June 11, 2023 • 19 mins
When it comes to your breasts, I've got you covered!
In this episode, I dive deep into all things related to BREASTS 🌸
I cover:
🎀 The occasional discomfort and why that happens
🎀 A new lump - Should you be worried?
🎀 Demystifying the mammogram experience - putting your mind at ease
I've got the answers you need!
Plus, I share empowering LIFESTYLE CHANGES that can make a real difference in common breast issues.
💪 Start implementing these tips today and take charge of your breast health!
#forvaginasonly #breasthealth #breastcancerawareness
Instagram: https://instagram.com/forvaginasonly
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_00 (00:00):
Hey guys, welcome to another episode of Four Vaginas
Only.
In this episode, we're going totalk about all things breasts.
We are going to go from top tobottom all the issues that you
guys have ever worried aboutwhen it comes to your breasts,
whether it's one side, the otherside, or both at the same time.
We'll get into it.
But first, let's cue the music.
(00:23):
Hello and welcome to For VaginasOnly, the podcast about
everything female.
I'm your host, Dr.
Celestine, bringing youimportant information about
understanding your health andbody in the way you wish your
doctor would actually explainit.
All right.
(00:44):
Well, hi again.
I'm Dr.
Celestine, host of the FourVaginas Only podcast.
I'm a board-certified OBGYN, andI do this stuff every day.
So I thought, what better waythan to also share with the
general community out there,outside of my own patients, and
I can bring my knowledge to theworld.
So welcome to the Four VaginasOnly podcast.
In this episode, like Imentioned in the intro, we're
(01:06):
going to be talking aboutbreasts.
We're breast symptoms andredness, pimples or lesions
around the areola that you mighthave noticed.
And also, if you have any extralumps or bumps in your armpit,
what could that be?
We'll get into it.
Okay, before we get started, Iwill say that if you notice
(01:30):
anything that is different ornew to you or concerning in your
breasts, you need to go to yourOBGYN or breast doctor, okay?
Even though I might be talkingabout some things in here that
are normal, I don't want you tojust brush off what you're going
through as normal.
This is just for you to beempowered to take that
information, bring it to yourdoctor, maybe also calm you down
(01:52):
a little bit when you noticesomething abnormal, but it
doesn't mean you don't show itto your doctor.
You still have to, even if itseems like it might not be
anything major based off whatyou hear in today's podcast
episode.
So I want to clear that up rightoff the bat.
And since we're talking aboutyou finding an abnormality
yourself, let's talk aboutwhat's recommended now in terms
(02:12):
terms of checking your breastsat home.
So back in the day, we used tosay, check your breasts every
month, feel around, see if youfeel any abnormal lumps, bumps,
if you notice any abnormalnipple discharge and do that
monthly.
Now, ACOG, which is thegoverning body of obstetrics and
gynecology in the United States,we talk more about breast
self-awareness.
(02:33):
So it's not that you have to doa breast exam every month.
What I tell my patients is youjust have to do the breast exam
enough so that you feelcomfortable with what your
normal breast And the way you dothe breast exam doesn't really
matter.
I'll explain that a little bit.
So some people go around theentire breast in a circular
form.
(02:54):
Some people go up and down.
They call it more of a lawnmowertype of pattern.
But what matters is that you doit the same way every time.
So if your doctor goes in acircular pattern, you go in a
lawnmower pattern.
Doesn't matter as long as you'redoing it the same way.
Make sure you're also feeling upby your clavicle bone, which is
that bone that's rightunderneath your neck.
on each side above the breast.
(03:15):
And also make sure you'refeeling deep into your armpit
because the breast tissueactually has a little tail that
extends into the armpit.
So you can still get breastabnormalities in that area.
So breast self-awareness justmeans you're doing this maybe
every few months until you feelcomfortable with what's normal
for you.
And I would always recommend notdoing a breast exam around the
(03:38):
time of your period because yourbreasts are more lumpy bumpy
around that time.
It's also great to do it in theshower with soapy hands.
You use the opposite hand forthe opposite breast and put the
arm on the same side up so thatyou can feel into the armpit
with that opposite hand.
And that's the way that you doit.
If you have any questions aboutthat, make sure you talk to your
OB-GYN because it's important tolearn it at any age, but
(04:02):
especially when you're youngerso you get used to your normal
breast tissue because as you getolder, the breast cancer risk
increases.
So it's important to know whatnormal is early on.
All right.
So I mentioned the big C word,cancer.
So let's go right into any lumpsor abnormal masses that you feel
deep inside of your breast.
(04:22):
So not on the skin level like apimple, but deeper.
