I had my first mammogram at 27.
My mother is a breast cancer survivor, but unfortunately my paternal aunt was taken by the disease. So I was well aware that I had risks from both sides of my parents.
Besides the fact that I think everything is going to kill me, I had been noticing a lump in my breast, so naturally I headed to my gyno. She confirmed that she felt it too, and sent me off to the mammogramer just to be safe — although mammograms are typically routine after you turn 40.
I had my cold and awkward mammogram as well as an ultrasound, where I got a free pink nail file and a cool self-exam check-off chart to hang on my bathroom doorknob. But neither test showed anything because my breast tissue is so dense, which meant the next step was an MRI scan.
When I headed back in for my appointment to review my results, the nurse told me she liked my eye shadow and walked me back to the consultation room. About half an hour later, I left the room walking on air: I didn’t have cancer — I had fibrocystic breasts.
“Fibrocystic breast changes are a benign condition that causes breasts to become tender and lumpy,” explains Dr. Thaïs Aliabadi, OB-GYN at Cedars Sinai Medical Center. She continues, “The severity can fluctuate throughout the month with your menstrual cycle. It is most common in those of childbearing age and can be affected by birth control pills or other hormone therapy.”
Ah, let me interject here for a moment: My breasts don’t look lumpy, they actually look great, it’s just that they can feel that way at certain times of the month. This, as you can imagine, can make it difficult for a squeamish scaredy-cat to determine if a new lump is just me being me, or something I should be concerned about.
Differences between cancer and a cyst
To help determine if a lump is a cause for concern, Aliabadi explains: “Benign breast masses often have a smooth edge, are very mobile and do not quickly grow. Breast cancer can present with other symptoms such as nipple discharge, nipple retraction, skin changes, redness and/or pain.” However, she makes it clear the difference is not always so cut-and-dried. If any new masses or symptoms are noticed, then it is “always important to follow up with a physician.”
“Having fibrocystic breasts generally does not increase the risk of breast cancer. However it is important to evaluate a patient’s individual risk based on clinical exams, medical imaging, and family history,” Aliabadi tells SheKnows.
What about dense breast tissue?
“Dense breasts are detected on mammograms. It is a common finding in younger, premenopausal women,” Aliabadi says. She explains that denser breasts “are composed primarily of glandular and fibrous tissue, versus fatty tissue,” and that additional imaging may be required because of the difficulty of detecting abnormalities from mammograms.
However, Aliabadi does note: “Some research suggests that having dense breasts can increase one’s risk of breast cancer.”
Best screening practices
Aliabadi suggests that yearly mammograms are a must for women over 40. But she also agrees that “these conditions can give reason to begin mammograms at an earlier age.”
Depending on your health and family history, it really comes down to you and your physician’s decisions. If your breasts do not “take” well via mammograms, your doctor may opt for other imaging procedures — like Aliabadi recommends. “Ultrasounds and MRIs are also important diagnostic tools when abnormalities may be suspected. Your physician will determine which method is appropriate.” But don’t be afraid to ask your doctor if you have dense breasts either.