Our consultant Ms Lucy Khan was recently featured in a Daily Mail article. We have reproduced her answers to 10 common questions about breasts.
One boob is bigger than the other should I be worried?
Having a difference in size between the breasts is completely normal. In the clinic we say they are ‘sister not twins’! It is actually very rare for a woman to have exactly the same cup size for each breast. A large difference can make it difficult to get a bra that fits well. If you notice a sudden change in the size of one breast then this can rarely mean a problem. If one of your breasts swells up then it might be due to an infection or inflammation. It’s definitely OK to get it checked out if the difference is new, and you should see your doctor to arrange this
Is it normal to have discharge from my nipples?
Most women get fluid coming from their nipples at some time in their lives. This can be more common if you smoke. The general rule is that a small amount of creamy or greenish fluid coming from both nipples is safe. You might see it on your nightie when you wake up or if you squeeze the breast. This is usually fluid coming from the ducts under the nipple. As you get a bit older, or if the ducts are damaged by smoking, then they don’t work as well. White or greenish mucus and material can build up before it escapes through the nipple. A little bit more worrying is when fluid is only coming from one nipple and not the other. If you have a clear/watery discharge, or you notice some blood, then it is worthwhile getting it checked out.
What can I do about pain in my breasts?
Breast pain is one of the most common reasons for women to seek help for their breasts. The good news is that pain is not normally a symptom of serious disease or cancer. The breasts are held on to the front of your chest by strands of tissue- Cooper’s ligaments. If you have large or heavy breasts, or as you get older and your breasts change, the weight of the tissue pulls on these ligaments. As they stretch sometimes they can actually break. A torn ligament heals by scarring and this can affect the nerves inside the breast. This might cause electrical or shooting-type pains.
Another problem is inflammation or damage to the muscles or ribs of the chest wall under the breast. This is ‘referred’ so that the pain is felt in the breasts. Breast pain is a really difficult thing and women often feel that the problem is ignored. There are a couple of things that can really help. A well-fitted bra supports the breasts and their ligaments. Get re-fitted every couple of years as the breasts change along with your body and weight. Avoiding underwired bras and using a sports-type bra is very useful for women who get pain in the lower crease of the breast. Finally, use simple painkillers such as paracetamol. Topical gel such as ibuprofen (provided you can take it), can be rubbed into a sore area and will not harm the breast tissue.
My mum had breast cancer, will I get it too?
Breast cancer is a really common disease, affecting up to 1 in 7 women in the UK. Because of that, it is not unusual to have a relative who has had breast cancer. But, if you have more than 1 first-degree relative (e.g. mum, sister) who has had breast cancer then you might be at a higher risk. You should see your doctor who may refer you on for an assessment of ‘family history’.
If they find out that there are a lot of women (or even men) in your family who have had breast or ovarian cancer then you might have a gene test. This will check that you don’t carry a breast cancer BRCA gene (this is what Angelina Jolie had). If you do then it is good to know about because you can consider surgery or medication to reduce the risk of cancer in the future. You would be followed-up closely to make sure you don’t develop any signs of cancer. All women in the UK are offered regular breast screening as they approach the age of 50 years.
What are breast cysts and why do I get them?
As you get older, changes in the breasts can cause cysts to form. These are little collections of fluid, but they can grow and become large lumps! The breast tissue breaks down and liquifies. We don’t really know why some women get lots of cysts and others don’t get any. We do know that if you have had breast cysts before you are more likely to get them again. But you are no more or less likely to get breast cancer. This means that you can’t just ignore new lumps and rely on them being cysts- always get a lump checked. If it looks like a cyst in the clinic then the surgeon can easily drain the fluid using a fine needle and the cyst should disappear!
I have extra folds of fatty tissue under my armpits, what are they?
Guess what? You don’t always only grow breast tissue in normal places! In fact, breasts can develop anywhere in the lines on either side of your body going from the armpit to the belly. It is really common for women to have extra breast tissue at the upper/outer part of the breast and in the armpit. We call this axillary breast tissue. Some ladies even have a small nipple on top of it and the tissue will increase in size if you are pregnant or breastfeeding! It isn’t something to worry about but it can make it difficult to wear a bra or you might feel it is a bit unsightly. If it is a big problem for you then you can have surgery or liposuction to remove the extra tissue, although this isn’t routinely available on the NHS.
Do I have to take my top off at the breast clinic?
It is really important that if you have noticed a lump in the breast or another problem that the surgeon can examine you fully. You will be asked to go behind a curtain and take your top off. When you are ready, the surgeon will look at the breasts before checking them by gently feeling all parts of the armpit and breast tissue. The good news is that you will always be offered a female chaperone to be with you. Under normal circumstances it is fine to have your partner or mum or a friend in the room with you (outside the curtain).
You can’t always guarantee having a female surgeon or doctor, but they should always be gentle and explain what they are doing. A breast surgeon examines hundreds of breasts of all shapes and sizes, with all kinds of weird and wonderful diseases and problems. You don’t need to be embarrassed about yours. If you feel very anxious before an examination, let your doctor know.
Is a mammogram painful?
A mammogram is an X-ray of the breast. It is used in breast screening and assessment of a lump. The breast is placed between 2 flat screen ‘plates’ and gently squeezed to spread the tissue out. The more spread-out the breast tissue is, the easier it is for the X-ray doctor (radiologist) to check the breast for any abnormalities. Some women have no trouble at all getting their mammogram, others can find it quite painful. Most ladies have a degree of discomfort while having the X-ray but it gets better almost immediately afterwards. If you are worried or have had a bad experience in the past, always tell the mammogram specialist (mammographer). They may be able to do some things to make it a bit more bearable. Breast screening saves lives so it is really important to attend if you can.
Can I breastfeed after a breast reduction?
Breast reduction surgery is becoming more popular as women look to get fit and undertake more vigorous exercise. The good news is that it has an excellent satisfaction rate and careful surgery by a qualified specialist normally has good outcomes. When you have a breast reduction operation, breast tissue is removed and the position of the nipples are changed to be higher and more youthful. This means that some of the ducts under the nipple need to be cut and re-arranged. This interrupts the flow of milk if you have a baby in the future. Some ducts are left undamaged and others may eventually heal, but no surgeon can guarantee that you will be able to breastfeed in the future. If this is really important to you then you should wait until after your family is complete before you have breast reduction. Click here to read more.
Can I go from an A cup to an E cup with a boob job?
Breast implants are still very popular! Young women particularly feel the pressure of instagram and facebook to look amazing. Careful surgery by a specialist surgeon can give a fuller, more shapely breast. But no careful surgeon can guarantee a particular cup size after the operation. They will fully assess you and give a recommendation on the size of implant that your breast can safely accept. An increase of 300-400cc is normal, and this might lead to going up approximately 2 cup sizes. The types of incision, implants and the place where implants are placed (e.g. under or in front of muscle) all have a big effect on the end result of surgery.