So it's very important if youfeel anything like this, like I
mentioned, bring it up to yourdoctor.
However, I will say that moreoften than not, any lump that I
feel in the breast is usually abenign lump, meaning a not
cancerous mass or lump in thebreast.
So there's many non- canceroustumors.
(04:44):
The most common one is somethingcalled fibrocystic changes.
We call it like peas on a plate.
So you feel kind of like a wide,solid lump that moves around
with your breast tissue.
It's also normally the area thatgets a little bit tender around
your period.
And on top of that wide lump,there's some small little lumps.
(05:04):
So peas on a plate, if thatmakes sense.
Fibroadenomas or fibrocysticchanges are really common in
young women and can extendthrough your life as you age as
well.
And that's a benign ornon-cancerous mass.
There's also cysts that can forminside the breast.
They move around a lot with thebreast tissue as well.
They're more like spongy andsquishy.
(05:26):
And they're also a non-cancerouslump that you can feel in your
breast.
And then, of course, there'scancer.
I describe cancer as being morefirm, a firm lump that doesn't
move around as much with thebreast tissue.
It's a new lump that you havehaven't felt before.
So that's why it's moreimportant to know what your
normal kind of lumps and bumpsare when you're younger.
(05:47):
So it would be something new.
Sometimes it can be small.
Sometimes it can be large.
Sometimes it can be painful.
It can cause skin changes on thebreast as well.
It can cause even dimpling ofthe skin around the area of the
lump.
So any new mass that's kind offirm and on one side usually, I
definitely would be concernedabout a cancer and you would
(06:10):
need to get more imaging andfollow-up.
But when you come to your OBGYNwith this, they can distinguish
it a lot of the time right thenand there.
But we'll also probably send youfor follow-up imaging just to be
sure.
Okay, so imaging.
What does that look like?
So a lot of people come to myoffice and they're concerned
about mammograms because they'veheard that they're painful.
But I will say if you'reyounger, you're most likely
(06:32):
going to start with anultrasound of the breast.
And that's because the breasttissue when you're younger is
more dense.
Think about it.
When you're young, your breastsare up and perky and more firm.
And when you're older, They kindof sag a little bit and they're
softer.
So when you're younger, they'remore dense.
And when you're older, they'remore filled with fatty tissue
and sag a little bit more.
So a mammogram is not so greatfor that dense, young breast
(06:54):
tissue.
An ultrasound is better.
So when you're younger, weusually get an ultrasound.
But you can also get a mammogramat any age, really.
A mammogram is when they squeezeyour breast between two plates
to kind of flatten it like apancake and take an x-ray of the
breast in order to see what'sgoing on deeper inside.
Mammograms are recommended forevery woman starting at age 40
(07:16):
and continuing yearly, yearlywomen over 40 every year.
And then sometimes recommendedat a younger age if you have a
family history of breast canceror if there's something
concerning that we're lookingfor.
And mammograms, they are alittle bit uncomfortable.
Yes, you can get them also ifyou've had breast implants in
place.
But I mean, the level ofdiscomfort compared to finding
(07:38):
out if you have a cancer, to me,it's just not equal.
Just endure the pain.
I wouldn't even say it'spainful.
I've had it done.
It's just a little bituncomfortable and it's a peace
of mind and it can detect cancerearly.
So suck it up, guys.
And if the mammogram showssomething abnormal, you might
then go to a breast specialistfor a biopsy.
(08:00):
Now, I want to say here thatOBGYNs are not breast
specialists.
So if you have somethingabnormal on your mammogram or if
you need a procedure on thebreast, it's not going to be
your OBGYN.
There are breast surgeons outthere that That's their
specialty and that's what theydo.
The OB-GYN is more of the firstline person to find out if
there's a problem or not.
Okay, so let's jump from lumpsinto talking about your nipples.
(08:25):
So nipple discharge and invertednipples are things that people
come into my office to talkabout quite a bit.
So an inverted nipple is whenyour nipple goes in instead of
coming out like a point.
Now, some people have theirbreasts have been this way their
whole life.
That's normal.
Sometimes it even can changeafter you breastfeed or
(08:46):
something like that, but I wouldstill say it's at that point
required to look into as well.
Because sometimes when you havea nipple that becomes inverted
at a later time, that can be asign of a breast cancer.
So it's important that if you'vealways had regular kind of
nipples, I don't want to saythey're regular, but nipples
that kind of stick out and thenone or both become inverted
(09:09):
later in your life, that'ssomething to see a doctor about
because you might need someimaging and an exam.
