Signs You Should Get Your Breasts Checked

In a breast self-exam, you use your eyes and hands to determine if there are any changes to the look and feel of your breasts and it helps to increase your breast awareness. Though most breast changes detected during a self-exam for breast awareness have benign causes, some changes may signal something serious, such as breast cancer. Many women find lumps or changes in their breasts since some of these are normal changes that occur at various points in the menstrual cycle. Finding a change or lump in your breast is not a reason to panic. Breasts often feel different in different places. The look and feel of your breasts will change as you age. 

There are a few findings that should prompt you to get checked by a physician sooner rather than later, which may differ depending on if you have breast implants or not.

For Women Without Breast Implants

For women without implants, the key things to watch for/that should alert you to see your doctor include:

• A hard lump or knot near your underarm

• Changes in the way your breasts look or feel, including thickening or prominent fullness that is different from the surrounding tissue

• Dimples, puckers, bulges, or ridges on the skin of your breast

• A recent change in a nipple to become pushed in (inverted) instead of sticking out

• Redness, warmth, swelling, or pain

• Itching, scales, sores or rashes

• Bloody nipple discharge

The concern here of course is breast cancer. However, the way your breasts look and feel can be affected by your period, having children, losing or gaining weight, and taking certain medications. Breasts also tend to change as you age, so it is not a reason to panic. These signs do mean that you need to see your doctor and she or he will likely order some imaging (mammogram or ultrasound) to get more information and rule out a serious diagnosis.

There are also a large number of non-cancerous (benign) conditions that may be causing your breast symptoms, which include:

• Fibrocystic breast changes: Your breasts will feel lumpy. These lumps are made up of a fibrous, rubber-like, thick tissue, or a fluid-filled cyst. Most commonly the management is lifestyle modification (e.g., avoiding caffeine).
• Cysts: These are fluid-filled lumps in your breasts that may be tender when you touch them. You may notice they appear and disappear each time you have your period.  Occasionally they need to be drained. 
• Fibroadenomas: These will feel like a small, round, moving marbles in your breast.  A mammogram can typically confirm this. 
• Mastitis:  You may feel a lump that may appear red, warm, and painful. People diagnosed with mastitis typically have a fever. This is typically treated with oral anti-biotics
• Fat necrosis: This is a lump that may feel round and hard. It happens when fatty tissue becomes hard. It’s common in women who are extremely overweight. Sometimes, these lumps are the result of an injury to your breast. It may be filled with liquid fat. These are most often left alone as they can resolve over time (though they do take a long time to resolve).
• Calcification: You may or may not feel these tiny, hard spots. They are due to leftover, hardened calcium deposits in your breast. Eating or drinking too much calcium doesn’t cause it. Most are benign. However, some calcification can be a sign of cancer.
• Nipple discharge: The fluid coming from your nipple may be different colors. A clear or milky color represents a problem with your hormones. If the discharge is green-black, it may represent a blocked milk duct. If the discharge is bloody, it could be related to an injury, infection, or benign tumor. It also can be associated with breast cancer.

For Women with Breast Implants

For women with implants, the key things to watch for / that should alert you to see your doctor include all of the above, as well as:

• Hardening or a change in the shape or softness or mobility of the implant/breast. This is by far the most common complaint/finding in women with breast implants. The most common reason for this is capsular contracture or hardening of the scar tissue around the implant. It can occur in up to 10-15% of women with breast implants. While not an emergency, there is a reason to see your surgeon. Caught early, there are some non-surgical options that may prevent the need for surgery. Much less commonly it can be a sign of BIA-ALCL or rarely BIA-SCC.

• Breast implant anaplastic large cell lymphoma (BIA- ALCL). This is an uncommon cancer that has only been found in patients with breast implants that have a rough (textured) surface. BIA-ALCL is not a cancer of the breast tissue. Instead, it is located in the scar tissue that naturally forms around the implant (the implant capsule). By far the most common symptom is unexplained breast enlargement. Other symptoms include unexplained pain, asymmetry, lump in the breast or armpit, overlying skin rash, hardening of the breast, or a large fluid collection. For any patient experiencing these or any symptoms, they should see their doctor for evaluation. Fluid will need to be aspirated (usually with a needle in the office) to be sent for testing. 

• Breast implant-associated squamous cell carcinoma (BIA-SCC).  It is a very rare, but potentially aggressive tumor that appears to be associated with breast implants. BIA-SCC is not breast cancer. Instead, it is located in the implant capsule or scar tissue that naturally forms around the implant. Common BIA-SCC symptoms mimic those of BIA-ALCL. The key differentiating factor is the length of time you have had your implants.  BIA-ALCL presented on average 11 years after getting implants while BIA-SCC appeared on average after 22 years. 

• One breast getting smaller. If you have saline implants, this could mean you have a deflation or leak of the implant. With silicone implants, it can be a sign of implant rupture. It does happen, that some women think one breast is getting smaller when in fact the other breast is getting larger. And that is the more concerning feature, as it could be a sign of BIA- ALCL.

Schedule a Consultation

At Tucson Plastic Surgery, our board-certified plastic surgeons perform an array of breast procedures including breast implant placement and removal. If you are interested in scheduling an appointment with Dr. Mahabir or Dr. Kurtovic, please contact Tucson Plastic Surgery today