Breast problems (Female)

Breast size and shape

The size and shape of breasts are something you inherit from your parents. The way your breasts may look and feel will change throughout your life, for example during puberty, pregnancy or the menopause. Below we have highlighted the most common breast problems that women report.

Having one breast larger than the other

Breast Asymmetry – the noticeable difference in the size or shape of one breast compared to another – is completely normal, and most differences will even themselves out following puberty.

Many women find a good fitting bra can help the differences between the breasts look less obvious. Some women choose to wear padded bras and use gel or foam inserts to even out their shape when wearing clothes.

Please note that surgery to correct breast asymmetry is currently not funded on the NHS and will only be considered in exceptional circumstances. Breast asymmetry is normal and poses no health concerns, which would mean any surgery would only carry cosmetic benefit. You can read the local policy here.

Women can have either smooth or lumpy breasts, and both are normal. Breasts can often feel different if you are due or on your period but can go back to normal after your period has finished. Lumps can develop within the breast tissue during puberty, pregnancy or the menopause; this is almost always caused by normal, expected changes in the tissue. If you are concerned, however, speak with your practice nurse or GP.

Stretch marks

When breasts develop very rapidly, stretch marks can develop. These are red lines that appear on the surface of the skin. Stretch marks are very common during puberty, pregnancy or during times of significant, rapid weight gain or loss.

Not much can be done to stop stretch marks developing, although keeping the skin well moisturised is thought to help. It can be reassuring to know that stretch marks are extremely common and do not pose any health risk.

Inverted nipples

Inverted nipples are where one or both nipples are turned inwards instead of outwards. Nipples can be inverted from birth or happen during breast development. This is a perfectly normal variant and causes no health concerns.

However, development of an inverted nipple in adulthood can be a sign of breast cancer, so it is important to get this checked out by a doctor.

Please note surgery to correct inverted nipples is not routinely paid for by the NHS as it is a cosmetic procedure. You can read the local cosmetic policy here.

Hair growing around nipples

It is normal for some girls and women experience hairs growing around the nipple or the darker area of skin around the nipple (areola). You can remove this hair yourself at home if this is bothering you, however it is not advised to pluck or shave the area as this could cause infection. Instead, you could – very carefully – cut the hair close to the skin using a small pair of scissors.

Nipple discharge

Breasts are usually fully developed around the age of 17, and you may experience some discharge (fluid/liquid) coming from them from time to time, particularly after exercising or after massaging the breast or the nipple. This discharge is usually white but can be more yellow/green or brown/red and often appears in very small amounts.

A small amount of discharge is nothing to worry about, but it is always best to speak to your GP if you have concerns. You can visit the NHS website for further information.

Extra breasts or nipples

Some girls may develop what is called polymastia, which is an extra breast or pair of breasts; also referred to as accessory breasts. These are usually found in the lower armpit. These can appear during puberty but are most likely to be apparent from birth. It is also known for people to develop an extra nipple or nipples. These are usually found in the area below the breasts but above the belly button.

If you are experiencing problems with your polymastia or an extra nipple or nipples, you may wish to speak to your GP or practice nurse for further support.

Large breasts (hypertrophy)

Hypertrophy is when a woman develops excessive breast tissue, resulting in large breasts which may appear out of proportion with the rest of the body. This is thought be down to an increased sensitivity to hormones.

Some women dealing with Hypertrophy may feel embarrassed about the size and look of their breasts, however they should remember that the condition is normal and unlikely to cause health problems.

For more information on treating the symptoms that large breasts can cause, please read on in our managing my breast problems section.

Breast pain

There are many reasons as to why you may be experiencing painful breasts. It is very unlikely that the pain you are experiencing is a symptom of cancer.

Breast pain, or ache, is often linked to your menstrual cycle (your period). When this is the case, you may feel:

• pain that begins 2 weeks before your period and ends the same time as your period does

• pain that can be described as achy, dull or heavy

• pain that is often in both breasts, sometimes spreading to the armpit area

Breast pain is not always linked to periods. It can be caused by:

• sprains or injuries to the neck, shoulder or back area – the pain can often be felt in the breast area
• certain medicines – check the information leaflet that goes with your current medication to see if Breast Pain is a side effect. This is seen most frequently in people who take the contraceptive pill or antidepressants
• conditions such as breast abscess or mastitis
• pregnancy – this can be an early sign of pregnancy or a symptom felt throughout
• the menopause – hormone changes during this time can cause some women to suffer with breast pain

If you are experiencing changes in the size, shape or feeling of the breast, you should consider getting further advice from your GP. For information on helping ease breast pain, please read on to our “Managing my breast problems” section.

Large Breasts

• Lose weight if you are overweight – this sometimes helps reduce the amount of fatty tissue in the breast area
• Visiting a professional bra fitting service to ensure you are wearing the correct size bra for your body shape
• Physiotherapy to help with any aches and pains that may be caused by your larger breasts
• Referral to your local depression and anxiety service – for people who believe their breasts are causing them emotional distress. You can click here for some resources and links to local services

Breast Pain

• For breast pain, you can take pain killers such as paracetamol or NSAIDs such as ibuprofen or use topical pain killing gel directly onto the breast. It is important to speak to your local pharmacist for further advice regarding suitable medications
• It is also advised for you to wear a correctly fitted bra during the day and a soft bra for bedtime

Inverted Nipples

• If your inverted nipples are an issue to you, you can use a device called a niplette – these are thimble shaped devices worn for a period daily to help make your nipples stick outwards. These are available in most pharmacies and some supermarkets

Please see below guidance on when to see your GP about your breast problems, as provided by the NHS website:

• It’s not improving, or painkillers are not helping
• You have a very high temperature or feel hot and shivery
• Any part of your breast is red, hot or swollen
• There is a history of breast cancer in your family
• You have any signs of pregnancy – you could do a pregnancy test first

Please see below guidance on when to call 111 for more urgent advice about your breast problems, as provided by the NHS website:

• There is a hard lump in your breast that does not move around
• You get nipple discharge, which may be streaked with blood
• 1 or both breasts change shape
• The skin on your breast is dimpled (like orange peel)
• You have a rash on or around the nipple, or a previously out turned nipple has sunk into the breast
• These can be signs of something more serious

111 will tell you what to do. They can arrange a phone call from a nurse or doctor if you need one.

You can visit 111.nhs.uk or call 111.

The following surgical procedures for breast problems are seen as cosmetic, and are therefore not routinely funded under the NHS:

• Breast Asymmetry Correction
• Breast Augmentation (enlargement)
• Breast Lift (Mastopexy)
• Breast Reduction
  • (click here for the policy supporting information sheet for patients)
• Inverted nipple correction

These treatments will only be performed in exceptional cases. If your healthcare provider believes your case is exceptional, they can make a case to the Individual Funding Request Panel.

The following surgical procedure for breast problems is sometimes funded on the NHS, depending on your symptoms. Please click the links to read the associated policy:

• Breast Implants – Removal and Replacement

• Breast problems page by Breast Cancer Now
• Causes of breast pain by Patient UK

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Published 16 September 2016