But it can also happen for manynormal reasons like trauma to
the breast, scarring, orbreastfeeding.
It can be on one side or both.
Now, let's talk about nippledischarge because nipple
discharge is a littleinteresting.
The discharge is fluid thatcomes out of your nipple.
It can be milky.
(09:31):
It can be clear.
It can be yellow, green, bloody.
And the color of the nippledischarge kind of signifies
different things.
So clear and milky tend to bebenign or non-cancerous
discharge that we're not asconcerned about, but can
indicate other things likeinfection in the breast,
(09:52):
especially if it's like green oryellow, that color too can be
more of an infection.
Galacteria is something whereyou kind of have a milky
discharge where we might need tolook at brain imaging actually,
because that can indicatesomething going on in the brain
if you have a milky discharge.
And we might get lab work,especially because of that.
Certain medications can startnipple discharge and also
(10:15):
touching your breasts a lot canlead to discharge from the
nipple, especially a clear ormilky discharge.
Now, when you have a bloodydischarge, we get more concerned
for a cancer, but it doesn'thave to be.
It's just important for us torule that out.
Another reason for a bloodydischarge is something called a
papilloma, which is another kindof mass within the breast, and
(10:35):
that's actually non-cancerousand can lead to nipple
discharge.
So I don't want you to freak outif you see the bloody discharge,
but definitely see your doctor.
Okay.
Now let's talk about breastpain.
I get this a lot in my officewhere somebody starts to have
breast pain.
It might not always be relatedto their cycle, but a lot of
times it is.
So commonly you get tendernessof the breasts a few days or
(10:58):
even a week before your periodand can last through like the
first few days of your period.
That's a common change thathappens because of hormonal
changes with the menstrual cyclethat are actually normal.
Okay.
But sometimes it can be reallysevere where you have to take
medication such as NSAIDs likeibuprofen, Motrin, Advil to help
with that pain that can reallybe debilitating.
(11:20):
So it's important to still bringit up to your doctor and it can
be a sign of premenstrualsyndrome or PMS.
So check out that PMS podcastepisode that I did a few months
ago, I believe at this point, ifyou want a little bit more
detail on that.
So if you have breast pain,definitely see your doctor.
And if we determine that it'sjust hormonal breast pain or
something with your cycle, thereare ways to improve it.
(11:42):
So I mentioned taking NSAIDslike ibuprofen and Motrin.
That can work, but also somelifestyle changes can help as
well.
And I love giving lifestylechanges because I want you to
feel empowered at home to helpyourself solve some of your
problems.
And, you know, lifestyle changesare great for people that don't
really even want to takemedication all the time.
(12:02):
So some things for breast pain,once you've ruled out that it's
normal breast pain with yourdoctor, you can change your bra.
So go to a actual lingeriestore, even Victoria's Secret,
and get fitted for a bra.
Get measured so that you knowyou're wearing the right size
bra that's supportive for yourbreasts.
Also, sometimes if you're on acertain birth control, they can
(12:23):
cause breast tenderness.
So consider changing your birthcontrol with your doctor.
Limit caffeine.
So stop the coffee, stop thecaffeinated teas, stop the
sodas.
Limiting or cutting out caffeinealtogether can decrease or
eliminate breast pain.
And of course, Stop smoking.
I mean, smoking does so manythings to your body that you
(12:45):
don't even think about, and thisbreast pain is one of them.
So stop all tobacco use,including vaping, okay?
There are also some supplementsthat have shown in smaller
studies to be beneficial forbreast pain.
One of them is taking vitamin E.
There was a study of about 80patients that showed that it was
better than the placebo inhelping with pain.
(13:06):
So taking about 200international units of vitamin E
daily can be beneficial.
Another one is vitamin B as inboy, B6.
Taking 40 milligrams a day ofvitamin B6 can be beneficial for
breast pain as well.
And overall, B6 has been showingsome benefits in PMS symptoms if
you take it daily.
(13:26):
So that's important to know aswell.
Now, there was a study and a lotof people talk about taking
evening primrose oil.
And the kind of hype orexcitement about this is that
evening primrose oil kind ofhave the same properties as
taking your NSAIDs, ibuprofenAdvil.
But there was a study that wasdone with 1,700 people where
they compared it to a placebo,which is a medication that
(13:50):
actually has no activeingredients that should not
change anything.
And it showed that eveningprimrose oil didn't actually
have any benefit over theplacebo medication.
So no proof yet that it works,but I know some people have
tried it.
They say it works for them.
I don't see where it can harmyou unless you have an allergy
to NSAIDs or evening primroseoil.
