What's the difference between a cyst and a lymph node?

A cyst is a small, fluid filled sack. A lymph node is part of the body's natural defense system. It swells up in response to infection or other stimulus.

How does hormone replacement therapy affect breast cancer?

There has been a slight increase in risk of breast cancer with some hormone replacement regimen. For most women, protection against heart disease and osteoporosis far outweighs the risk of breast cancer. Your physician can do risk factor analysis and determine the relative risks and benefits for you as an individual. Fibrocystic breast disease is one of the most common causes of breast pain and tenderness. Fibrocystic disease is associated with small cysts. These can swell and become tender or painful.

Is it necessary to have surgery on either a benign cyst or lymph node?

It may be necessary to have surgery to determine that it is a benign cyst or lymph node. Often, ultrasound or diagnostic fine needle aspiration can be used instead of surgery.

I have breast tenderness around my period. At what point should I seek help from a doctor?

It is a good idea to get a baseline breast examination after your period when your tenderness is minimal. That way, the doctor can determine if there are any lumps or abnormal areas. If there are any lumps, additional work-up with ultrasound or fine needle aspiration may be required. Most breast tenderness that comes and goes with the period is due to benign fibrocystic disease and should not be a cause for concern.

My mom has already had a biopsy and she was told that it was a benign lymph node.

That happens sometimes. No diagnostic tests are perfect. Fine needle aspiration has become available in the last couple of years. Often, fine needle aspiration can be done instead of biopsy. And if it is benign, nothing further needs to be done.

Can you please tell me about Tamoxifen?

Tamoxifen is an estrogen-blocking agent. It is used in the treatment of breast cancer. It is also proven to lower the risk of breast cancer in women who are at high risk. There is currently a national trial, called the STAR trial, that is comparing Tamoxifen with another drug for prevention of breast cancer. We believe that Tamoxifen and the other drug that is being used are the first of a new class of drugs that can be much more effective for treatment and prevention.

Is breast pain ever a symptom of breast cancer?

Breast pain is very, very rarely a symptom of breast cancer. We used to teach that breast cancer was not painful, and that breast pain was not a sign of breast cancer. We now know that occasionally, breast cancer does cause pain and that that is the first symptom. Most breast pain is caused by fibrocystic problems or by cysts. Most breast cancer pain is either hormone sensitive or not hormone sensitive. If the breast cancer is hormone sensitive, then the effect of hormones is to stimulate the growth. Thus, we recommend that women who have breast cancer not take hormone replacement therapy.

Is there anything that can make a mammography exam less painful?

Schedule your mammogram after your menstrual period, when your breasts are least tender. Some women take an aspirin or ibuprofen before the mammogram to minimize discomfort. Finally, remember that the compression used in mammography is to help them get a good view and is only temporary.

What constitutes liver enzymes?

These are blood chemistries that tell how well the liver is working. Sometimes, they are elevated with gallstones, sometimes when there is hepatitis or tumor in the liver. In breast cancer patients, these tests are measured to check for tumor in the liver or side effect of treatment. There is an American Liver Society that may have information on the Web. I would try their web site.

I keep hearing about new kinds of mammography. Are these new techniques less painful? I'm going for my first one and I'm a little scared.

Ultrasound and magnetic resonance imaging are both being used for diagnosis of breast disease. They will probably be less painful than mammography because no compression is required. They are not used routinely for screening. You should not be afraid to go have a mammogram because of concern about the pain.

I haven't had my period for some time and my breasts are very painful and I'm beginning to worry--what could be causing this? I'm 39 and not pregnant.

Hormone fluctuations can cause both failure of menstruation and breast pain. I recommend checking with your gynecologist to see if you need to be put on a medication to regulate your period.

I use vitamin E and Evening Primrose oil for breast pain. Why does that work? It comes back when I stop.

We're not sure why these medications work, but they do seem to help some women. There are theories about inflammation related to the kinds of fatty acids that are produced by the body and Vitamin E and Evening Primrose may change both of these.

I think I have a breast infection--red, hurts, and nipple pain (I'm also breastfeeding). What could cause this?

