Breast Symptoms 101: Your Guide to Causes and Treatment

When it comes to your breasts, I've got you covered! 

In this episode, I dive deep into all things related to BREASTS 🌸 

I cover:

🎀 The occasional discomfort and why that happens
🎀 A new lump - Should you be worried?
🎀 Demystifying the mammogram experience - putting your mind at ease

I've got the answers you need! 

Plus, I share empowering LIFESTYLE CHANGES that can make a real difference in common breast issues. 
💪 Start implementing these tips today and take charge of your breast health!

#forvaginasonly #breasthealth #breastcancerawareness

Transcript

SPEAKER_00: 0:00

Hey guys, welcome to another episode of Four Vaginas Only. In this episode, we're going to talk about all things breasts. We are going to go from top to bottom all the issues that you guys have ever worried about when it comes to your breasts, whether it's one side, the other side, or both at the same time. We'll get into it. But first, let's cue the music. Hello and welcome to For Vaginas Only, the podcast about everything female. I'm your host, Dr. Celestine, bringing you important information about understanding your health and body in the way you wish your doctor would actually explain it. All right. Well, hi again. I'm Dr. Celestine, host of the Four Vaginas Only podcast. I'm a board-certified OBGYN, and I do this stuff every day. So I thought, what better way than to also share with the general community out there, outside of my own patients, and I can bring my knowledge to the world. So welcome to the Four Vaginas Only podcast. In this episode, like I mentioned in the intro, we're going to be talking about breasts. We're breast symptoms and redness, pimples or lesions around the areola that you might have noticed. And also, if you have any extra lumps or bumps in your armpit, what could that be? We'll get into it. Okay, before we get started, I will say that if you notice anything that is different or new to you or concerning in your breasts, you need to go to your OBGYN or breast doctor, okay? Even though I might be talking about some things in here that are normal, I don't want you to just brush off what you're going through as normal. This is just for you to be empowered to take that information, bring it to your doctor, maybe also calm you down a little bit when you notice something abnormal, but it doesn't mean you don't show it to your doctor. You still have to, even if it seems like it might not be anything major based off what you hear in today's podcast episode. So I want to clear that up right off the bat. And since we're talking about you finding an abnormality yourself, let's talk about what's recommended now in terms terms of checking your breasts at home. So back in the day, we used to say, check your breasts every month, feel around, see if you feel any abnormal lumps, bumps, if you notice any abnormal nipple discharge and do that monthly. Now, ACOG, which is the governing body of obstetrics and gynecology in the United States, we talk more about breast self-awareness. So it's not that you have to do a breast exam every month. What I tell my patients is you just have to do the breast exam enough so that you feel comfortable with what your normal breast And the way you do the breast exam doesn't really matter. I'll explain that a little bit. So some people go around the entire breast in a circular form. Some people go up and down. They call it more of a lawnmower type of pattern. But what matters is that you do it the same way every time. So if your doctor goes in a circular pattern, you go in a lawnmower pattern. Doesn't matter as long as you're doing it the same way. Make sure you're also feeling up by your clavicle bone, which is that bone that's right underneath your neck. on each side above the breast. And also make sure you're feeling deep into your armpit because the breast tissue actually has a little tail that extends into the armpit. So you can still get breast abnormalities in that area. So breast self-awareness just means you're doing this maybe every few months until you feel comfortable with what's normal for you. And I would always recommend not doing a breast exam around the time of your period because your breasts are more lumpy bumpy around that time. It's also great to do it in the shower with soapy hands. You use the opposite hand for the opposite breast and put the arm on the same side up so that you can feel into the armpit with that opposite hand. And that's the way that you do it. If you have any questions about that, make sure you talk to your OB-GYN because it's important to learn it at any age, but especially when you're younger so you get used to your normal breast tissue because as you get older, the breast cancer risk increases. So it's important to know what normal is early on. All right. So I mentioned the big C word, cancer. So let's go right into any lumps or abnormal masses that you feel deep inside of your breast. So not on the skin level like a pimple, but deeper. So it's very important if you feel anything like this, like I mentioned, bring it up to your doctor. However, I