The so-called breast anomalies include various deviations from normal, which can have a number of causes – from hormonal and other changes, to disorders and diseases of different nature and severity. There are also congenital anomalies, which tend to be a mere aesthetic problem. Among the most common manifestations related to this topic are breast pain, swelling, lump, cyst or breast tumor, discharge from the nipples or an inverted nipple.
Content: Breast anomalies – types and possible causes
Anatomy and development of the breast
What is gynecomastia?
Breast pain and possible causes
Breast lump and possible causes
Benign lumps in the breast
Carcinoma or malignant tumor of the breast
Breast discharge and possible causes
Congenital anomalies of the breast
Do not underestimate breast anomalies
The conditions mentioned above occur much more often in women, but they can also occur in men, such as in the case of gynecomastia . In the article, we will briefly review the most common phenomena, changes and possible diseases of which they may be a symptom.
Anatomy and development of the breast
At the beginning, we will present a few facts about the development and anatomy of the breast. In the embryonic phase, the so-called milk line extending from the armpit to the groin is formed in both women and men . In it, the foundations of the apocrine glands are formed, from which the mammary gland subsequently develops , usually as a paired organ.
In women, the breast (lat. mamma ) develops gradually, while the breast of an adult woman occurs in several anthropological shape types, which alternate during life. At the top of the breast is the nipple surrounded by the areola . The nipple has sebaceous glands , there are small bumps in the areola, and smooth muscle in the nipple and areola.
Female breasts contain mammary glands and fatty tissue. The mammary gland consists of 15 to 20 lobes that branch into lobules from which the milk ducts emerge . Men also have a physiologically functional mammary gland, but they are dwarfed. In men, the basis of the mammary gland remains rudimentary, but exceptionally it can develop further – then gynecomastia arises , the first term we will discuss in the article.
In men, the base of the mammary gland remains rudimentary, but exceptionally it can continue to develop – then gynecomastia arises , the first term we will discuss in the article.
What is gynecomastia?
Gynecomastia is unilateral or bilateral enlargement of the mammary gland in men . Clinically, it manifests itself as enlargement of the nipple and areola (mostly bilaterally) and the body of the mammary gland, which is often manifested by pain and stiffness.
Gynecomastia can lead to subjective problems – a feeling of tension in the breasts and sensitivity of the nipples to the touch, or it can be completely symptomless. If there is only an accumulation of fat, it is called pseudogynecomastia . Cysts also appear in the enlarged gland , which should not be underestimated – breast cancer is not only a female issue, it occurs in 0.5% of men.
A possible main cause of gynecomastia is the increased level of estrogens affecting the growth of breast tissue. This is complemented by a deficiency of circulating androgens or a disorder of the receptors on which these hormones attach and together produce an effect.
Not all gynecomastia needs to be treated – some types go away on their own. Treatment of gynecomastia is therefore only necessary in case of pain or psychological problems for aesthetic reasons. There are 2 methods of treatment available – drug / hormonal treatment and plastic surgery, in which the enlarged mammary glands are removed and liposuction of the surrounding areas is performed.
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Breast pain and possible causes
Breast pain is among the most common symptoms associated with changes in the breast. It is most often related to the menstrual cycle, benign changes in a woman’s mammary gland, pregnancy, breastfeeding and diseases of the musculoskeletal system.
- Breast pain before menstruation– often accompanied by increased sensitivity of the nipples or swollen breasts. Breast pain after menstruation can be related to ovulation, when there is also burning, itching or nipple pain to the touch, which is related to the level of hormones, which fluctuates during the menstrual cycle.
- Breast pain during pregnancy– here again, the cause is turbulent hormonal changes caused by the production of hormones during the implantation of the embryo. The pain usually goes away on its own after childbirth and with regular breastfeeding.
- Breast pain during breastfeeding– in addition to hormones, complications that occur in women after childbirth are to blame. The causes can be cracked nipples, painful nipple discharge, blocked milk duct, inflammation of the mammary gland, fungal infection, nipple discharge or whitish nipple syndrome.
