Breast anatomy

 What are breasts and what is their function?

 Breast components
 Breast structure
 Nipple and areola structure and function
 Vasculature of the breast
 Breast changes during pregnancy
 Hormonal regulation effect on breasts
What are breasts and what is their function?
The breasts are specialised organs, which are located on the anterior chest wall. The female breast is more
developed than the male breast, as their primary function is to produce milk for nutrition of the infant and
baby. There are lots of glands in our breasts, which grow and develop during puberty and maturation.
Female hormones such as oestrogenand progesterone are important in promoting growth and changes that
occur in the breast, especially during pregnancy and the menstrual cycle. Lying in a superficial layer of our
skin above our chest muscles, the mammary glands in our breast drain via many ducts to our nipples. There
is a dark, circular layer around the nipple, called the areola. It is important for women to understand the
normal anatomy and function of their breasts so that any abnormalities can be detected and treated.
Breast components
The breast consists of:
 Milk glands (lobules) that produce and supply milk
 Special ducts that transfer milk from the lobules to the nipple
 Nipple
 Areola (pink/brown pigmented region surrounding the nipple)
 Fat
 Connective (fibrous) tissue
Breast structure
Female breasts are rarely symmetrical. In most cases, a breast is usually slightly larger or smaller, higher or
lower or of different shape to the other side. When fully developed, the female adult breast is composed of
15–20 lobes of branching glands. These lobes are separated by bands of connective tissue, which radiate out
from the nipple like spokes from the middle of a bicycle wheel. There is lots of fat tissue within the breast.
The amount of fat determines the size of the breast. The fatty tissue gives the breast its soft consistency.
The special glands in the breast are called tuboalveolar glands, which are modified sweat glands. Each of
these glands end in a lactiferous duct (2–4 mm in diameter) and opens up through a small hole onto the
nipple. Deep to the areola, each duct has a dilated part called the lactiferous sinus, in which milk can
accumulate and remain in the nursing mother. Cells which are important in contraction movements, called
myoepithelial cells, are present in the gland and help in secreting fluids.
Nipple and areola structure and function
The nipple and areola are the darker areas of the breast. The nipples contain no fat, hair or sweat glands.
There are many smooth muscle fibres in tissues of the breast, which are specially arranged to help the nipple
to become erect when stimulated. During puberty, the pigment in the nipple and areola increases and the
nipple becomes more prominent
Within the areola, there are sebaceous glands, sweat glands and modified mammary glands (glands of
Montgomery). These glands produce small elevations on the areola surface. The sebaceous glands enlarge
during pregnancy and secretes oily material, which acts as a lubricant for the areola and nipple.
Vasculature of the breast
Arteries carry oxygen-rich blood from the heart to the chest wall and the breasts, while veins take de-
oxygenated blood back to the heart.
The arterial supply of the breast is from:
 Internal thoracic artery
 Lateral thoracic and thoracoacromial arteries
 Posterior intercostal arteries
Venous drainage of the breast is mainly through the axillary vein, and some drainage occurs through the
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internal thoracic veins.