So you can try it if you wouldlike to.
And those are some things tolook into.
(14:12):
Some people also talk aboutmagnesium, but I haven't seen
any studies where magnesiumworks for breast pain per se,
but it's something you can tryand it's in a lot of
multivitamins that you'reprobably taking already.
Okay, another thing I see andtalk about commonly in my
practice is when people come inand they have a lot of
irritation under the breast withredness and moisture.
(14:34):
Sometimes if you're darker skin,it can actually be completely
black under the breast, can beitchy, can have a rash, can be a
little blister And that's reallycommon in people that sweat a
lot and also that have largerbreasts where the breast kind of
completely covers that skinunderneath on your chest wall.
And that is more commonly thannot a yeast infection.
(14:58):
So just like you get yeastinfections kind of in the
vagina, you can also get a yeastinfection under the breast.
growing.
So yeast can become itchy,blistery, darkened skin, red
skin.
So the best things that you cando in your lifestyle to treat
(15:21):
this is to make sure that underthe breast stay as clean and dry
possibly every day.
So make sure you're showeringtwo times a day, keeping that
area dry as much as possible.
Some people, I've even had apatient the other day that one
of the biggest reasons she got abreast reduction surgery is
because she was chronicallyhaving that issue and her
breasts were so large It wasreally hard to control in
(15:43):
addition to other things likeback pain and things like that.
But, you know, if you're having,if you have really large
breasts, they're hurting yourback, it's making you kind of
affecting your everyday life,including something like these
yeast infections under yourbreast, maybe consider a breast
reduction if that's in the cardsfor you.
The other thing that can help isgoing to your doctor to get a
(16:05):
yeast powder or a yeast cream.
So a lot of times I prescribeNystatin cream.
or nystatin powder to be placedunder the breast as needed if
the irritation or sweatinessstarts to become itchy or red or
really uncomfortable.
And that's an actual activetreatment.
But the prevention is trying tokeep it as clean and dry as
possible at home.
(16:27):
Okay, so let's talk about theareola.
So the areola is a kind ofdarker or different color area
that circles around your actualnipple that's in the middle.
So you can get little pimples,even on the breast skin, you can
get little pimples which canstill be checked out by your
doctor to make sure that they'renot larger, what we call
abscesses or deeper masses.
(16:49):
But it's important to know thatyour areola also has glands on
it that are bumps around orwithin that darkened or reddish
pinkish area of the areola.
And those are normal.
They're called Montgomeryglands.
And they're actually there tohelp kind of create moisture
around that area, especiallyimportant for breastfeeding and
(17:09):
things like that.
So if you have like little lumpsaround the areola that are on
both sides of the breast, thoseare most likely normal and
they're Montgomery glands.
So I don't want you to beconcerned too much about those.
They can become larger withbreastfeeding and the areola can
become darker with pregnancy andbreastfeeding and postpartum as
well.
So those are normal changes tothe breast and areola.
(17:31):
And last but not least, let'stalk about if you have your
breast, most people know wherethat is, right?
And then you go into your armpitand you have a lump kind of in
your armpit that either connectsdirectly with the breast or you
have a little skip of tissue andthen the lump, sometimes you've
had it your whole life and itstarts to become larger when you
(17:53):
get older, can also becomelarger and tender around your
period or if you'rebreastfeeding or pregnant.
And that's because that isactually breast tissue in your
armpit.
Some people, it's just flat andyou don't feel it.
In everybody, it extends intothe armpit a little bit, but
some people, have a little bitmore of that tissue than others.
(18:15):
So that is actually called thetail of Spence.
It's the tail of the breasttissue that in some people can
be a little bit larger.
If you notice this for the veryfirst time or you've never had
it before and now it's there,definitely get it checked out by
your doctor.
But like I said, some peoplehave had this their whole lives.
I've seen it become reallyuncomfortable for some people
where they actually get itexcised or removed by a breast
(18:37):
surgeon.
But most of the time, it'sbenign tissue that really
doesn't need to be touched.
And that's it.
That is all things breasts orBreast 101 course, as I like to
say about this episode.
There is everything I could havegone into much, much more
detail, but I wanted to give anoverview of the common things
that I see people concernedabout in my practice.
(18:59):
Hopefully to give you all alittle bit of peace of mind and
also to trigger in you when youshould go to your doctor for an
exam to figure out if somethingis normal or not.
I hope you gained some greattips and some lifestyle changes
for those of you that have thebreast pain that has been deemed
normal and hormonal.
And I hope that this empowersall of you out there to take
(19:22):
kind of control of your body,control of your health, just
like all my Four Vaginas Onlyepisodes.
