Breast development happens in distinct seasons of life

Understanding can help discern normal from serious.

A woman’s breasts will go through multiple changes throughout her lifespan as her body adapts to various stages of life such as puberty, childbearing and menopause. Understanding these transitions can help her to discern normal changes from those that might signal something more serious, according to one local breast surgeon.

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“A woman’s breasts will undergo significant change throughout her life and nearly all of it can be pointed back to estrogen,” said Thomas Heck, MD, a breast surgeon with Gem City Surgical Breast Care Center. “A woman’s breast development ebbs and flows with the level of estrogen in her body.”

Dr. Heck said a female should expect the following differences throughout her life:

Gearing up for puberty: A girl's breast tissue is very dense, which is why mammograms are not recommended until she is out of this stage. During this phase a girl's ovaries are producing little, if any, estrogen.

Moving into menstruation: Girls in their early to late teens will begin to experience active menstruation and, as a result, their breasts undergo a significant amount of change. In these years, all aspects of the breast are developing including the ductal system and lobules.

Preparing for mothering: Women in their early 20s will notice a new phase of change as their breasts prepare for possible conception. The ductal system that began in her late teens will finish their development in order to be prepared to feed a baby, if ever needed.

Entering menopause: Estrogen dramatically falls as a woman nears and eventually enters her menopause years. The lack of estrogen causes the breast tissue to lose its elasticity. A physical exam in a doctor's office will reveal possible sagging of the breasts while a mammogram may show the breasts have lost density.

These are all common changes that most women will experience throughout their lives. There are other issues that can develop over time that may at first cause alarm, but upon physical examination aren’t anything serious.

“A large percentage of women do have a finding on their breast, either during a breast exam or on their mammogram, during their lifetime,” he said. “The important thing for women to know is that not all findings carry a lot of significance. However, they still need to be evaluated.”

For example, fibrocystic changes are common for many women. Fibrocystic change is when there is a small or large collection of fluid — much like a water balloon — that forms in a woman’s breast.

“These fluid-filled masses can come and go,” Dr. Heck said. “I may have a woman who comes in one month with a large mass who then returns a month later with nothing.”

Women should always be aware of certain changes that signal something more serious. A new lump felt in a self-breast exam, the color of the breast such as a red rash, nipple discharge or a dimpled or sunken nipple should always be evaluated by a physician right away.

“I’m a big proponent of monthly breast self-exams,” Dr. Heck said. “I know to a lot of women this can feel scary because they don’t know what they are looking for, but if they do it month-to-month they will get to know their breasts and be the first to recognize if something is wrong.”

For more information on breast changes or to find a Premier Physician Network physician near you, go online to www.premierhealthspecialists.org/breast.

Premier HealthNet is one of the largest groups of pediatrics, family medicine, internal medicine, and urgent care practices in southwest Ohio. For more information, go online to www.premierhealthnet.com/news.

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