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 Information on re-publishing of our images
Drainage of lymph (a clear fluid that travels through the body’s arteries, circulates through tissues to help
clean them, and then drains away through the lymphatic system) through the breast is very important,
especially in metastases involving breast cancer cells. Lymph runs from the nipple, areola and lobules into a
special network, which then drains to the axillary lymph noses, parasternal and subclavicular nodes.
The nerve supply of the breast is derived from the intercostal nerves. Nerves convey sensory fibres to the
skin of the breast so there is sensation of the breast, and nerve fibres also run to the blood vessels and
smooth muscles within the breast.
Breast changes during pregnancy
During pregnancy, many changes occur in the breast, to prepare for the baby and produce milk. Cells in the
glands of breast tissue change shape and increase in size and number. The areola enlarges and becomes
darker.
Later in pregnancy, subsequent increases in breast size occur through cells which secrete milk products and
these secretory products accumulating in the ducts. A special thick white/yellow fluid called colustrum is
produced in the breast during the last few weeks of pregnancy and first few episodes of nursing. This is rich
in protein and agents which protect the baby from harmful substances such as bacteria.
For more information about pregnancy, including preconception advice, stages of
pregnancy, investigations, complications, living with pregnancy and birth,
see Pregnancy.
Hormonal regulation effect on breasts---During puberty, growth and development of the breast occurs due to
oestrogens and progesterones. After this development, changes in breast morphology occur during the
ovarian cycle due to hormonal fluctuations.
During pregnancy, oestrogen and progesterone produced by the corpus luteum stimulate proliferation and
development of the breast. Prolactin (produced by the adenohypophysis), somatomammotrophin from the
placenta and adrenal corticoids also play a role during pregnancy.
After delivery, levels of circulating hormones decrease with degeneration of the corpus luteum and the
placenta. Milk secretion is stimulated by increased prolactin (as a neurohormonal response to suckling) and
adrenal cortical steroids. Oxytocin is also produced, which stimulates contraction of myoepithelial cells in
the mammary glands to eject milk.
With absence of ovarian hormones after menopause, breast glands atrophy and secretory cells of the alveoli
degenerate. Connective tissue also shows degenerative changes with a decrease in stromal cells and
collagen.
Facts on the Breast
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 The breast generally refers to the front of the chest and medically specifically to the mammary gland.
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 (The word "mammary" comes from "mamma," the Greek and Latin word for the breast, which
derives from the cry "mama" uttered by infants and young children, sometimes meaning "I want to
feed at the breast.")
Mammary Gland Design
 The mammary gland is a milk-producing structure that is composed largely of fat cells (cells capable
of storing fat). The fat deposits are laid down in the breast under the influence of the female hormone
estrogen.
 Just as the surge of estrogens at adolescence encourages this process, androgens, such as
testosterone, discourage it.
 Within the mammary gland there is a complex network of branching ducts (tubes or channels). These
ducts exit from sac-like structures called lobules.
 The lobules in the breast are the glands that can produce milk in females when they receive the
appropriate hormonal stimulation.
 The breast ducts transport milk from the lobules out to the nipple. The milk exits the ducts from the
breast at the nipple.

Picture of the anatomy of the breast

Human Breasts Differ from Other Primates Breasts
Human breasts function somewhat differently than those of other primates. In other primates, the breasts
grow only when the female is producing milk (lactating). When the non-human primate female has weaned
her young, her breasts flatten back down. In humans, the breasts develop at adolescence usually well before
any pregnancy has occurred and the breasts stay enlarged throughout the remainder of life.
Breast Changes During Pregnancy
During pregnancy the breasts grow further. This growth is much more uniform than that at adolescence. The
breasts of women with small breasts tend to grow about as much during pregnancy as those of women with
large breasts. The amount of milk-producing tissue is essentially the same. This is the reason that when milk
production begins, small-breasted women produce as much milk as do large-breasted women.
Function of the Nipples and Surrounding Pigmented Tissue
The nipple becomes erect because of such stimuli as a cold environment, breastfeeding, and sexual activity.
The nipple of the post-partum female is used by the infant to breastfeed.
The small darkened (pigmented) area around the nipple is called the areola. (The word "areola" is the
diminutive of the Latin "area" meaning a small space.) In pregnancy the areola darkens further and spreads
in size. The areola contains small modified sweat glands (Montgomery's glands) that secrete moisture that
acts as a lubricant for breastfeeding.

Other Internal Features of the Breast

The lobules and ducts in the breast are supported by surrounding fatty tissue and the suspensory ligaments of
the breast. There are no muscles in the breast. However, the breast tissue is located on top of the muscles of
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the chest wall. The characteristic bounce of the breast comes from the elasticity of the matrix of connective
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tissue fibers in the breast.

 There are blood vessels and lymphatic vessels in the breast. The lymphatic vessels are thin channels similar
to blood vessels; they do not carry blood but collect and carry tissue fluid which ultimately re-enters the
blood stream. Breast tissue fluid drains through the lymphatics into the lymph nodes located in the underarm
(axilla) and behind the breast bone (sternum).
Cosmetic Aspects of the Breast
 Although the primary biologic function of the breast is to produce milk to feed a baby, the breast has for
many centuries been a symbol of femininity and beauty.
Despite the contemporary concept of an ideal breast, there is no single model that is ideal. The appearance of
the normal female breast differs greatly from one woman to another woman, and the breast of any given
woman even differs at different times during the woman's life -- before, during and after adolescence, during
pregnancy, during the menstrual cycle, and after menopause.
Development of Breast Tissue in the Fetus
Breast tissue begins to originate by the fourth week of fetal life. It grows along two ridges, one on either
side, running from the armpit (axilla) to the groin. These are the so-called milk ridges or milk lines. Breast
tissue can develop anywhere along the milk line. It is quite common to have breast tissue up toward and
even in the armpit. An extra nipple (supernumerary nipple) can also develop anywhere along the milk line in
both women and men, as can a complete auxiliary breast.