That's the main goal.
And I want you to feel empoweredto actually have full
understanding of what's going onwithin you.
Thank you so much for listeningto the Four Vaginas Only
podcast.
I'm Dr.
Celestine, and I'll see you inthe next one.
Bye.
Hey guys, welcome to another episode of Four Vaginas
Only.
In this episode, we're going totalk about all things breasts.
We are going to go from top tobottom all the issues that you
guys have ever worried aboutwhen it comes to your breasts,
whether it's one side, the otherside, or both at the same time.
We'll get into it.
But first, let's cue the music.
(00:23):
Hello and welcome to For VaginasOnly, the podcast about
everything female.
I'm your host, Dr.
Celestine, bringing youimportant information about
understanding your health andbody in the way you wish your
doctor would actually explainit.
All right.
(00:44):
Well, hi again.
I'm Dr.
Celestine, host of the FourVaginas Only podcast.
I'm a board-certified OBGYN, andI do this stuff every day.
So I thought, what better waythan to also share with the
general community out there,outside of my own patients, and
I can bring my knowledge to theworld.
So welcome to the Four VaginasOnly podcast.
In this episode, like Imentioned in the intro, we're
(01:06):
going to be talking aboutbreasts.
We're breast symptoms andredness, pimples or lesions
around the areola that you mighthave noticed.
And also, if you have any extralumps or bumps in your armpit,
what could that be?
We'll get into it.
Okay, before we get started, Iwill say that if you notice
(01:30):
anything that is different ornew to you or concerning in your
breasts, you need to go to yourOBGYN or breast doctor, okay?
Even though I might be talkingabout some things in here that
are normal, I don't want you tojust brush off what you're going
through as normal.
This is just for you to beempowered to take that
information, bring it to yourdoctor, maybe also calm you down
(01:52):
a little bit when you noticesomething abnormal, but it
doesn't mean you don't show itto your doctor.
You still have to, even if itseems like it might not be
anything major based off whatyou hear in today's podcast
episode.
So I want to clear that up rightoff the bat.
And since we're talking aboutyou finding an abnormality
yourself, let's talk aboutwhat's recommended now in terms
(02:12):
terms of checking your breastsat home.
So back in the day, we used tosay, check your breasts every
month, feel around, see if youfeel any abnormal lumps, bumps,
if you notice any abnormalnipple discharge and do that
monthly.
Now, ACOG, which is thegoverning body of obstetrics and
gynecology in the United States,we talk more about breast
self-awareness.
(02:33):
So it's not that you have to doa breast exam every month.
What I tell my patients is youjust have to do the breast exam
enough so that you feelcomfortable with what your
normal breast And the way you dothe breast exam doesn't really
matter.
I'll explain that a little bit.
So some people go around theentire breast in a circular
form.
(02:54):
Some people go up and down.
They call it more of a lawnmowertype of pattern.
But what matters is that you doit the same way every time.
So if your doctor goes in acircular pattern, you go in a
lawnmower pattern.
Doesn't matter as long as you'redoing it the same way.
Make sure you're also feeling upby your clavicle bone, which is
that bone that's rightunderneath your neck.
on each side above the breast.
(03:15):
And also make sure you'refeeling deep into your armpit
because the breast tissueactually has a little tail that
extends into the armpit.
So you can still get breastabnormalities in that area.
So breast self-awareness justmeans you're doing this maybe
every few months until you feelcomfortable with what's normal
for you.
And I would always recommend notdoing a breast exam around the
(03:38):
time of your period because yourbreasts are more lumpy bumpy
around that time.
It's also great to do it in theshower with soapy hands.
You use the opposite hand forthe opposite breast and put the
arm on the same side up so thatyou can feel into the armpit
with that opposite hand.
And that's the way that you doit.
If you have any questions aboutthat, make sure you talk to your
OB-GYN because it's important tolearn it at any age, but
(04:02):
especially when you're youngerso you get used to your normal
breast tissue because as you getolder, the breast cancer risk
increases.
So it's important to know whatnormal is early on.
All right.
So I mentioned the big C word,cancer.
So let's go right into any lumpsor abnormal masses that you feel
deep inside of your breast.
(04:22):
So not on the skin level like apimple, but deeper.
So it's very important if youfeel anything like this, like I
mentioned, bring it up to yourdoctor.
However, I will say that moreoften than not, any lump that I
feel in the breast is usually abenign lump, meaning a not
cancerous mass or lump in thebreast.
So there's many non- canceroustumors.
