Breast Changes: Pain, Hardness, and Size Discrepancies - Surgery

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I would like to inquire about issues related to the breasts?


I would like to ask about a breast issue because my chest feels strange.
The left side is hard (it hurts when I squeeze it, and sometimes I feel sharp pain, but not often), while the right side is soft (it feels okay when I squeeze it and doesn't hurt much).
The left side is larger than the right, about a cup size difference.
I would like to know what might be the cause.
Please respond as soon as possible! Thank you!

Yi Qiao, 20~29 year old female. Ask Date: 2004/10/30

Dr. Xie Wenhuai reply Surgery


First, may I ask if you are married? In unmarried women, breast lumps are often benign fibroadenomas, while in married women, they are typically cystic fibroadenomas, which represent a degenerative change in breast tissue but still fall within the normal range of breast tissue, with a low risk of malignancy.
It is common for breasts to feel fuller during menstruation, and there may be a size difference between the two breasts, with the left breast often being larger (some believe this is related to the heartbeat).
If you describe the left breast as hard and experiencing sharp pain, it is important to consider the possibility of inflammation, cystic fibroadenoma, or other lesions.
Please consult a breast surgeon nearby.
Thank you.

Reply Date: 2004/10/30

More Info


Breast changes, including pain, hardness, and size discrepancies, can be concerning and warrant a thorough understanding. Based on your description, it seems you are experiencing a combination of symptoms that may be related to hormonal fluctuations, anatomical variations, or other underlying conditions.

Firstly, breast pain, or mastalgia, is a common issue that many women experience, often linked to the menstrual cycle. Hormonal changes during the menstrual cycle can lead to breast tenderness and swelling. This is particularly common in the luteal phase, which occurs after ovulation and before menstruation. The pain can be bilateral or unilateral, and it can vary in intensity. In your case, the left breast being harder and more painful than the right could suggest localized changes, possibly due to hormonal influences or even benign conditions such as fibrocystic breast changes.

The hardness you feel in your left breast could be due to several factors. One possibility is the presence of fibrocystic changes, which are characterized by the development of fibrous tissue and cysts in the breast. These changes can lead to areas of tenderness and can cause the breast to feel lumpy or hard. While these changes are generally benign, they can sometimes cause discomfort and may fluctuate with your menstrual cycle.

Another consideration is the possibility of a benign breast lump, such as a fibroadenoma, which is a solid, non-cancerous tumor that can occur in the breast tissue. These lumps can vary in size and may feel hard or rubbery. If you have previously had a breast ultrasound that showed normal findings, it is less likely that a new lump has developed, but it is still important to monitor any changes.

Size discrepancies between breasts are also quite common and can be attributed to normal anatomical variations. Many women have breasts that are not perfectly symmetrical, and this can be influenced by factors such as genetics, hormonal changes, and even weight fluctuations. However, if the difference in size is significant or accompanied by other symptoms such as pain or changes in the skin or nipple, it is advisable to seek further evaluation.

In your case, the intermittent sharp pain you experience in the left breast, along with the hardness, should be evaluated by a healthcare professional. It is essential to rule out any serious conditions, including breast infections or, although rare, breast cancer. While breast cancer typically does not present with pain, it can sometimes be associated with other symptoms such as changes in breast shape, skin texture, or the presence of a lump.

Given your symptoms, I recommend scheduling an appointment with a healthcare provider, preferably a breast specialist. They may suggest further imaging studies, such as a mammogram or a targeted ultrasound, to assess the area of concern more closely. Additionally, they may perform a clinical breast exam to evaluate the texture and size of the breast tissue.

In summary, breast changes can be multifactorial, often related to hormonal fluctuations, benign conditions, or anatomical variations. While many breast changes are benign, it is crucial to monitor your symptoms and seek professional evaluation to ensure proper diagnosis and management. Remember, early detection and intervention are key to maintaining breast health.

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