Picture of the milk lines

Rarely, the breast may be absent. The normal growth of the breast or nipple never takes place and there is no
sign whatsoever of the breast tissue, areola or nipple. Absence of the breast (also called amastia) frequently
does not occur as the only physical problem. Unilateral amastia (amastia just on one side) is often associated
with absence of the pectoral muscles (the muscles of the front of the chest). Bilateral amastia (with absence
of both breasts) is associated in 40% of cases with multiple congenital anomalies (birth defects) involving
other parts of the body as well.
Amastia can be distinguished from amazia -- wherein breast tissue is absent, but the nipple is present -- a
condition that typically is a result of radiation or surgery.

Breast Lumps and Pain Overview

 Breast changes are common. From the time a girl begins to develop breasts, begins menstruating and
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throughout life, women may experience various kinds of breast pain and other breast changes. Some of these
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 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 not cancer.
The breast is composed of several glands and ducts that lead to the nippleand 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 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
symptom of 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.
 Breast infection: 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. This causes an infection and painful
inflammation of the breast.
What Causes Breast Lumps and Pain?
 Many possible causes exist for pain or tenderness in one of your breasts or in both breasts. Most often the
pain can be attributed to harmless causes such as puberty or pregnancy. It can also be a recurrent problem
for women with cyclical pain associated with the menstrual cycle. Although cancer is a major concern for
most women, it is rarely the cause of isolated breast pain.
Some causes of breast pain are:
 Fibrocystic breast disease
 Premenstrual syndrome, cyclic mastalgia
 Normal hormonal fluctuations
 Onset of puberty or menopause
 Pregnancy
 Breastfeeding (nursing)
 Estrogen therapy
 Chest wall tenderness (costochondritis)
 Injury to the breast (trauma, after breast surgery)
 Shingles (pain is only in 1 breast, usually accompanied by a rash)
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  Use of certain medications such as digoxin
(Lanoxin), methyldopa(Aldomet), spironolactone (Aldactone), oxymetholone (Anadrol),
and chlorpromazine (Thorazine)
 An infection in the breast (breast abscess, mastitis)
 Breast cancer
If you have a lump in your breast, your doctor will check for the following:
 Fibrocystic changes: Fibrocystic changes, previously called Fibrocystic Disease, are the most
common benign or harmless (does not threaten health or life) condition of the breast. Changes can
occur in one or both breasts, most commonly in the upper and outer sections. You may feel a
thickening of the fibrous tissue that supports your breasts. Common lumps, called fibroadenomas,
occur during the reproductive years. They feel rubbery and moveable. They often occur with
fibrocystic changes.
 Cysts: Breast cysts are fluid-filled lumps. They can be tender, especially before your period.
 Breast cancer: Some lumps may be cancer. Breast cancer is usually associated with the risk factors
of age, genetics, or hormones. About 75% of breast cancers occur in women older than 50 years,
23% occur in women ages 30 to 50 years, and 2% occur in women under 30 years of age.
o Genetics is believed to play a role if your mother or sister (referred to as first-degree
relatives) were diagnosed with breast cancer before menopause. You have a two to three
times higher risk than the general population of developing breast cancer.
o Hormonal factors may play a role. If you have had the following conditions, you may have an
increased incidence of breast cancer (possibly because of longer exposure to a hormone
called estrogen).
 Had your first period at an early age
 Had menopause at a later age
 Have never had a child or your first pregnancy was after age 30
o Cancer may also be explained by one of many theories including exposure to viruses,
chemicals, radiation, dietary factors, and genes (for example, BRCA-1). No single theory
explains all types of breast cancer.
What Are the Symptoms of Breast Lumps and Pain?
 Breast lump: Although alarming when you find one, most breast lumps are not cancer.
 Breast pain: Most commonly associated with fibrocystic changes, pain may occur in both breasts,
though one may be more painful than the other. With fibrocystic changes, the pain occurs about a
week before your menstrual period. The pain usually goes away gradually with the onset of your
period.
o Cyclic breast pain is typically most severe before your period and gets better during your
period.
 It is usually described as bilateral (in both breasts), in the upper outer areas of your
breast, and is often associated with lumpiness.
 Women tend to describe this pain as dull, aching, heavy, or sore, and it can radiate to
your armpit or even down your arm.
 The intensity of pain can vary widely with the range of severity from mild to severe
enough to limit clothing selections,sleep positions, or hugging.
o Noncyclic breast pain is typically unilateral (only on 1 side) with no relationship to your
menstrual cycle.
 This pain may be constant or on and off and irregular. It is described as a sharp,
stabbing, burning pain that appears to be right below the area around your nipple.
 If it is localized and persistent, it may be due to the presence of a fibroadenoma or
cyst. But other more serious causes must be ruled out.
 Nipple discharge: May occur from an infection, or from cancer, or from very small tumors within a
part of the brain called the pituitary gland, which influences secretions from the breast. In cases of
infection, the discharge is usually brown or greenish. The color and characteristic of nipple
discharge, however, cannot be used reliably as an indicator for, or against, the diagnosis of cancer.
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Your health care professional can make this assessment.