will say that more often than not, any lump that I feel in the breast is usually a benign lump, meaning a not cancerous mass or lump in the breast. So there's many non- cancerous tumors. The most common one is something called fibrocystic changes. We call it like peas on a plate. So you feel kind of like a wide, solid lump that moves around with your breast tissue. It's also normally the area that gets a little bit tender around your period. And on top of that wide lump, there's some small little lumps. So peas on a plate, if that makes sense. Fibroadenomas or fibrocystic changes are really common in young women and can extend through your life as you age as well. And that's a benign or non-cancerous mass. There's also cysts that can form inside the breast. They move around a lot with the breast tissue as well. They're more like spongy and squishy. And they're also a non-cancerous lump that you can feel in your breast. And then, of course, there's cancer. I describe cancer as being more firm, a firm lump that doesn't move around as much with the breast tissue. It's a new lump that you have haven't felt before. So that's why it's more important to know what your normal kind of lumps and bumps are when you're younger. So it would be something new. Sometimes it can be small. Sometimes it can be large. Sometimes it can be painful. It can cause skin changes on the breast as well. It can cause even dimpling of the skin around the area of the lump. So any new mass that's kind of firm and on one side usually, I definitely would be concerned about a cancer and you would need to get more imaging and follow-up. But when you come to your OBGYN with this, they can distinguish it a lot of the time right then and there. But we'll also probably send you for follow-up imaging just to be sure. Okay, so imaging. What does that look like? So a lot of people come to my office and they're concerned about mammograms because they've heard that they're painful. But I will say if you're younger, you're most likely going to start with an ultrasound of the breast. And that's because the breast tissue when you're younger is more dense. Think about it. When you're young, your breasts are up and perky and more firm. And when you're older, They kind of sag a little bit and they're softer. So when you're younger, they're more dense. And when you're older, they're more filled with fatty tissue and sag a little bit more. So a mammogram is not so great for that dense, young breast tissue. An ultrasound is better. So when you're younger, we usually get an ultrasound. But you can also get a mammogram at any age, really. A mammogram is when they squeeze your breast between two plates to kind of flatten it like a pancake and take an x-ray of the breast in order to see what's going on deeper inside. Mammograms are recommended for every woman starting at age 40 and continuing yearly, yearly women over 40 every year. And then sometimes recommended at a younger age if you have a family history of breast cancer or if there's something concerning that we're looking for. And mammograms, they are a little bit uncomfortable. Yes, you can get them also if you've had breast implants in place. But I mean, the level of discomfort compared to finding out if you have a cancer, to me, it's just not equal. Just endure the pain. I wouldn't even say it's painful. I've had it done. It's just a little bit uncomfortable and it's a peace of mind and it can detect cancer early. So suck it up, guys. And if the mammogram shows something abnormal, you might then go to a breast specialist for a biopsy. Now, I want to say here that OBGYNs are not breast specialists. So if you have something abnormal on your mammogram or if you need a procedure on the breast, it's not going to be your OBGYN. There are breast surgeons out there that That's their specialty and that's what they do. The OB-GYN is more of the first line person to find out if there's a problem or not. Okay, so let's jump from lumps into talking about your nipples. So nipple discharge and inverted nipples are things that people come into my office to talk about quite a bit. So an inverted nipple is when your nipple goes in instead of coming out like a point. Now, some people have their breasts have been this way their whole life. That's normal. Sometimes it even can change after you breastfeed or something like that, but I would still say it's at that point required to look into as well. Because sometimes when you have a nipple that becomes inverted at a later time, that can be a sign of a breast cancer. So it's important that if you've always had regular kind of nipples, I don't want to say they're regular, but nipples that kind of stick out and then one or both become inverted later in your life, that's something to see a doctor about because you might need some imaging and an exam. But it can also happen for many normal reasons like trauma to the breast, scarring, or breastfeeding. It can be on one side or both. Now, let's talk about nipple discharge because nipple discharge is a little interesting. The discharge is fluid that comes out of your nipple. It can be