Breast Health: Common Concerns and Cancer Symptoms

Regarding the breasts?

Hello Dr.
Zhao: I would like to ask you a few questions regarding my breasts.
My right breast is smaller, which may also be related to scoliosis, making it appear smaller.
Both nipples have a milky white discharge, and the center of the nipples is indented (not just the center).
However, it seems that the right side has more discharge, or there are pimple-like formations that can be squeezed out, resembling comedones.
It feels like the area around the right areola is slightly more wrinkled.
I previously had a sebaceous cyst removed from my right shoulder, but recently there seem to be similar pimple-like formations (the left side seems to have some as well).
These symptoms have been present for about 5 to 6 years, but they don't seem to have worsened.
I am concerned because some of these symptoms resemble characteristics of breast cancer, but it seems like nothing serious.
I would like to know what symptoms are more definitive for breast cancer, or if this could just be part of some individuals' developmental process during puberty.
Thank you, doctor.

Miao Miao, 10~19 year old female. Ask Date: 2011/05/08

Dr. Zhao Ming reply Breast and Thyroid

Please schedule an appointment with the breast surgery department.
Wishing you well.

Reply Date: 2011/05/08

More Info

Breast health is a significant concern for many individuals, and understanding the symptoms and signs associated with breast conditions, including breast cancer, is crucial for early detection and treatment. Based on the information provided, it seems you have several concerns regarding breast changes, including discharge, asymmetry, and skin changes. Let's delve into these issues and clarify what might be happening.

Firstly, breast asymmetry is quite common and can occur for various reasons, including anatomical differences, hormonal changes, or conditions like scoliosis, which you mentioned. It is important to note that having one breast smaller than the other does not inherently indicate a problem, especially if there are no other concerning symptoms.

The presence of white or yellowish discharge from the nipples can be alarming, but it is not uncommon. This discharge can result from hormonal fluctuations, particularly around menstrual cycles, or from benign conditions such as duct ectasia or intraductal papillomas. If the discharge is spontaneous (occurring without squeezing), especially if it is bloody or accompanied by other symptoms, it warrants further evaluation.

The indentation of the nipple (inversion) can also be a normal anatomical variation, but if this is a new development, it should be assessed by a healthcare professional. Changes in the appearance of the breast skin, such as wrinkling or the presence of small bumps, can sometimes be benign, but they can also indicate underlying issues, including infections or, in rare cases, inflammatory breast cancer.

Regarding your concerns about breast cancer, it's essential to recognize that while some symptoms can overlap with benign conditions, certain signs are more indicative of malignancy. These include:
1. A new lump or mass: Particularly if it feels different from the surrounding tissue or if it persists after your menstrual cycle.

2. Changes in breast size or shape: Sudden changes can be concerning.

3. Nipple discharge: Especially if it is bloody or occurs without squeezing.

4. Skin changes: Such as redness, swelling, or a texture that resembles the skin of an orange (peau d'orange).

5. Persistent pain: While breast pain is often related to hormonal changes, persistent pain that does not correlate with your menstrual cycle should be evaluated.

Given your age (21 years) and the absence of a family history of breast cancer, the likelihood of developing breast cancer is relatively low. However, it is crucial to remain vigilant and proactive about your breast health. Regular self-examinations and clinical breast exams are recommended, and if you notice any changes, you should consult a healthcare provider.

In terms of prevention, maintaining a healthy lifestyle, including a balanced diet, regular exercise, and avoiding smoking, can contribute to overall breast health. Additionally, being aware of your body and reporting any changes to your healthcare provider is vital.

In conclusion, while many breast changes can be benign, it is essential to have any concerning symptoms evaluated by a healthcare professional. They may recommend imaging studies, such as a mammogram or ultrasound, and possibly a biopsy if there are suspicious findings. Early detection is key in managing breast health effectively, so do not hesitate to seek medical advice when in doubt.

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