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  Skin changes: In cancer there is fibrosis (scarring) of underlying breast structures (small ligaments)
causing retraction (pulling) of the breast that can lead to dimpling of the skin or flattened or deviated
nipples. Cancer may block up the drainage (lymphatics) of the breast, and your skin may take on the
appearance of the peel of an orange. Take these symptoms very seriously and see your health care
professional if they occur.
 Mastitis: Such breast infections may cause pain, redness, and warmth of the breast along with these
symptoms:
o Tenderness and swelling
o Body aches
o Fatigue
o Breast engorgement
o Fever and chills
 Abscess: Sometimes a breast abscess can complicate mastitis. Harmless, noncancerous masses such
as abscesses are more often tender and frequently feel mobile beneath the skin. The edge of the mass
is usually regular and well defined. Signs and symptoms that this more serious infection has occurred
include the following:
o Tender lump in the breast that does not get smaller after breastfeeding a newborn (If the
abscess is deep in the breast, you may not be able to feel it.)
o Pus draining from the nipple
o Persistent fever and no improvement of symptoms within 48 to 72 hours of treatment
Call your health care professional as soon as you feel any suspicious lump. You should also consult your
doctor if you detect a significant change while doing a monthly breast self-exam.
Breast lumps ideally should be checked about one week after your period starts. Fibrocystic changes in the
breast are usually irregular and mobile, and you may find more than one lump. Cancerous tumors are usually
hard and firm and do not typically move a great deal.
Call your health care professional if you experience the following:
 You have any abnormal discharge from your nipples.
 Breast pain is making it difficult for you to function each day.
 You have prolonged, unexplained breast pain.
 You have any other associated symptoms that you are worried about. You should see a doctor if you
experience any changes in your breasts.
o Redness
o Swelling
o Pain, especially pain that interferes with nursing
o Drainage from the nipple
o A mass or tender lump in the breast that does not disappear after nursing
o Changes in the skin
o Any of these symptoms with or without fever
 If you are breastfeeding, you should call your doctor if you develop any symptoms of breast
infection so that treatment may be started promptly.
How Are Breast Lumps and Pain Diagnosed?
 If you find a breast mass or lump, you should schedule an appointment with your health care professional who will
do a breast examination to check your breasts for irregularities, dimpling, tightened skin, lumps, inflamed or tender
areas, and nipple discharge. The areas of each breast and underarms will be examined.
If your doctor finds a lump at this time, you may have a re-examination in two to three weeks. If it is still
present, then your doctor may recommend some further testing. The ideal time for the breast examination is
seven to nine days after your period.
If the physical examination is normal and no mass is found, laboratory and imaging tests are not usually
necessary in women younger than 35 years. Women older than 35 years should probably still have a
mammogram unless they have had a mammogram in the past 12 months.
 Mammography is an X-ray technique that looks for changes in the breast. These appear as changes
in the shape of the breast or calcifications. Mammograms can see abnormalities that you may not be
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aware of or that the doctor cannot feel or identify by physical exam.

