Concerns about your Breasts

Breast Discharge

Breast discharge is normal soon after giving birth and continues if a woman is breastfeeding. In other circumstances, however, release of breast milk can mean that the hormones causing milk production are out of balance. This condition is called galactorrhea. Release of a liquid other than breast milk can be a sign of infection, inflammation, or a tumor in the breast.

The pituitary, thyroid, adrenal, and ovarian glands all release hormones that govern production of breast milk. If the thyroid gland is not producing enough hormone it can lead to untimely release of breast milk. Another explanation is a benign (non-cancerous) growth on the pituitary gland. In these cases, menstruation usually stops as well. Diseases of the part of the brain that controls the pituitary gland are a third possibility. Other causes are stress, sexual stimulation, and drugs, including birth control pills, marijuana, narcotics, anesthetics, reserpine (Diupres, Hydropres, others), methyldopa (Aldomet), antidepressants, and other medications prescribed for mental and emotional problems.

In half of all cases, no cause is found. Your doctor may order blood tests, breast x-rays, and analysis of the fluid. If the liquid from the breast is not milk and is bloody, thin, white, green, or yellow, the cause is more likely to be a breast infection or tumor. If blood levels of a hormone that controls breast milk, called prolactin, are high, or your menstrual periods have changed, your doctor may look for a growth on the pituitary gland. An underactive thyroid can be identified through blood tests and can be treated by taking hormones in pill form. One drug, called bromocriptine (Parlodel), lowers prolactin production and may be helpful. Pituitary tumors may be removed surgically.

Breast Lumps

Finding a lump in the breast strikes fear into the heart of most women, and justifiably so. Depending on which estimate you use, breast cancer affects as many as 1 in 9 women throughout their lifetime until age 90. However, this statistic is a bit misleading. At any one point in time, your risk may be higher or substantially less. Risk increases with age, and, all other factors being equal, is highest from 80 to 90. Nonetheless, breast cancer is common and lumps are often its first sign. Because early diagnosis and treatment greatly increases chances of survival, see your doctor immediately if you find a lump in your breast. He or she will discuss with you the steps to be taken to determine if it is cancerous. Monthly breast self-examinations, following your period, are the best way to know what your breast normally feels like and to detect any changes at an early stage.

It's also important to remember that most breast lumps are NOT cancer. The most common cause of non-cancerous breast lumps is a condition called fibrocystic breast changes. About 20 percent of women have symptoms of this problem. It is so wide-spread that some experts consider it a variation of normal rather than a disease. These lumps are filled with fluid and become painful and swollen 5 to 7 days before each menstrual period. They shrink after menstruation is over and enlarge again before the next period. Reducing your caffeine intake can help relieve the symptoms. If the lumps do not go away after a month or two, your doctor may insert a needle into one of them and remove some fluid for analysis.

Other non-cancerous lumps can be caused by:

• Blood clots in the breast
• Breast infection (usually during breastfeeding)
• Fibroadenoma (benign tumors more common in women under 25)
• Intraductal papilloma (lumps in breast ducts; symptoms include bloody liquid from the nipple)
• Mammary duct ectasia (inflammation of tissue beneath the nipple due to a hole in the duct; symptoms include burning pain, thick liquid from the nipple, and nipple swelling)

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