(04:44):
The most common one is somethingcalled fibrocystic changes.
We call it like peas on a plate.
So you feel kind of like a wide,solid lump that moves around
with your breast tissue.
It's also normally the area thatgets a little bit tender around
your period.
And on top of that wide lump,there's some small little lumps.
(05:04):
So peas on a plate, if thatmakes sense.
Fibroadenomas or fibrocysticchanges are really common in
young women and can extendthrough your life as you age as
well.
And that's a benign ornon-cancerous mass.
There's also cysts that can forminside the breast.
They move around a lot with thebreast tissue as well.
They're more like spongy andsquishy.
(05:26):
And they're also a non-cancerouslump that you can feel in your
breast.
And then, of course, there'scancer.
I describe cancer as being morefirm, a firm lump that doesn't
move around as much with thebreast tissue.
It's a new lump that you havehaven't felt before.
So that's why it's moreimportant to know what your
normal kind of lumps and bumpsare when you're younger.
(05:47):
So it would be something new.
Sometimes it can be small.
Sometimes it can be large.
Sometimes it can be painful.
It can cause skin changes on thebreast as well.
It can cause even dimpling ofthe skin around the area of the
lump.
So any new mass that's kind offirm and on one side usually, I
definitely would be concernedabout a cancer and you would
(06:10):
need to get more imaging andfollow-up.
But when you come to your OBGYNwith this, they can distinguish
it a lot of the time right thenand there.
But we'll also probably send youfor follow-up imaging just to be
sure.
Okay, so imaging.
What does that look like?
So a lot of people come to myoffice and they're concerned
about mammograms because they'veheard that they're painful.
But I will say if you'reyounger, you're most likely
(06:32):
going to start with anultrasound of the breast.
And that's because the breasttissue when you're younger is
more dense.
Think about it.
When you're young, your breastsare up and perky and more firm.
And when you're older, They kindof sag a little bit and they're
softer.
So when you're younger, they'remore dense.
And when you're older, they'remore filled with fatty tissue
and sag a little bit more.
So a mammogram is not so greatfor that dense, young breast
(06:54):
tissue.
An ultrasound is better.
So when you're younger, weusually get an ultrasound.
But you can also get a mammogramat any age, really.
A mammogram is when they squeezeyour breast between two plates
to kind of flatten it like apancake and take an x-ray of the
breast in order to see what'sgoing on deeper inside.
Mammograms are recommended forevery woman starting at age 40
(07:16):
and continuing yearly, yearlywomen over 40 every year.
And then sometimes recommendedat a younger age if you have a
family history of breast canceror if there's something
concerning that we're lookingfor.
And mammograms, they are alittle bit uncomfortable.
Yes, you can get them also ifyou've had breast implants in
place.
But I mean, the level ofdiscomfort compared to finding
(07:38):
out if you have a cancer, to me,it's just not equal.
Just endure the pain.
I wouldn't even say it'spainful.
I've had it done.
It's just a little bituncomfortable and it's a peace
of mind and it can detect cancerearly.
So suck it up, guys.
And if the mammogram showssomething abnormal, you might
then go to a breast specialistfor a biopsy.
(08:00):
Now, I want to say here thatOBGYNs are not breast
specialists.
So if you have somethingabnormal on your mammogram or if
you need a procedure on thebreast, it's not going to be
your OBGYN.
There are breast surgeons outthere that That's their
specialty and that's what theydo.
The OB-GYN is more of the firstline person to find out if
there's a problem or not.
Okay, so let's jump from lumpsinto talking about your nipples.
(08:25):
So nipple discharge and invertednipples are things that people
come into my office to talkabout quite a bit.
So an inverted nipple is whenyour nipple goes in instead of
coming out like a point.
Now, some people have theirbreasts have been this way their
whole life.
That's normal.
Sometimes it even can changeafter you breastfeed or
(08:46):
something like that, but I wouldstill say it's at that point
required to look into as well.
Because sometimes when you havea nipple that becomes inverted
at a later time, that can be asign of a breast cancer.
So it's important that if you'vealways had regular kind of
nipples, I don't want to saythey're regular, but nipples
that kind of stick out and thenone or both become inverted
(09:09):
later in your life, that'ssomething to see a doctor about
because you might need someimaging and an exam.
But it can also happen for manynormal reasons like trauma to
the breast, scarring, orbreastfeeding.
It can be on one side or both.
Now, let's talk about nippledischarge because nipple
discharge is a littleinteresting.
The discharge is fluid thatcomes out of your nipple.
It can be milky.
(09:31):
It can be clear.
It can be yellow, green, bloody.