TIP: You can read more about pain associated with menstruation in our article Menstrual pain .
If breast or breast pain is not dependent on hormonal changes, etc., it can have a wide variety of causes. It can therefore also indicate a specific disease and sometimes even a tumor, and in case of embarrassment it is therefore advisable to visit a specialist, points out MUDr. Petr Váša , head of the RDG department at EUC Clinic Ústí nad Labem and head physician of EUC radiodiagnostics.
- Mastitis– inflammation of the breast or mammary glands is typical for lactation and beyond, it also rarely occurs in men. Symptoms of breast inflammation are usually present, such as redness, pain, swelling, fever, local heat, or purulent discharge from the nipple. Treatment consists of administering antibiotics. These inflammations are caused by injury to the nipple and the passage of bacteria (mostly staphylococci) into the gland. Inflammation can also take on a limited form – a so-called abscess, which is also painful and is treated with antibiotics or surgery.
- Mastopathy– fibrocystic disease of the breast (fibrocystic mastopathy) affects 30 to 60% of women. These are benign changes in the breast tissue with an increase in tissue and the formation of bulges or cysts in the mammary gland, sometimes accompanied by increased breast pain. Cysts are cavities filled with fluid and their formation is mainly related to hormonal changes during the menstrual cycle, pregnancy or menopause. The fluid from the cyst may be absorbed over time and the lumps will disappear. If increased cell proliferation is not detected, the risk of developing breast cancer is the same as in the general population of women
- Breast cancer– in the case of breast cancer, pain in the breast is associated with more advanced tumors, or with a more aggressive, so-called inflammatory form of cancer (more on cancer below).
- Other causes of breast pain– sharp and stabbing pain in the chest between the breasts that worsens with inhalation, is not related to the breasts, but to inflammation of the cartilage or blockage of the ribs. The pain often spreads to the armpit. In the case of a heart attack, the pain is felt on the breasts, not in them.
Breast lump and possible causes
Finding a lump, nodule or induration in the breast of different consistency and size is a relatively common phenomenon, in the overwhelming majority of cases in women. Lumps can be very small and painless, but also large up to several centimeters, painful and associated with other symptoms. They can be located under the skin or in the mammary gland, both on the breast and in the armpit. Sometimes the lumps found are mistakenly considered to be swollen nodes in the breast – however, the nodes are mostly located in the armpits, and only rarely in the breast, explains MUDr. Petr Váša from EUC Clinic Ústí nad Labem.
A lump in the breast indicates a change in tissue structure , which occurs, for example, in the already mentioned mastopathy, dysplasia, tumor or inflammatory disease of the breast. The cause of occurrence can therefore be very different. However, it is necessary to draw attention to the fact that these are often benign formations , of which there are countless types (fibroadenoma, papilloma…). However, when any changes are found in the breast, it is always necessary to see a doctor who will rule out the possible malignancy of cancer.
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Benign lumps in the breast
Non-malignant or benign formations in the breast can therefore be a manifestation of the following changes, diseases or disorders:
- Mastopathy– fibrous cystic disease of the breast, a brief description of which can be found above.
- Dysplasia– disorders of breast development caused by hl. an excess of estrogens and a lack of progestogens. Some types of dysplasia can be a precursor to breast cancer. Dysplasia can also occur in men, e.g. with cirrhosis of the liver.
- Fibroadenomas– the most common benign breast tumors in women aged 20 to 40. They arise from the proliferation of connective and glandular tissue, and it can generally be assumed that their occurrence is not associated with an increased risk of breast cancer. It is a variable size, hard, smooth or slightly bumpy and mobile lump.
- Papillomas– benign cauliflower-like growths on the inner surface of the milk duct, which occur in during menopause. It is usually found in the large milk ducts near the nipple. Papillomas occur singly or multiplely and are typically manifested by a discharge (sometimes bloody) from the nipple of the affected breast.
