Breast Problems: Self-Exam, Lumps, and Pain

Written by WebMD Editorial Contributor, Deanna Altomara
Medically Reviewed by Shruthi N, MD on December 12, 2024
7 min read

The breast is an organ that changes with puberty, monthly menstrual cycle, and pregnancy. It also continues to change with age.

Most changes in your breasts are perfectly normal and no cause for concern. But some breast problems need medical attention, including breast lumps.

Breast lumps come in many forms, including cysts, adenomas, and papillomas. They differ in size, shape, and location, as well as in causes and treatment. About half of all women have lumpy breasts, or fibrocystic change. They are more common during the premenstrual period and usually disappear after menopause. Most lumps are benign and do not signal cancer; however, any time you find a new or unusual lump, have your doctor check it to make sure it is not precancerous or cancerous.

Cysts

Cysts can be large or small. They are often harmless, fluid-filled sacs that may be painful.

After menopause, many cysts shrink or disappear. If you have any lumps that form after menopause, you should immediately have your doctor check them.

Fibroadenomas

Fibroadenomas are the most common benign breast tumors in women under 25 and can sometimes affect adolescents, too. These tumors are usually round, several centimeters across, and mobile. They tend to regress after menopause. Your doctor may suggest removal if the lump persists, gets larger, or if you are anxious about it. Tests will be done to check for cancer when it is removed.

Nipple adenomas

Nipple adenomas are tumors of the nipple area. They vary in appearance, sometimes come back after being removed, and may even be associated with cancer.

Intraductal papillomas

An intraductal papilloma is an uncommon small growth in the lining of the milk ducts near the nipple. Usually seen in women over 40, papillomas produce a discharge, which may be bloody.

Hormone replacement therapy (HRT) and breast lumps

Researchers are studying the incidence of breast lumps in women using hormone replacement therapy (HRT). In HRT, women take the hormones estrogen or progestin (or both) to ease the symptoms of menopause. A study of over 1.2 million women found that HRT often resulted in more harm than good. Taking HRT by mouth or by skin raised the women’s risk of developing breast cancer. In particular, women who took a pill with both estrogen and progestin had a breast cancer risk more than double that of people who didn’t take any HRT. The longer the women took the combination pill, the more their risk went up.

 

Most breast changes are harmless. But some need a doctor's attention and might be signs of breast cancer.

Breast cancer

This is an abnormal growth of cells in the breast. It’s the second most common type of cancer among women in the U.S. But it can affect men and nonbinary people, too. Breast cancer detection and treatment have improved greatly over the last few decades. Because of this, more people are surviving than ever before.

Some signs of breast cancer are:

  • A lump or thick patch of skin in the breast
  • Flat or inverted (turned inward) nipple
  • Changes in size, shape, skin color, or appearance of the breast
  • Changes in skin texture (for example, skin that’s puckered like an orange peel)
  • Flaky, scaly, or crusty rash on the breast

Paget’s disease of the breast

This rare type of breast cancer affects the nipple and the dark circle (areola) surrounding the nipple. You might notice: 

  • Flaky or scaly nipple
  • Crusty, eczema-like rash on the nipple and areola
  • Yellowish or bloody fluid leaking from the nipple
  • Flat or inverted (turned inward) nipple
  • Itching, tingling, or burning
  • Redness
  • Breast lump
  • Thick skin on the breast

Paget’s disease usually affects people over the age of 50 and tends to occur alongside ductal breast cancer.

Lobular carcinoma in situ

This is when unusual cells form in the milk glands. It doesn’t cause any symptoms, but your doctor might accidentally discover it if you have a breast biopsy done for a different reason. It’s not cancerous but can raise your risk for breast cancer.

The American Cancer Society states that research has not shown a clear benefit of performing regular breast self-exams. If you decide to perform breast self-exams, your doctor should go over how to perform them with you. Premenstrual changes can cause temporary thickening in breast tissue that disappears after your period, so your doctor may tell you to wait until a few days after your period to do them.

A breast self-exam is easiest in the shower, using soap to smooth your skin. Look for dimpling. Using light pressure, check for lumps near the surface. Use firm pressure to explore deeper tissues. Squeeze each nipple gently; if there is any discharge, especially if it is bloody, consult your doctor.

Any time you find a new or unusual lump in your breast, have your doctor check it to make sure it is not cancer. Most lumps are harmless. The best test for distinguishing a cyst from a solid tumor is ultrasound; a needle biopsy may also be done.

Mammograms are detailed X-ray pictures of the breasts and can reveal tumors too tiny to be felt by hand. There is disagreement as to when a woman should start getting mammograms: Some doctors say age 40; others say not until age 50. The American Cancer Society recommends women ages 40 to 44 should have a choice to start yearly screening mammograms if they would like. Women aged 45 to 54 should have a mammogram each year and those aged 55 years or older should continue getting mammograms every one to two years. The U.S. Preventative Services Task Force recommends routine screening for women starting at 50. If you have a family history of breast cancer, especially in your mother or sister, your doctor may want you to start them earlier. Three-dimensional mammograms, to be used along with traditional digital mammograms, are also available in some screening centers.

Breast pain (also called mastalgia) can have many causes, including the normal swelling of breast tissue during the menstrual cycle. Other causes include infection or injury, growths including cancer, and perhaps diet.

The general swelling of breast tissue with your period can be painful, but it is not dangerous, and no treatment is necessary if you can tolerate the discomfort. Each monthly cycle brings about changes in hormones, including more estrogen and progesterone, that bring more fluid into the breasts, expanding tissue, stretching nerve fibers, and causing pain. Some women have this painful swelling just before their periods, with symptoms easing near the end of the menstrual flow. Others have it as a side effect of birth control pills.

Trauma and infection in the breast have the same symptoms you would see elsewhere in your body. Infections tend to become walled off from surrounding tissue, producing small abscesses. This may give them the appearance of cysts. If you think you have an infection, see your doctor. Your doctor will usually prescribe antibiotics, although many times the infection will come back and may require the removal of the infected tissue.

Cysts may produce pain, but breast cancer rarely does — although pain does not rule out the possibility of cancer.

Talk to your doctor right away if you have:

  • A new or unusual lump in your breast or under your arm
  • Inverted nipple
  • Dimpled skin on your breast
  • Clear or bloody fluid leaking from the nipple
  • Redness and pain
  • Scaly nipple
  • Any other change in your breasts
  • Breast pain that gets worse, doesn’t go away after two weeks, or makes it hard to sleep

It’s important to talk with your doctor about breast problems as soon as possible. Most of the time, they’re not dangerous. But if it is cancer, catching it early can be life-saving.

Most breast lumps are harmless, but some could be a sign of breast cancer. If you notice any changes in your breast, talk with a doctor right away.

How do you know if something is wrong with your breasts? 

Changes in the way your breast looks or feels could be a sign of a problem.

What kind of breast pain indicates cancer? 

Breast pain is usually caused by getting your period. But if have pain in a specific spot, feel a lump, notice a different texture, or nipple discharge or changes, talk to your doctor.

What are abnormal findings in the breast?

Getting regular mammograms can help doctors look for abnormalities that otherwise would be impossible to see or feel.

What kind of doctor should you see for breast pain? 

If you have breast pain, you can see your primary care doctor or your gynecologist. They may refer you to a breast health specialist.

How can I get instant relief from breast pain? 

For breast pain related to periods, you can try over-the-counter medicines such as acetaminophen (Tylenol) and ibuprofen (Advil). Other options include avoiding caffeine and alcohol, taking certain supplements, or trying therapy that can lessen stress.