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“Normal Breasts”: What Does This Mean?
There isn’t a perfect or perfect definition of a normal breast; all shapes and sizes are its valid definitions. Where observing one breast, it sometimes differs in shape and size from the other—even on the same individual.
The size, shape, and color of the nipple—and its surrounding skin, or areola—vary. Nipples can stand out, retract, or appear flat. Areola colors can be pale pink, brownish-black, or somewhere in-between shades. You may or may not notice hair around your nipples and stretch marks on your breasts either.
Normal for you is subject to change during your lifetime.
Breast changes happen during menstruation, pregnancy, lactation, puberty, and menopause. Other changes occur with weight loss or gain, while contraceptive or hormone replacement therapy will also affect breast changes. As a trans woman, the hormone treatments become factors in breast change.
Nonetheless, it’s a good idea to get to know your breasts and, knowing when they change, figure out when is the right time to stay calm and when you should call the doctor.
Breast Anatomy
There is breast tissue in equal measure from birth. Most relate to the more pronounced presence of breast tissue in puberty in those designated female at birth.
A fully developed breast contains about 15 to 20 sections, or lobes, that more or less encircle the nipple like spokes on a wheel. These lobes themselves contain small compartments called lobules. Tiny ‘bulbs’ at the very end of each lobule make the milk. These connect together through little ducts that lead to the nipples.
The nipple is situated at the center of an area of darker skin called the areola. The areola possesses small glands called Montgomery glands, facilitating lubrication of the nipple during breastfeeding. The spaces between the lobes and ducts are filled with fat.
While the pectoralis muscle is present on the ribs and below each breast, the breasts lack muscle.
Each breast also has blood vessels running into them; the remaining relevant fat is still present. The lymphatic system helps take lymph throughout the body. Cell lymph nodes with the power to counter infections are also a part of the lymphatic system. They branch into lymph vessels leading to lymph nodes, the latter represented by the small-shaped glands shaped like beans.
Hormones such as estrogen and progesterone are responsible for breast development and prepare the breasts for breastfeeding. Estrogen also elongates the ducts and causes them to create side branches. The emergence of progesterone causes lobules to form in the breast tissue.
For instance, a swelling of the breast may be found, tenderness, and it may become engorged with fluid after the ovulatory period every month. That happens to be a stage when the breasts may become engorged, with swelling or becoming tender.
Different Breast Shapes
Healthy breasts come in multitudes of shapes. When in doubt, a breast can be best described by any one of a dozen or so terms that have gathered through plastic surgeons and bra producers, which essentially encompass all breast shapes.
- Round or archetype breasts, which are evenly full on the top and bottom
- Teardrop breasts, which are fuller on the bottom than the top
- Asymmetrical breasts, which are uneven in size or shape
- Wide-set breasts, which sit far apart from each other on the chest
- Close-set breasts, which are close together on the chest
- Tubular or conical breasts, which are narrow, long, and less rounded
- Relaxed or sagging breasts, which may appear to droop, often after pregnancy or as a result of weight loss or age
Knowing your breasts makes it easier to pick up on changes. Most changes are not going to indicate breast cancer or any serious health problems, but you should bring certain changes to your doctor’s attention. Here’s what you need to know about breast changes you might notice.
Breast lumps
Don’t worry too much; most of them aren’t cancers. Most lumps are cysts and harmless; indeed, most cancers don’t start off with a lump you can feel. But do visit a doctor for an assessment. It is particularly important that you see a doctor if you find large lumps in your armpit or if the bumpy area doesn’t get any better by six weeks.
The doctor will check your breasts and likely order a mammogram, possibly other tests. They may insert a needle and remove fluid from this area or take a small sample from the lump so that it can be studied further.
No matter how recent your last mammogram, check for breast lumps. Because breast cancers can develop between mammograms.
Men and everyone assigned male at birth do very seldom get mammograms, but they can be affected by breast cancer. So, they should also see a doctor if they have any breast lumps. The most common cause of a breast lump in men is a very simple condition called gynecomastia.
Color and texture changes in breasts
If your breast skin is dimpled, itchy, scaly, or red, see a doctor. He may either watch this or take a biopsy—which is the removal of a little tissue—to be assured that all is OK.
Breast rash
On the breast, there can be red or irritated skin or a rash that is dry, itchy, painful, scaly, or blistered. Speak to your doctor if you see or feel either one.
You could find this also in other areas of your body, such as:
- Eczema
- Candidiasis
- Cellulitis
- Hives
- Psoriasis
- Scabies
- Seborrheic dermatitis
- Shingles
There are certain rashes that can develop only on your breast. The causes of such rashes include:
- An abscess
- Mammary duct ectasia (the widening of milk ducts beneath your nipple)
- Mastitis (a breast tissue infection usually related to breastfeeding)
- Nipple eczema (dermatitis)
It is important to know that a rash on your nipple may also signify a couple of conditions indicating breast cancer. One rare type of breast cancer is Paget’s disease, which starts on the nipple and spreads to the skin around the nipple, which your doctor may call your areola. Then there is inflammatory breast cancer, which turns the breast red, swollen, and painful. This is the one that occurs when cancer cells block the lymphatic vessels in your breast skin.
