Intro
Call your health care provider 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 provider if you experience the following:
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You have any abnormal discharge from your nipples.
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Breast pain is making it difficult for you to function each day.
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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.
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Redness
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Swelling
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Pain, especially pain that interferes with nursing
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Drainage from the nipple
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A mass or tender lump in the breast that does not disappear after nursing
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Changes in the skin
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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.
Self-Care at Home
Breast changes are common and often get better without any treatment. But you may be able to lessen or control the pain associated with fibrocystic or cyclic breast pain. First, consider nonmedical options for treatment:
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Talk with your doctor about using birth control pills to control your hormone levels. Some women find relief with oral contraceptives
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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.
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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.
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Apply warm compresses to your breasts for pain relief.
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Over-the-counter pain medication may help.
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Make note, and avoid, any foods that may seem to cause the pain.
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Keep a diary of pain, documenting frequency and severity for at least a two month period. This may be enough to convince you and your doctor that the pain is cyclic and not severe enough to warrant 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.
Mastitis: Breast infections require treatment by a doctor. After you see a doctor, try pain medication, frequent feedings of your infant and warm compresses.
Other Therapy
Avoid the use of home remedies or herbal remedies until you discuss the idea with your health care provider. 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).
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 provider.
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 does not cause cancer, but cancer can mimic mastitis in appearance. If a breast infection is slow to go away, your health care provider may recommend a mammogram or other tests to rule out cancer.
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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 provider for testing. Tumors found during your monthly breast 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-exam 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.
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