And the color of the nippledischarge kind of signifies
different things.
So clear and milky tend to bebenign or non-cancerous
discharge that we're not asconcerned about, but can
indicate other things likeinfection in the breast,
(09:52):
especially if it's like green oryellow, that color too can be
more of an infection.
Galacteria is something whereyou kind of have a milky
discharge where we might need tolook at brain imaging actually,
because that can indicatesomething going on in the brain
if you have a milky discharge.
And we might get lab work,especially because of that.
Certain medications can startnipple discharge and also
(10:15):
touching your breasts a lot canlead to discharge from the
nipple, especially a clear ormilky discharge.
Now, when you have a bloodydischarge, we get more concerned
for a cancer, but it doesn'thave to be.
It's just important for us torule that out.
Another reason for a bloodydischarge is something called a
papilloma, which is another kindof mass within the breast, and
(10:35):
that's actually non-cancerousand can lead to nipple
discharge.
So I don't want you to freak outif you see the bloody discharge,
but definitely see your doctor.
Okay.
Now let's talk about breastpain.
I get this a lot in my officewhere somebody starts to have
breast pain.
It might not always be relatedto their cycle, but a lot of
times it is.
So commonly you get tendernessof the breasts a few days or
(10:58):
even a week before your periodand can last through like the
first few days of your period.
That's a common change thathappens because of hormonal
changes with the menstrual cyclethat are actually normal.
Okay.
But sometimes it can be reallysevere where you have to take
medication such as NSAIDs likeibuprofen, Motrin, Advil to help
with that pain that can reallybe debilitating.
(11:20):
So it's important to still bringit up to your doctor and it can
be a sign of premenstrualsyndrome or PMS.
So check out that PMS podcastepisode that I did a few months
ago, I believe at this point, ifyou want a little bit more
detail on that.
So if you have breast pain,definitely see your doctor.
And if we determine that it'sjust hormonal breast pain or
something with your cycle, thereare ways to improve it.
(11:42):
So I mentioned taking NSAIDslike ibuprofen and Motrin.
That can work, but also somelifestyle changes can help as
well.
And I love giving lifestylechanges because I want you to
feel empowered at home to helpyourself solve some of your
problems.
And, you know, lifestyle changesare great for people that don't
really even want to takemedication all the time.
(12:02):
So some things for breast pain,once you've ruled out that it's
normal breast pain with yourdoctor, you can change your bra.
So go to a actual lingeriestore, even Victoria's Secret,
and get fitted for a bra.
Get measured so that you knowyou're wearing the right size
bra that's supportive for yourbreasts.
Also, sometimes if you're on acertain birth control, they can
(12:23):
cause breast tenderness.
So consider changing your birthcontrol with your doctor.
Limit caffeine.
So stop the coffee, stop thecaffeinated teas, stop the
sodas.
Limiting or cutting out caffeinealtogether can decrease or
eliminate breast pain.
And of course, Stop smoking.
I mean, smoking does so manythings to your body that you
(12:45):
don't even think about, and thisbreast pain is one of them.
So stop all tobacco use,including vaping, okay?
There are also some supplementsthat have shown in smaller
studies to be beneficial forbreast pain.
One of them is taking vitamin E.
There was a study of about 80patients that showed that it was
better than the placebo inhelping with pain.
(13:06):
So taking about 200international units of vitamin E
daily can be beneficial.
Another one is vitamin B as inboy, B6.
Taking 40 milligrams a day ofvitamin B6 can be beneficial for
breast pain as well.
And overall, B6 has been showingsome benefits in PMS symptoms if
you take it daily.
(13:26):
So that's important to know aswell.
Now, there was a study and a lotof people talk about taking
evening primrose oil.
And the kind of hype orexcitement about this is that
evening primrose oil kind ofhave the same properties as
taking your NSAIDs, ibuprofenAdvil.
But there was a study that wasdone with 1,700 people where
they compared it to a placebo,which is a medication that
(13:50):
actually has no activeingredients that should not
change anything.
And it showed that eveningprimrose oil didn't actually
have any benefit over theplacebo medication.
So no proof yet that it works,but I know some people have
tried it.
They say it works for them.
I don't see where it can harmyou unless you have an allergy
to NSAIDs or evening primroseoil.
So you can try it if you wouldlike to.
And those are some things tolook into.
(14:12):
Some people also talk aboutmagnesium, but I haven't seen
any studies where magnesiumworks for breast pain per se,
but it's something you can tryand it's in a lot of
multivitamins that you'reprobably taking already.