Nipple Discharge
This refers to any fluid that springs out of the nipple. It can occur during pregnancy and breastfeeding. In fact, some people can have it up to two years after that. This is normal.
Hormonal changes during menopause can also cause some nipple leakage. Transgender women using hormone therapy can also experience nipple leakage. Everyone else assigned male at birth should consult their physician about any type of nipple discharge.
Anyone with nipple discharge should seek medical attention if:
- They are getting blood through the nipple discharge.
- The discharge has been seen from one breast only.
- There is no reason at all for that discharge, i.e., it appears without anybody touching or squeezing it.
- It’s associated with breast tenderness, redness, or swelling or changes in the nipple.
Possible origins of the issue include infection, a fluid-filled sac called a cyst, benign tumors (a fibroma), neoplasm, or even cancer.
Your doctor, having conducted a physical examination of both breasts, will no doubt inquire about your symptoms and family medical history. Likely to follow will be a mammogram or sonogram to examine the inside of your breasts.
Nipple Pain
Your nipples are quite sensitive, and there are many reasons why they could be hurting, from poorly fitting clothes to more serious ones.
Such skin conditions are dermatitis, contact dermatitis, and eczema, sometimes combined with certain infections, normal pregnancy, and breastfeeding. Hormonal changes causing nipple soreness sometimes also signal the approaching period. Pain can be due to infections such as mastitis and thrush.
Sore nipples may raise the alert of breast cancer. But while it can be a sign of breast cancer, nipple pain is hardly ever the main symptom.
Nipple Changes
Once in a while, something unusual will come up with your nipples.
If you notice them with hair, please don’t get worked up. The dark circular area surrounding your nipple, the areola, has hair follicles. If it gets annoying, then you can just trim this irritation with a pair of nail scissors.
Some people are born with curved nipples. Others have them become inverted in their lifetime. Your doctor may call them retracted. That’s normal with aging; sometimes you get them during breastfeeding, and they also happen after breast surgery. An injury to the breast may also result in this.
If it’s recent that they’ve become inverted, you should report to your doctor. It could be an indicator of mastitis, mammary duct ectasia, or an abscess under your areola.
Sudden inversion in one or both nipples could signal the presence of breast cancer.
Breast Soreness and Tenderness
If you are menstruating, breast soreness is always a possibility. This breast soreness can start before or after a period begins. This is normal and commonly fading on its own. If it worsens, focuses on one area of your chest, or interferes with your normal activities (like working out or lifting your children), see a doctor.
Causes can include birth control pills, hormonal treatments, or large breast size. During your examination, your doctor may consider whether a change in hormonal medications might even help. If the pain is from caffeine, sometimes cutting back can help with some types of breast pain.
Armpit Pain
If you’re having pain under your armpit and uncertain what causes it, see your physician.
While it could be something simple, such as muscular strain or a viral infection affecting the lymph nodes, it might as well be a symptom of breast cancer.
You may have no symptoms of cancer occurring within your breast. However, pain and swelling in the armpit could signify that breast cancer has metastasized into lymph nodes.
Sometimes a better-fitting bra helps relieve discomfort for some women with large breasts. In some cases, breast reduction surgery may make sense.
Changes in Your Breast Size or Shape
Your breast size and shape can change during your life. For example, before or during your menstrual cycle or pregnancy, when hormones might cause breast enlargement.
After menopause, you might feel your breasts are sagging and shrinking in size. Such changes are common.
However, if at any time you notice changes to your breasts—how they look or feel—check with your health care professional; things may not be well.
What to Do If You Worry About Breast Pain
Temporary breast pain from menses or other causes you could easily explain (new, poorly fitted bra) is nothing to worry over. But, at times, you’ll need your doctor’s expertise to make a diagnosis. Bear in mind that pain itself usually isn’t a sign of breast cancer.
See the doctor if you have pain in one or both of your breasts and one of the following applies:
- Your breast has suddenly swelled or turned red, or it feels heavy.
- The breast has thickened and dimpled on the skin.
- You have breast implants that could rupture and develop scarring.
- You have bloody or clear nipple discharge.
- Your breasts are swollen and hard within days of having given birth.
- A lump that persists beyond your next period.
- Signs of possible infection include any redness, pus, or fever.
- Pain that persists is entirely unexplained.
Takeaways
Breast size and shape vary hugely. They grow and change throughout life. Most changes, even lumps and pain, aren’t signs of serious health problems. Knowing your breasts and working with a doctor when something seems to have changed or gone awry can prevent a great deal of worry and assist you in finding problems while you are still in touch with an early diagnosis.
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