Ever noticed some breast swelling and tenderness and thought nothing of it? Most of the time, you’re right! Breast swelling is a harmless sign of natural hormonal fluctuations that will eventually pass. But don’t be fooled: at certain times, swelling could indicate a medical condition hiding in plain sight. Hormones, infections, or cysts might be the cause, but peace of mind comes from knowing for sure. That’s why scheduling a breast screening is key—quick, easy, and potentially life-saving. Read on to find out more about the causes of breast swelling and when you should get a breast screening.
What Is Swollen Breast?
Breast swelling is from an increase in fluid volume within breast tissues. The breasts will appear larger with more visible veins, and often comes with uncomfortable sensations including
- Heaviness
- Dense, bumpy feel
- Tenderness from breasts to armpits
- Changes in skin texture
Temporary swelling during hormonal fluctuations such as puberty, menstrual period, pregnancy, menopause, or breastfeeding is normal. It becomes a cause for concern when the swelling persists and comes with other anomalies like pain, nipple discharge, or breast lumps.
Common Causes of Swollen Breasts
Swollen breasts can arise from both natural body changes or external factors requiring medical attention. Some common causes include:
Hormonal Changes
Menstrual cycle, pregnancy, or menopause cause hormonal fluctuations in the female body. This can often lead to water retention, causing swollen breasts. Increased estrogen and progesterone levels can enlarge the milk ducts, causing more tenderness and pain.
Breast engorgement is common for the first few weeks after giving birth, as more blood and lymph are directed to the breasts to increase milk production, creating firm, swollen breasts.
Infection
Also known as mastitis, an infection in breast tissues can cause swelling, redness, and tenderness. This is most common among breastfeeding women, where improper latching, clogged milk ducts, or bacteria from the baby’s mouth could infect the breasts.
Trauma or injury
Bruising and sharp pain are more characteristic of breast swelling from trauma. Cause ranges from sports injury, surgery, or breastfeeding. Wearing an unsupportive bra can press against the breast tissue, creating prolonged pressure that can lead to inflammation and swelling.
Sometimes, muscle strain near the breasts could be mistaken as breast pain. This can be from improper movement during exercise or heavy lifting.
Breast cysts or benign lumps
Breast cysts are fluid-filled lumps that grow on the breast tissues. Also known as fibrocystic breast disease, these cysts are benign (non-cancerous) and usually come from hormonal fluctuations during your menstrual cycle or pregnancy. Nonetheless, a diagnostic test is required to confirm whether the lump is benign or cancerous.
Medications
Birth control pills or long-term hormone replacement therapy affect estrogen and progesterone levels, causing breast swelling or enlargement. It is important to discuss these symptoms with your doctor and adjust your medications as needed.
Lifestyle factors
A high-fat or high-salt diet coupled with a sedentary lifestyle can disrupt the balance of estrogen and insulin, hormones that can trigger cancer cell growth. This is especially prevalent for postmenopausal women, where a slower metabolism increases the risk of accumulating fat tissues which is linked to an elevated estrogen level.
Smoking introduces cancer-causing agents called carcinogens in the body. They work by breaking DNA, increasing the risk of mutations which allows cancer cells to grow continuously.
Swollen Breast as a Symptom of Breast Cancer
Swollen breasts alone is low risk for cancer. It is usually a cause for concern only when accompanied by other signs such as breast lumps, breast pain, and changes in the nipple.
Inflammatory breast cancer is a rare but aggressive type of cancer often associated with breast swelling. It is caused by cancer cells growing in the breast tissues and moving to the surrounding lymph vessels. As the tumour grows, the lymph vessels are blocked, causing lymph to accumulate, giving a swollen appearance. Unlike other types of breast cancer, inflammatory breast cancer grows quicker, with visible symptoms within weeks or months. It is harder to detect due to a lack of breast lump, a common feature in other types of breast cancers like ductal carcinoma.
Inflammatory breast cancer shares many symptoms with mastitis such as tenderness and redness, making diagnosis more challenging. Thankfully, there are some unique signs:
- Swelling only on one breast
- Swelling of the lymph nodes (near the underarms or collarbones)
- Dimpling and thickening of the skin
- Red or purple skin around the skin appearing like a bruise
- Nipple inversion/ Nipple discharge
Nonetheless, observing these symptoms is subjective. Screening tests are necessary to get a more accurate diagnosis.
Breast Cancer Screening: When Is It Necessary?
While most cases of swollen breasts are linked to normal hormone changes or benign cysts, they can be an early sign of breast cancer. If swelling persists, it is always better to play safe and schedule a breast cancer screening. For women aged 50 and above, it is recommended to get a screening every year. While it might feel like a hassle, getting an early diagnosis significantly improves the treatment outcome.
There are multiple screening tools. Depending on the density of your breast tissues or other physical conditions, your physician may perform one or more of these screenings:
Mammograms
A mammogram is an X-ray examination of the breast to detect signs of lumps, masses, or other abnormalities that could be indicative of breast cancer or benign tumours. During the screening, you will be asked to remove your clothing and other jewellery. Two compression plates will be placed on either side of the breast at various angles to spread out the breast tissues. This will capture a more accurate X-ray image. While you may feel some discomfort from the compression of the plates, it is generally painless.
Ultrasound
An ultrasound is a scan that uses sound waves to produce images. Without using radiation, this is a relatively safe process and a good alternative for pregnant women. A breast ultrasound is commonly used to determine the characteristics of a lump found in a mammogram e.g. a tumour or a cyst.
