Breast health for everyone

Unless you’ve been on a solo trek in the wilderness for the past few weeks, you know that October was breast cancer awareness month. Pink ribbons and fundraisers were everywhere — with good reason. According to the American Cancer Society, each year almost 65,000 women are diagnosed with early stage breast cancer, and 232,000 are told they have an invasive type of the disease. Almost 40,000 women die from breast cancer annually.

Cortez family physician Kameo Smith, DO, says that recommendations on when women should begin having screening mammograms and how often they should get them vary according to which research studies you read. It also depends on a woman’s family history for breast cancer and other risk factors. “In general, women should get their first screening mammogram at around age 40 and have one every two years. From age 50 to 65, an annual mammogram is recommended,” said Smith. “After 65, it depends on a women’s overall health, and she should discuss the pros and cons with her doctor.”

It’s important to remember that, while relatively rare, men can also develop breast cancer. About 2,240 men are diagnosed with breast cancer each year, and more than 400 die from the disease annually. Another little known fact is that boys around the age of puberty often develop lumps in their breasts. Fortunately, these lumps are almost always harmless and go away on their own. “It’s caused by fluctuating hormones,” said Smith, who sees this in her practice fairly regularly.

While breast cancer gets most of the press, it should be noted that breast health extends beyond the realm of malignancy. There are a number of issues related to breasts that women deal with. One that is quite common is fibrocystic breast disease. “These are non-cancerous lumps that can cause pain and tenderness,” said Smith. The lumps are usually fluid-filled cysts and feel squishy like soft grapes. Breast tenderness, whether caused by these benign cysts or if it’s cyclical and related to menstrual cycles, can often be alleviated by wearing a supportive bra and reducing or eliminating caffeine intake.

“Lumps that are cancer, in general, feel hard like a rock,” said Smith. This is where breast self-exams become important, especially for women prone to developing cysts. “If you always feel lumpy you’re used to it, you don’t get too concerned. If you find new lumps, however, it’s important to see your doctor,” said Smith.

Nipple discharge is another issue that raises concern for some women. “This is most often the result of an infection. It could be a sign of cancer, but that’s rare,” said Smith. “If a discharge is ever bloody, foul-smelling, or one-sided, bring it to the attention of your doctor.” Discharge from both breasts in women who have had children may simply be breast milk. “If you’ve ever had a baby you can continue to leak milk off and on throughout your adult life,” said Smith.

Smith says the most common breast-related problem she sees in her practice is mastitis (inflammation) in breast-feeding women.

“It’s sometimes an infection, but most often it’s a blocked milk duct that’s causing pain and heat,” said Smith. Warm compresses to encourage milk flow and an over-the-counter anti-inflammatory medication will often solve the problem. “It’s important to continue to breast-feed or pump as this unblocks the milk ducts,” said Smith. “If home remedies don’t work, then the women should talk to her doctor.”

While many women long for a more ample bosom, those who are exceedingly well-endowed sometimes suffer from neck, shoulder and back pain, indentations from bra straps and skin irritation under the breasts.

“This is more common than people realize,” said Smith.

Breast-reduction surgery may be an option for women who have significant physical discomfort because of their size. Called reduction mammoplasty, this procedure should be performed by a board-certified plastic surgeon. If certain criteria are met, the operation may be covered by insurance.

Smith said that some concerns women have about their breasts are not of a medical nature at all.

“We’re not equal on the right and left side. One nipple may be higher than the other. This is normal,” said Smith.

Southwest Health Notes is a public service feature provided by Southwest Memorial Hospital in Cortez. The information provided herein is not intended as patient-specific medical advice or as a substitute for consultation with your personal health-care provider.