Okay, another thing I see andtalk about commonly in my
practice is when people come inand they have a lot of
irritation under the breast withredness and moisture.
(14:34):
Sometimes if you're darker skin,it can actually be completely
black under the breast, can beitchy, can have a rash, can be a
little blister And that's reallycommon in people that sweat a
lot and also that have largerbreasts where the breast kind of
completely covers that skinunderneath on your chest wall.
And that is more commonly thannot a yeast infection.
(14:58):
So just like you get yeastinfections kind of in the
vagina, you can also get a yeastinfection under the breast.
growing.
So yeast can become itchy,blistery, darkened skin, red
skin.
So the best things that you cando in your lifestyle to treat
(15:21):
this is to make sure that underthe breast stay as clean and dry
possibly every day.
So make sure you're showeringtwo times a day, keeping that
area dry as much as possible.
Some people, I've even had apatient the other day that one
of the biggest reasons she got abreast reduction surgery is
because she was chronicallyhaving that issue and her
breasts were so large It wasreally hard to control in
(15:43):
addition to other things likeback pain and things like that.
But, you know, if you're having,if you have really large
breasts, they're hurting yourback, it's making you kind of
affecting your everyday life,including something like these
yeast infections under yourbreast, maybe consider a breast
reduction if that's in the cardsfor you.
The other thing that can help isgoing to your doctor to get a
(16:05):
yeast powder or a yeast cream.
So a lot of times I prescribeNystatin cream.
or nystatin powder to be placedunder the breast as needed if
the irritation or sweatinessstarts to become itchy or red or
really uncomfortable.
And that's an actual activetreatment.
But the prevention is trying tokeep it as clean and dry as
possible at home.
(16:27):
Okay, so let's talk about theareola.
So the areola is a kind ofdarker or different color area
that circles around your actualnipple that's in the middle.
So you can get little pimples,even on the breast skin, you can
get little pimples which canstill be checked out by your
doctor to make sure that they'renot larger, what we call
abscesses or deeper masses.
(16:49):
But it's important to know thatyour areola also has glands on
it that are bumps around orwithin that darkened or reddish
pinkish area of the areola.
And those are normal.
They're called Montgomeryglands.
And they're actually there tohelp kind of create moisture
around that area, especiallyimportant for breastfeeding and
(17:09):
things like that.
So if you have like little lumpsaround the areola that are on
both sides of the breast, thoseare most likely normal and
they're Montgomery glands.
So I don't want you to beconcerned too much about those.
They can become larger withbreastfeeding and the areola can
become darker with pregnancy andbreastfeeding and postpartum as
well.
So those are normal changes tothe breast and areola.
(17:31):
And last but not least, let'stalk about if you have your
breast, most people know wherethat is, right?
And then you go into your armpitand you have a lump kind of in
your armpit that either connectsdirectly with the breast or you
have a little skip of tissue andthen the lump, sometimes you've
had it your whole life and itstarts to become larger when you
(17:53):
get older, can also becomelarger and tender around your
period or if you'rebreastfeeding or pregnant.
And that's because that isactually breast tissue in your
armpit.
Some people, it's just flat andyou don't feel it.
In everybody, it extends intothe armpit a little bit, but
some people, have a little bitmore of that tissue than others.
(18:15):
So that is actually called thetail of Spence.
It's the tail of the breasttissue that in some people can
be a little bit larger.
If you notice this for the veryfirst time or you've never had
it before and now it's there,definitely get it checked out by
your doctor.
But like I said, some peoplehave had this their whole lives.
I've seen it become reallyuncomfortable for some people
where they actually get itexcised or removed by a breast
(18:37):
surgeon.
But most of the time, it'sbenign tissue that really
doesn't need to be touched.
And that's it.
That is all things breasts orBreast 101 course, as I like to
say about this episode.
There is everything I could havegone into much, much more
detail, but I wanted to give anoverview of the common things
that I see people concernedabout in my practice.
(18:59):
Hopefully to give you all alittle bit of peace of mind and
also to trigger in you when youshould go to your doctor for an
exam to figure out if somethingis normal or not.
I hope you gained some greattips and some lifestyle changes
for those of you that have thebreast pain that has been deemed
normal and hormonal.
And I hope that this empowersall of you out there to take
(19:22):
kind of control of your body,control of your health, just
like all my Four Vaginas Onlyepisodes.
That's the main goal.
And I want you to feel empoweredto actually have full
understanding of what's going onwithin you.
Thank you so much for listeningto the Four Vaginas Only
podcast.
I'm Dr.
Celestine, and I'll see you inthe next one.
Bye.
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