milky. It can be clear. It can be yellow, green, bloody. And the color of the nipple discharge kind of signifies different things. So clear and milky tend to be benign or non-cancerous discharge that we're not as concerned about, but can indicate other things like infection in the breast, especially if it's like green or yellow, that color too can be more of an infection. Galacteria is something where you kind of have a milky discharge where we might need to look at brain imaging actually, because that can indicate something going on in the brain if you have a milky discharge. And we might get lab work, especially because of that. Certain medications can start nipple discharge and also touching your breasts a lot can lead to discharge from the nipple, especially a clear or milky discharge. Now, when you have a bloody discharge, we get more concerned for a cancer, but it doesn't have to be. It's just important for us to rule that out. Another reason for a bloody discharge is something called a papilloma, which is another kind of mass within the breast, and that's actually non-cancerous and can lead to nipple discharge. So I don't want you to freak out if you see the bloody discharge, but definitely see your doctor. Okay. Now let's talk about breast pain. I get this a lot in my office where somebody starts to have breast pain. It might not always be related to their cycle, but a lot of times it is. So commonly you get tenderness of the breasts a few days or even a week before your period and can last through like the first few days of your period. That's a common change that happens because of hormonal changes with the menstrual cycle that are actually normal. Okay. But sometimes it can be really severe where you have to take medication such as NSAIDs like ibuprofen, Motrin, Advil to help with that pain that can really be debilitating. So it's important to still bring it up to your doctor and it can be a sign of premenstrual syndrome or PMS. So check out that PMS podcast episode that I did a few months ago, I believe at this point, if you want a little bit more detail on that. So if you have breast pain, definitely see your doctor. And if we determine that it's just hormonal breast pain or something with your cycle, there are ways to improve it. So I mentioned taking NSAIDs like ibuprofen and Motrin. That can work, but also some lifestyle changes can help as well. And I love giving lifestyle changes because I want you to feel empowered at home to help yourself solve some of your problems. And, you know, lifestyle changes are great for people that don't really even want to take medication all the time. So some things for breast pain, once you've ruled out that it's normal breast pain with your doctor, you can change your bra. So go to a actual lingerie store, even Victoria's Secret, and get fitted for a bra. Get measured so that you know you're wearing the right size bra that's supportive for your breasts. Also, sometimes if you're on a certain birth control, they can cause breast tenderness. So consider changing your birth control with your doctor. Limit caffeine. So stop the coffee, stop the caffeinated teas, stop the sodas. Limiting or cutting out caffeine altogether can decrease or eliminate breast pain. And of course, Stop smoking. I mean, smoking does so many things to your body that you don't even think about, and this breast pain is one of them. So stop all tobacco use, including vaping, okay? There are also some supplements that have shown in smaller studies to be beneficial for breast pain. One of them is taking vitamin E. There was a study of about 80 patients that showed that it was better than the placebo in helping with pain. So taking about 200 international units of vitamin E daily can be beneficial. Another one is vitamin B as in boy, B6. Taking 40 milligrams a day of vitamin B6 can be beneficial for breast pain as well. And overall, B6 has been showing some benefits in PMS symptoms if you take it daily. So that's important to know as well. Now, there was a study and a lot of people talk about taking evening primrose oil. And the kind of hype or excitement about this is that evening primrose oil kind of have the same properties as taking your NSAIDs, ibuprofen Advil. But there was a study that was done with 1,700 people where they compared it to a placebo, which is a medication that actually has no active ingredients that should not change anything. And it showed that evening primrose oil didn't actually have any benefit over the placebo medication. So no proof yet that it works, but I know some people have tried it. They say it works for them. I don't see where it can harm you unless you have an allergy to NSAIDs or evening primrose oil. So you can try it if you would like to. And those are some things to look into. Some people also talk about magnesium, but I haven't seen any studies where magnesium works for breast pain per se, but it's something you can try and it's in a lot of multivitamins that you're probably taking already. Okay, another thing I see and talk about commonly in my practice is when people come in and they have a lot of