The breasts are constantly changing from the time of puberty. When girls reach puberty they develop lobules at the end of the ducts that sit behind the nipples. Mainly made up of fatty tissue, the breasts are supported by ligaments and muscle attached to the chest wall.

Each female breast has 15-20 lobes with a number of lobules and ducts surrounded by fatty and supportive tissue. Each lobule has about 30 major ducts that open onto the nipple. The darker area of skin around the nipple is called the areola. It has large glands around it which produce fluid to lubricate the nipple.

In each armpit there are about 20-30 lymph nodes that drain fluid from the breast. These form part of the lymphatic system that helps the body to fight infection.

Nipples
The nipples usually point forward, and can quite often look different on each breast. Nipples can be turned inwards (inverted), and although nipples are hairless, some women have a few hairs around the areola.

Accessory breasts
Some people have an extra breast or pair of breasts (accessory breasts), or an extra nipple. Accessory breasts and extra nipples are unlikely to cause a problem and do not need to be removed. Breast tissue begins to lose its firmness with age; the milk-producing tissue is replaced by fat, which makes the breasts sag. This is more noticeable after the menopause when oestrogen levels fall and periods have stopped. As you grow older your breasts may also change size.

HRT
If you take hormone replacement therapy (HRT) your breasts may feel firmer and sometimes quite tender.

Normal changes and benign breast conditions
Most breast changes are directly related to developing or ageing breast tissue. These include tenderness/pain, lumps/lumpiness and nipple changes. However, sometimes changes may be diagnosed as benign breast conditions. For example, breast pain linked to the menstrual cycle is considered normal. When it is severe and long lasting it may require further investigation.

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What is Fibroadenoma? A fibroadenoma is a benign solid lump of tissue which, although very common in young women, can occur at any age. Doctors believe it is a result of increased sensitivity to the female hormone oestrogen. Normally rubbery in texture and often painless, a fibroadenoma is smooth to the touch and moves easily under the skin – which is why it is often called a breast mouse - and it is not unsual to have more than one.

Fibroadenomas between 1-3cm in size are referred to as ‘common’, those growing to more than 5cm in size are known as 'giant', and fibroadenomas found in teenage girls are called ‘juvenile'. They usually stay the same size, although some get smaller and some eventually disappear over time. A small number get bigger and this may be more noticeable during pregnancy and breastfeeding.

Diagnosis
Your GP may be able to say whether a lump is a fibroadenoma, but you may be referred to a breast clinic for diagnosis.

The breast clinic assessment will consist of a triple assessment and includes:
breast examination
mammogram or ultrasound
fine needle aspiration cytology (FNAC).

The FNAC involves drawing off cells from the lump with a fine needle, although some clinics conduct a core biopsy instead. This involves the removal of a small tissue sample rather than cells.

Women under 35 will normally have an ultrasound scan as younger breast tissue is denser and produces a less clear mammogram picture. You can find out more about breast clinic investigations from the link below.

Treatment
In most cases no follow up treatment will be required after a diagnosis has been confirmed. You will normally only be asked to return to your GP or the breast clinic if the lump gets bigger or becomes painful. If this happens, it can be removed in a small operation.

What this means
Having a fibroadenoma does not increase your risk of breast cancer. However, it is still important to be breast aware and go back to your GP if you notice any further lumps or other changes.

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