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o Mammograms are the best tool for the early detection of breast cancer.
 o The test is more sensitive in women over the age of 30. Mammograms detect 85% of cancers,
but up to 15% can be missed. Thus, if a suspicious lump is found, and mammography is
normal or the doctor cannot distinguish the lesion as having a cancerous appearance, then the
doctor may order an ultrasoundor fine-needle aspiration to be performed. An alternative
would be to repeat the mammogram in another 6 to 12 months.
 Ultrasound: If a lump is found, an ultrasound scan helps distinguish between a fluid-filled sac (cyst)
in the breast and a solid lump. This distinction is important because cysts are usually not treated, but
a solid lump must be biopsied to rule out cancer. In a breast biopsy, a piece of the lump is taken out
and tested for cancer.
 Aspiration: If a cyst-like lump is found, fluid may be drawn out of it by suction (aspiration) with a
syringe and needle. Examination of the fluid and repeat exams will help your doctor decide what
other tests to do.
 Fine needle aspiration: Special techniques of aspiration (drawing out a sample of fluid or tissue with
a needle) may be used on certain masses.
 Excisional biopsy: Occasionally, the surgeon may prefer to remove the whole lump and send it for
analysis in a lab. In this case, you will be scheduled for surgery to remove the lump.
 If you have a family history of breast cancer, your doctor may also suggest genetic testing to see if
you have any genes known to put you at higher risk for breast cancer.
Your doctor will be able to classify your breast pain as cyclic or noncyclic by taking a thorough history.
After performing a physical examination, the different causes of noncyclic breast pain can be found. Both
components of your visit to the doctor will determine an appropriate management strategy for you.
 Questions that your doctor will ask you to help decide if you have cyclic or noncyclic breast pain
include your age, the position of the pain, the character of the pain, and the relation of the pain to
your menstrual cycle.
 You should inform your doctor if you have a history of taking hormone replacement therapy or oral
contraceptives, previous history of breast problems, breast surgery, or a family history of breast
cancer.
 It is also important to tell your doctor if you have any other breast symptoms such as nipple
discharge or a lump that you can feel.
The diagnosis of mastitis and breast abscess can usually be made based on physical examination.
 If it is unclear whether a mass is due to a fluid-filled abscess or to a solid mass such as a tumor, a test
such as an ultrasound may be done. An ultrasound may also be helpful in distinguishing between
simple mastitis and abscess or in diagnosing an abscess deep in the breast. This noninvasive test
allows your doctor to directly visualize the abscess by placing an ultrasound probe over your breast.
If an abscess is confirmed, aspiration or surgical drainage, and IV antibiotics, are often required.
 Cultures may be taken, either of breast milk or of material aspirated (taken out through a syringe)
from an abscess, to determine the type of organism causing the infection. This information can help
your doctor decide what kind of antibiotic to use.
 Non-breastfeeding women with mastitis, or those who do not respond to treatment, may have a
mammogram or breast biopsy. This is a precautionary measure because a rare type of breast cancer
can produce symptoms of mastitis.
Breast Lumps and Pain Self-Care At Home
 Limit your intake of caffeine in coffee and soft drinks, theophyllines in tea, and theobromine
in chocolate. Although the role of these methylxanthines is controversial, some women report
improvement in pain when they limit these.
 Daily vitamin E can reduce fibrocystic changes. Avoid doses higher than 600 mg per day.
 Wear a well-fitted bra or sports bra for support, especially if you have large breasts. You may want
to wear a comfortable bra to bed.
 Apply warm compresses to your breasts for pain relief.
 Over-the-counter pain medication may help.
 Make note, and avoid, any foods that may seem to cause the pain.
 Keep a diary of pain, documenting frequency and severity for at least a two month period. This may
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be enough to convince you and your doctor that the pain is cyclic and not severe enough to warrant
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medications that may have bothersome side effects.

