General Breast Health
Understanding Your Anatomy
Many women fail to perform breast self-examination (BSE) because they don’t know how their breasts should feel and how to recognize changes. Normal breast tissue often feels nodular (lumpy) and varies in consistency from woman to woman. Even within each individual woman, the texture of breast tissue varies at different times in her menstrual cycle, and from time to time during her life.
Understanding the normal anatomy of the breast will help you to become familiar with the normal feel of your own breast, and will help you gain confidence in your ability to do BSE correctly. You will be able to distinguish between suspicious new lumps and ordinary breast tissue that sometimes feels lumpy.
Interior Structure: Your breasts lie on top of, and are loosely attached to, the pectoral muscles on the front of your chest. The breasts move with these muscles which extend from the breastbone up to the collarbone and into the armpit and do the major work of your upper arm and shoulder. Except for tiny ones in the nipples, there are no muscles within your breast; their form and structure are supported by a framework of fibrous, semi-elastic bands of tissue called Cooper's ligaments (after the physician who first identified them).
These ligaments partition the breasts into a honeycomb of interconnecting pockets, each containing mammary glands surrounded by lobules of fatty tissue. During breast feeding the mammary glands ("milk lobes") produce milk, which is collected by a system of ducts which empty into the nipple. Your breasts are surrounded by two chains of lymph nodes – small, kidney-shaped glands that defend your body against disease and infection by filtering out invading organisms from surrounding tissues.
A large chain of lymph nodes extends from the lower rim of the breast up into the armpit, with a smaller chain reaching deeper in, toward the breastbone.
External Contours: You may notice that there is a slight difference in the size of your breasts or even in the size or shape of the nipples – this is normal. The shape and size of your breasts depend on your heredity, your weight, and the supporting ligaments. If the proportion of fibrous tissue is high, ligaments will be strong and not excessively stretched and the breasts will feel firm and retain their shape. If the proportion of fatty tissue is higher, breasts are heavy or pendulous and feel softer. Though the nipples may vary in size or shape, they are usually roughly symmetrical (unless one breast is markedly larger than the other). The areolae, or pigmented area around the nipple, may be any color from light pink to black, and may vary in size from a very narrow ring to one which covers as much as half of a small breast. Areolae, too are generally symmetrical.
To learn more about BSE, visit Frequently Asked Questions.
Normal Breast Changes
| Puberty |
Normal changes in the breasts, including enlargement of the areolae, begin when the breast begins to grow, before the onset of menstruation. Growth is controlled by the female hormones, estrogen and progesterone, which continue to produce normal changes in breast tissue throughout a women’s lifetime.
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| Pregnancy |
Brings changes similar to those occurring before the menstrual period:
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| Menopause |
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| At Any Age | Breasts will increase or decrease in size with changes in your weight; because they are largely composed of fatty tissue, their shape and texture may alter as well if your weight loss or gain is dramatic. |
| General | Most normal changes take place in both breasts, simultaneously and roughly symmetrically (that is, in the same relative position or are in each breast.) Such changes are less likely to indicate a problem than those occurring in one breast only. |
Diet and Exercise
The American Cancer Society has information and guidelines concerning nutrition and physical activity regarding cancer prevention and cancer treatment. Visit ACS.
Stony Brook Cancer Center has certified oncology nutritionists who provide education through the program: Healthy Forks, Fighting Cancer One Fork at a Time. Visit Nutrition Guidelines.
Smoking
Several studies have indicated smokers are at increased risk of breast cancer, with the risk increasing as the number of cigarettes smoked a day increases. These studies suggest smokers may have impaired immune systems.
Environmental tobacco smoke (ETS) is the smoke breathed out by a smoker and includes smoke from the tip of a burning cigarette, also increases the risk for serious health problems including impairing the immune system.
Oral Contraceptives
You should discuss this topic with your doctor and ask any questions you may have on both the advantages and disadvantages of using oral contraceptives so you can make an informed decision. If you are still uncomfortable with taking oral contraceptives, ask your doctor to recommend an alternate method of birth control.