That could be mastitis. Usually it responds to antibiotics and care of the nipple. Keep the nipple clean and use a good lubricant on it so that the skin does not become cracked.

I had a small lump removed from my breast last November, and the scar is beginning to look herniated and my breast hurts like needles and pins--what should I do about it?

There is a silicone sheeting that your doctor can prescribe. You cut a piece to the size of the scar and you wear it inside your bra. The pressure from the silicone sheet helps to flatten the scar and may make it less noticeable.

What are the chances of someone who is on HRT of getting breast cancer?

Hormone replacement therapy only very, very slightly increases a women's risk of breast cancer. For all practical purposes the additional risk is very small, so a women on hormone replacement is at the same risk as other women her age. If a women lives into her 90s, the cumulative risk is one out of eight or one out of nine.

Are there are medications that aggravate hormonal breast pain?

Caffeine seems to aggravate breast pain for some women. Thus, drinks that contain caffeine or medications that have caffeine in them may make it worse.

Is it normal to experience extreme breast pain two weeks prior to menstruation?

This is very common. If you have pain right around the middle of your cycle (2 weeks before menstruation) that goes away when your cycle is over, that is almost always fibrocystic and benign. The pain is sometimes localized to just one breast or just one part of the breast. Sometimes it comes back with every period, and sometimes it fluctuates.

Approximately 4 weeks ago I had a breast reduction and the pain still persists. Should I be concerned?

Check with the surgeon who performed the operation.

Do men ever experience breast pain?

Some men develop swelling of the breast tissue. This is called gynecomastia. It is often tender and sometimes painful.

Is swelling of the breast tissue in males the same as breast cancer?

Men do get breast cancer but it is extremely rare. Most swelling that men experience is benign gynecomastia.

Occasionally I will feel a twinge of pain in one of my breasts, which can continue for about 10 minutes per episode. Is that normal?

This kind of shooting pain is very common and usually normal. Some women feel a pain that seems to shoot out through the nipple. Sometimes it just lasts a second and it doesn't seem to be of any particular significance. If you feel a lump or other problem let your doctor check it out.

I just had my second child and have decided not to breast-feed. My breasts are full and tender. Is there anything I can do to un-stimulate milk production? How long does this normally take?

The main thing is not to stimulate the breasts. Don't try to empty them of milk or squeeze the nipple. Your doctor may be able to prescribe some medication that may help you.

I am 41 years old. How often should I have a mammogram done? I do have a history of breast cancer in my family.

Most women who are over 40 should have a mammogram every year. Some women who are in their early 40s have very dense breasts and may need an ultrasound as well. It is important that the radiologist know that you have a family history.

My mother was diagnosed with breast cancer and had a breast removed. She is now claiming to feel pain in her remaining breast. Should we be concerned?

Women who have had cancer in one breast are at increased risk of cancer in the other breast. Although breast pain is not usually a sign of cancer, she should have a physician check out the area in question.

Has breast cancer been proven to be hereditary?

Most women do not have "hereditary" breast cancer. There are families in which a clear hereditary syndrome can be identified. Most of the time, women in these families develop breast cancer at a young age or develop caner in both breasts. Generally, several (3 or 4 or more) female family members are affected. Ovarian cancer may occur in these families as well. Ovarian cancer is sometimes part of a hereditary syndrome.

My breasts often get tender not only prior to menstruation but remain tender weeks after. What can I do to ease the pain? Could it be something associated with diet?

Generally, aspirin or ibuprofen will help this kind of pain. Avoid caffeine, try to decrease the amount of salt in your diet to minimize fluid retention and take Vitamin E.

My daughter is 10 years old and says her chest hurts. Could this be growing pains? She seems too young to be having breast tenderness.

Sometimes, developing breast tissue in young girls can be very tender. When it is, it can cause pain.

In summary, most breast pain and tenderness is perfectly normal. Avoiding caffeine and taking Vitamin E may help. Some women find Evening Primrose oil beneficial. Under rare conditions, breast pain can be an early sign of breast cancer. If you are concerned about your breasts, have your doctor examine them.