What is normal and when to see your doctor

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What is normal and when to see your doctor

Certain age-related life stages can affect your breasts. This could include having a baby during the reproductive years or developing cancer after menopause.

Breast ptosis

Hormone levels change when a woman goes through menopause (usually in her late 40s and early 50s), which is why some may experience breast sagging at this time. For example, estrogen decreases significantly, leading to dehydration and loss of elasticity in the breast’s connective tissue. As a result, the fabric shrinks and loses its shape, which can lead to sagging.

This laxity extends to the breast ducts and supporting ligaments. The medical term for breast sagging is breast ptosis.

“During menopause, decreased estrogen leads to a decrease in fibrous tissue and an increase in fat intake, leading to decreased density and even softer tissue,” says Angela Wilson, MD, an obstetrician-gynecologist at Montefiore Einstein Advanced Care in New York City. In other words, the fat percentage of your breasts increases over time, thereby decreasing their firmness.

Poor posture can also contribute to a loss of flexibility in the chest muscles, causing sagging. Meanwhile, wearing the wrong bra size can damage breast ligaments, leading to breast sagging and pain over time.

Pregnancy

There are several breast changes during pregnancy that you can expect, as your body prepares to produce milk for a baby. Pregnancy causes the breasts’ ductal system to expand in preparation for lactation, leading to breast enlargement and fullness, Dr. Wilson says.

Additionally, your breasts will likely grow a cup size or two and may become itchy as the skin stretches.

“Due to rapid growth during this time, it is not uncommon to develop stretch marks on the skin,” says Wilson. “The nipples may become larger and the areola may also darken during pregnancy.” After breastfeeding, the ducts decrease in size and the tissues may begin to sag, adds Wilson.

Breast cysts

Breast cysts are fluid-filled sacs that are usually noncancerous. Although they can appear at any age, they are especially common in women aged 35 to 50.

Experts aren’t yet sure what causes breast cysts, but potential causes may include natural hormonal fluctuations or shrinkage of milk-producing tissues (which can trap fluid).

Your cysts may become more visible or tender before your period and shrink or disappear after menopause. Cysts usually don’t hurt, but your doctor can treat a painful cyst by using a needle to drain the fluid. They may send the tissue for analysis or recommend other treatments such as hormone therapy or surgery.

Breast cancer

The risk of breast cancer increases with age: at age 30, the risk of being diagnosed with breast cancer in the next 10 years is one in 204. At age 50, this increases to one in 42 – and at age 70, one in 24.

The median age of breast cancer diagnosis among women in the United States is 63 years.

Other risk factors for breast cancer include genetics, race, breast density, alcohol use, being overweight or obese after menopause, taking hormonal medications, and not staying physically active.

Maintaining a healthy weight, exercising regularly, drinking alcohol in moderation, and breastfeeding your children can help reduce your risk.

Research suggests that the risk of breast cancer decreases by 4.3 percent for every 12 months of breastfeeding.

Women aged 40 and older at average risk for breast cancer have the option of starting mammography screening every year. Different medical organizations have different recommendations. People ages 45 to 54 should get a mammogram every year, according to the American Cancer Society.

But some organizations, like the United States Preventive Services Task Force (USPSTF), recommend annual or biennial mammograms starting at age 40.

It’s important to talk to your doctor to get personalized recommendations based on your specific risk factors.

Mammograms are generally not recommended for women under 40 at average risk for breast cancer, although people at above-average risk should talk to their doctor about starting screening earlier.

If you are concerned, you can always ask your primary care provider for a breast exam, regardless of your age or appointment. “I do breast exams for most of my patients during their annual visits, and this provides an opportunity to discuss any changes the patients may have noticed,” says Wilson.