seen on mammogram. If  thiis seems confusing remember that on an x ray test, which a mammogram is, only structures which hav3e different shaddow densities will show up. So in breast tissue, which may be on the lumpy side anyway, you may have a mass that is not seen on the mammogram. This is not worrisome per se, but it means the mammogram may not accurately predict what the mass is, so it may be a reason your gyno would recommend a breast biopsy. Ultrasound has been said to be is more accurate than mammogram in young women (those under age 25) and in very dense breasts ultrasound may be more accurate for finding cancers, and the right answer...as to which test you need, has to be decided by your gyno, as based on what is felt, and what other symptoms you have, how long the mass in your...