MRI
Magnetic resonance imaging (MRI) uses large radio waves to produce detailed images of breast tissues. While they are more sensitive to early-stage cancers, the process is more complicated and riskier than other imaging tools. Doctors will schedule an MRI on a case-by-case basis, usually for those with a high risk of developing breast cancer.
When to See a Doctor?
See a doctor immediately if you experience:
- Persistent and sudden breast swelling that does not go away after your period
- Fever (indicative of infection)
- Swelling or lump on one breast only
- Changes in skin texture e.g. dimpling, rashes, thickening, bruising
- Nipple inversion or discharge
A doctor will conduct a physical examination, where they will look for any nipple and skin changes and feel for any lumps. Subsequently, a screening with be performed to observe for abnormalities invisible to the naked eye.
If an anomaly is detected during breast screening, a small tissue sample will be extracted and sent for testing (biopsy). Biomarkers, which are key features of cancer cells, are examined. These help doctors identify the type of breast cancer one has and what is the best treatment for the patient. Common markers include:
- HER2 protein: A receptor that binds to growth factors, allowing cancer cells to grow uncontrollably.
- Hormone receptors: This determines if the cancer cells are sensitive to estrogen and progesterone, which opens up hormone therapy as a viable treatment option.
- PD-L1 protein: More commonly observed in metastatic breast cancer, this protein allows cancer cells to hide from the immune system and continue to grow.
Treatment Options for Swollen Breast
For mild swelling, attempt some of these home remedies for some pain relief:
- Cold presses
- Getting a supportive bra
- Gentle massage by applying slight pressure around the nipple in a circular fashion
If the pain persists, you can get some over-the-counter pain to get you through the discomfort. Depending on the cause of the swelling, other medical treatments may be prescribed:
- Antibiotics for infection-caused swelling
- Birth control pills for hormone-related causes
For breastfeeding mothers, try to pump regularly and clean the area after breastfeeding. To reduce swelling, apply gentle pressure in the area around your areola to move fluids away from the nipple, which helps to ease latching. Alternatively, you can schedule a lymphatic drainage massage to improve lymph flow to and from the breasts.
If breast cancer is diagnosed, various general and specific types of therapy will be used in combination based on the type of cancer you have:
Radiation Therapy
This involves high-energy waves to target and destroy cancer cells. Depending on the size and location of the tumour, radiation therapy can vary in its dose, duration, and area applied. As radiation is not specific to cancer cells, healthy cells may be destroyed as well, causing fatigue, sickness, and skin irritation around the treated region.
Chemotherapy
Chemotherapy is the use of drugs to kill or slow down cancer growth. They come in the form of tablets, injections, or topical creams. The effectiveness of treatment can vary based on the duration, dosage, drug combination, and the patient’s overall health.
Hormonal Therapy
Effective for hormone receptor-positive breast cancer, hormone therapy blocks the reproductive hormones (estrogen and progesterone) from binding to the cancer cells. Common drugs include:
- Tamoxifen: Blocks estrogen receptors on cancer cells.
- Aromatase Inhibitors: Lower estrogen levels for postmenopausal women.
Targeted therapy
This is a new field in cancer treatment aimed to minimise side effects by targeting specific characteristics of cancer cells like a receptor or protein. Drugs or our immune cells can be engineered to identify and target cancer cells through their biomarkers.
Surgery
Breast cancer surgery involves the removal of cancerous tissue from the breast. There are several types of surgeries including:
- Lumpectomy: Only the tumour and a small margin of surrounding tissue are removed.
- Mastectomy: One or both breasts are removed partially or entirely.
The choice of surgery depends on the cancer’s stage, size, location, as well as the patient’s overall health and personal preferences. The priority is to preserve the breast while eliminating as many cancer cells as possible.
Preventing Swollen Breast and the Role of Breast Cancer Screening
Prevention is better than cure. While we cannot escape the genetic risk factors of breast cancer, we can still adopt better lifestyle practices to prevent escalating the risks:
- Healthy diet: Moderate your alcohol intake, avoid smoking, and incorporate healthy fibres like fruits and vegetables into your daily meals.
- Exercise: Aim for at least 150 minutes of moderate to vigorous exercise per week.
- Awareness: Knowing what signs to look out for and when to seek a doctor for breast cancer screening is crucial for early detection.
It is good practice to do a self-examination once a month, preferably a week after your menstruation. You can do this in the shower, and observe your breasts and underarms for:
- Rashes, redness, or lumps on your skin
- Changes in the shape and size of your breasts
- Nipple inversion
- Any bulging or puckered areas around the outline of your breast
Next, using your finger pads, apply different pressure in a circular motion from your collarbone to your cleavage and armpits to check for any lumps or distortions around your breasts. Gently squeeze your nipple to check for abnormal nipple discharge such as blood, yellow, or watery fluid.
Conclusion
Swollen breasts are most commonly a temporary symptom of natural hormonal fluctuations or breastfeeding. If they persist or you have other symptoms like nipple changes and skin dimpling, it could indicate a more serious condition like mastitis or even breast cancer.
Hence, it is important to be aware of how your body changes. Sometimes, a simple self-examination is the difference between an early and late diagnosis. If you notice any concerning signs for more than a week, schedule a breast screening appointment as soon as possible.
Safeguard Your Health Today
At Centre for Screening and Surgery, we prioritise delivering quality and comfortable early cancer screening and treatment using minimally invasive procedures. If you notice any abnormalities in the breasts and want a breast screening, call us to book an appointment today!