irritation under the breast with redness and moisture. Sometimes if you're darker skin, it can actually be completely black under the breast, can be itchy, can have a rash, can be a little blister And that's really common in people that sweat a lot and also that have larger breasts where the breast kind of completely covers that skin underneath on your chest wall. And that is more commonly than not a yeast infection. So just like you get yeast infections kind of in the vagina, you can also get a yeast infection under the breast. growing. So yeast can become itchy, blistery, darkened skin, red skin. So the best things that you can do in your lifestyle to treat this is to make sure that under the breast stay as clean and dry possibly every day. So make sure you're showering two times a day, keeping that area dry as much as possible. Some people, I've even had a patient the other day that one of the biggest reasons she got a breast reduction surgery is because she was chronically having that issue and her breasts were so large It was really hard to control in addition to other things like back pain and things like that. But, you know, if you're having, if you have really large breasts, they're hurting your back, it's making you kind of affecting your everyday life, including something like these yeast infections under your breast, maybe consider a breast reduction if that's in the cards for you. The other thing that can help is going to your doctor to get a yeast powder or a yeast cream. So a lot of times I prescribe Nystatin cream. or nystatin powder to be placed under the breast as needed if the irritation or sweatiness starts to become itchy or red or really uncomfortable. And that's an actual active treatment. But the prevention is trying to keep it as clean and dry as possible at home. Okay, so let's talk about the areola. So the areola is a kind of darker or different color area that circles around your actual nipple that's in the middle. So you can get little pimples, even on the breast skin, you can get little pimples which can still be checked out by your doctor to make sure that they're not larger, what we call abscesses or deeper masses. But it's important to know that your areola also has glands on it that are bumps around or within that darkened or reddish pinkish area of the areola. And those are normal. They're called Montgomery glands. And they're actually there to help kind of create moisture around that area, especially important for breastfeeding and things like that. So if you have like little lumps around the areola that are on both sides of the breast, those are most likely normal and they're Montgomery glands. So I don't want you to be concerned too much about those. They can become larger with breastfeeding and the areola can become darker with pregnancy and breastfeeding and postpartum as well. So those are normal changes to the breast and areola. And last but not least, let's talk about if you have your breast, most people know where that is, right? And then you go into your armpit and you have a lump kind of in your armpit that either connects directly with the breast or you have a little skip of tissue and then the lump, sometimes you've had it your whole life and it starts to become larger when you get older, can also become larger and tender around your period or if you're breastfeeding or pregnant. And that's because that is actually breast tissue in your armpit. Some people, it's just flat and you don't feel it. In everybody, it extends into the armpit a little bit, but some people, have a little bit more of that tissue than others. So that is actually called the tail of Spence. It's the tail of the breast tissue that in some people can be a little bit larger. If you notice this for the very first time or you've never had it before and now it's there, definitely get it checked out by your doctor. But like I said, some people have had this their whole lives. I've seen it become really uncomfortable for some people where they actually get it excised or removed by a breast surgeon. But most of the time, it's benign tissue that really doesn't need to be touched. And that's it. That is all things breasts or Breast 101 course, as I like to say about this episode. There is everything I could have gone into much, much more detail, but I wanted to give an overview of the common things that I see people concerned about in my practice. Hopefully to give you all a little bit of peace of mind and also to trigger in you when you should go to your doctor for an exam to figure out if something is normal or not. I hope you gained some great tips and some lifestyle changes for those of you that have the breast pain that has been deemed normal and hormonal. And I hope that this empowers all of you out there to take kind of control of your body, control of your health, just like all my Four Vaginas Only episodes. That's the main goal. And I want you to feel empowered to actually have full understanding of what's going on within you. Thank you so much for listening to the Four Vaginas Only podcast. I'm Dr. Celestine, and I'll see you in the next one. Bye.