  Injury: If you suffer an injury to your breast, apply an ice pack for 20 minutes just as you would for
any other bruise. Do not let the ice touch your skin directly. You can use a bag of frozen vegetables
wrapped in a towel. You may take a pain reliever such as ibuprofen(Advil, for example).
 Mastitis: Breast infections require treatment by a doctor. After you see a doctor, try pain medication,
frequent feedings of your infant and warm compresses.
What Medical Treatments Are There for Breast Lumps and Pain?
When your breast pain is severe enough to interfere with your lifestyle and when it occurs for more than a
few days each month, you may be treated with medications. Before treatment is begun, document the
frequency and severity of your pain on a daily basis for at least one to two menstrual cycles. This pain diary
will also help check your response to treatment.
Breast Lumps and Pain Medications
When nonmedical treatment fails to control cyclic breast pain, your health care professional may
prescribe birth control pills or danazol (Danocrine). Be sure to ask about possible side effects of these
medications and report them to your doctor if you experience them.
 Many other drugs have been tried in the treatment of cyclic breast pain and have been found not to
be useful or are generally not recommended because of their side effects.
 Noncyclic breast pain is managed by treating the underlying cause. If a mass or lump is found, it is
checked and treated. When your breast pain is caused by chest wall tenderness, it is treated with anti-
inflammatory medication or rarely by steroid injections.
 If no cause for the noncyclic pain is found, a pain treatment protocol for cyclic pain is usually tried
and often found to be successful.
 For simple mastitis without an abscess, oral antibiotics are prescribed. The antibiotic chosen will
depend on the clinical situation, your doctor's preference, and your medication allergies, if any. This
medicine is safe to use while breastfeeding and will not harm the baby.
 Chronic mastitis in nonbreastfeeding women is more complicated. Recurrent episodes of mastitis are
common. Occasionally this type of infection responds poorly to antibiotics. Therefore, close follow-
up with your doctor is mandatory.
Surgery
 In general, surgery is not necessary to treat breast pain unless a mass is found. Surgery is performed
to remove a lump.
 If an abscess is present, it must be drained. After injection of local anesthetic, the doctor may drain
an abscess near the surface of the skin either by aspiration with a needle and syringe or by using a
small incision. This can be done in the doctor's office or Emergency Department.
 If the abscess is deep in the breast, it may require surgical drainage in the operating room. This is
usually done under general anesthesia in order to minimize pain and completely drain the abscess. If
your infection worsens in spite of oral antibiotics or if you have a deep abscess requiring surgical
treatment, you may be admitted to the hospital for IV antibiotics.
Other Therapy
Avoid the use of home remedies or herbal remedies until you discuss the idea with your health care
professional. In one study in England, positive effects were found with evening primrose oil in 44% of
women with cyclical pain, although danazol was more effective (70% benefitted).
Breast Lumps and Pain Follow-up
 Recommended mammograms should be part of your routine health maintenance screening. Keep track of
when your last mammogram was done and inform your doctor when you are due for another, based on your
doctor's recommendations. Be aware of your body and the changes you notice on examining yourself. If you
notice a mass, this should also be reported to your health care professional.
 Follow-up care will vary depending on the cause of your breast pain, severity of symptoms, and
treatment strategy. You should discuss a follow-up plan with your doctor. Regular and routine
mammograms are an excellent investment in your future well-being.
 If you have a breast infection, you will usually be seen for a recheck in 24-48 hours. Take all
antibiotics as prescribed.
 Close follow-up of any breast lump or infection is also important to rule out breast cancer. Mastitis
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does not cause cancer, but some cancers can mimic mastitis in appearance. If a breast infection is
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 slow to go away, your health care professional may recommend a mammogram or other tests to rule
out cancer.
Breast Lumps and Pain Prevention
Once you reach age 20, you should begin to do a monthly breast self-exam. The best time to examine
yourself is about seven to eight days after your period begins. If you have passed menopause, do it the same
time each month. If you find any suspicious masses, report them immediately to your health care
professional for testing. Tumors found during your monthly self-exam are usually in an early stage. You
have a better outcome and a higher long-term survival in these cases if cancer is found. Most lumps are not
cancer.
 Performing regular breast self-exams will allow you to familiarize yourself with your body and alert
you when a change in your usual breast tissue is found.
 Repeating the breast exam and completing a pain diary for a few consecutive menstrual cycles will
also help establish whether your breast pain is cyclic or not.
 The American Cancer Society Guidelines for the Early Detection of Cancer recommend yearly
mammograms starting at age 40. Also, Women in their 20s and 30s should have a clinical breast
exam (CBE) as part of a periodic health exam by a health professional, preferably every three years.
After age 40, women should have a breast exam by a health professional every year.
 If you are younger than 40 and in a high-risk category (for example, many women in your family
have breast cancer), you should ask your doctor about how early you should have your first
mammogram.
 Sometimes mastitis is unavoidable. Some women are more susceptible than others, especially those
who are breastfeeding for the first time.
Breast Lumps and Pain Prognosis
Premenstrual breast pain usually increases with age and then generally stops at menopause. Most women are
able to control their symptoms without hormonal treatment.
When treated promptly, the majority of breast infections go away quickly without serious complications.

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