- Lipomas and adenomas– a lipoma arises from the accumulation of fat cells, occurs mostly individually, is semi-solid, limited and usually not dangerous. Atheroma is a cyst formed as a result of the accumulation of sebum when the outlet of a skin sebaceous gland is blocked.
- Paget’s disease / Paget’s carcinoma of the nipple– a rare cancer in the area of the nipple and areola that is on the borderline between benign and malignant breast disease. In early widespread forms, it is necessary to surgically remove the entire lesion, including the nipple, in more advanced forms, it is advisable to remove the entire mammary gland.
Breast cancer is a malignant tumor of the breast , which arises most often from the cells lining the ducts of the mammary gland (ductal) or from the cells of the lobules of the mammary gland (lobular). It is the most common cancer in women.
Carcinoma or malignant tumor of the breast
Breast cancer is a malignant tumor of the breast , which arises most often from the cells lining the ducts of the mammary gland (ductal) or from the cells of the lobules of the mammary gland (lobular). It is the most common cancer in women – 6 to 7 thousand new cases are diagnosed here every year. Breast cancer has a number of types and classification systems that typically include over 2 to 3 dozen different breast cancers.
The first clinical symptom here is swelling in the breast , which can be detected by palpation, but also visible as a bulge. If the emerging tumor is small, it may not be palpable, which is solved by ultrasound examination or mammography. The rule here is that the smaller the tumor is at the time of its detection, the lower the probability that it has already spread beyond the place of origin, and thus the higher the probability of a successful cure.
As already mentioned, breast pain in cancer is associated with more advanced tumors or a more aggressive inflammatory form. Advanced forms are also manifested by skin changes such as dimples on the skin, swelling, or reddening of the skin as a result of the spread of the tumor. An indentation of the originally normal nipple accompanied by changes in the area of the areola is often associated with an advanced breast tumor . There may also be discharge from the nipple , often with a mixture of blood. In the case of a purulent tumor, reddened skin and pain in one breast or stinging in the breast also appear.
The methods of breast cancer treatment are surgical treatment, chemotherapy, radiotherapy, hormone therapy and also biological treatment.
TIP: You can find a complete description of breast cancer in our article Breast cancer .
Breast discharge and possible causes
The term discharge from the breast, or more precisely from the nipple, has already been mentioned several times in our article. It can therefore have different causes and, in connection with them, a different character. Most often, it is a cloudy milk discharge , when milk is formed and secreted without connection with pregnancy or breastfeeding.
Another discharge is a reddish discharge , which is colored with blood. This is usually a sign of cancerous changes in the ducts of the mammary gland. Discharge colored yellow or green is purulent discharge and is a sign of an infectious inflammatory disease of the mammary gland or hormonal changes.
Congenital anomalies of the breast
Congenital anomalies of the breast or breasts include, for example, inverted nipples from birth, underdevelopment of the breast or lateral asymmetry. These are usually aesthetic problems that can eventually be solved by plastic surgery.
- An inverted nipple– can be a completely harmless congenital anomaly, but if it arises during life, it is a manifestation of various pathological changes in the breast and mammary gland, both inflammatory and tumorous (see above).
- Asymmetry of the breasts– some asymmetry of the breasts regarding the size or location can be detected in about 90% of women. Asymmetry as such is not a manifestation of disease and does not mean any health risk.
Do not underestimate breast anomalies
In conclusion, it is appropriate to remind that all unborn anomalies, i.e. changes occurring during life, namely in the structure of breast tissue, skin and the area of the areola and nipple, require a professional examination. The most feared possible cause of these changes are malignant breast tumors. Here, the most effective prevention is regular self-examination of the breast , and for women aged 45+, regular preventive mammography is recommended, which is aimed precisely at the early detection of cancerous changes. Always consult a doctor (gynecologist) for any suspicious findings.