Counseling Sheet

Agatha M. Thrash, M.D.
Preventive Medicine

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The human breasts are composed in the male of ducts only and in the female of both ducts and glandular material. Supporting both the ducts and the glandular material is a special connective tissue, which is unusually sensitive to various hormones, particularly estrogenic-type hormones. The breasts, being glands of the skin, are modified sweat glands and function under the same neurohormonal control as sweat glands. Therefore, anything that will increase sweating has the potential also to increase both the size and secretion of the breasts. By far the greatest bulk in the female breast is composed of fatty tissue, the ductal and glandular tissue comprising only a very small part. The breasts are under such special influences that many features of the environment can have a pronounced influence upon them.

It is a good practice to keep the breasts small by weight control. Overweight leads to a higher incidence of all kinds of cancers, especially those of the breasts. Furthermore, tumors in a large breast are more difficult to discover early than in a small breast.

Daily cleansing of the nipples is a good practice. All women have a very small secretion that dries as a pale tan crust on the large pores of the nipple center. The daily shower is usually sufficient for cleansing, as the secretions are water soluble and easily removed. The breast secretions should be kept thin by copious water drinking and by the avoidance of diuretics and methylxanthines. The methylxanthines are toxic alkaloids present in coffee, tea, colas, and chocolate. Recent reports in medical literature implicate all of these, and particularly chocolate, as a stimulatory chemical for the abnormal growth of tissues of the breasts. Fibrocystic disease of the breasts is promoted by the alkaloids present in chocolate and other members of the methylxanthine family. Many women who have repeatedly produced breast nodules find that their breast lumps disappear entirely when they stop using chocolate, coffee, tea, and colas. Cigarette smoking apparently functions in the same way to produce breast lumps.

A rich and unhealthful diet tends to promote many types of cancers, especially breast cancer. A diet high in fats, meats, and milk is associated particularly with breast and colon cancers as well as certain other malignancies. The very fact of being large, either being tall or overweight, increases the risk of cancer of the breast.

Another simple matter that tends to promote the formation of fibrocystic disease of the breast is overheating. If the clothing on the trunk is more bulky or warm than the clothing on the extremities, there tends to be congestion and a higher temperature of the breasts, with subsequent promotion of cysts and nodules in the breasts. Padded bras, vests, and bulky clothing over the chest with scantily clothed or bare extremities causes an unhealthful condition leading to malfunction of the breasts. Nursing is rendered more difficult in women who have had the habit of clothing the body in such a way that there is an unequal circulation between the extremities and the trunk. Normally the temperature of the breasts should be several degrees cooler than the surrounding skin. Women routinely notice that during heavy exercise the breast are quite cool, whereas the surrounding parts of the body are quite a bit warmer.

It should be pointed out that, contrary to information that has been taught in some circles, omitting the wearing of a bra does not cause tissue breakdown in the breasts. Even by medical persons one will sometimes hear this idea promoted. In countries of the world where garments on the order of bras are not worn, women have no more sagging of the breasts than in countries of the world where bras are routinely worn. It can be concluded that both the sagging of breasts and firmness of breasts is genetically controlled, and has nothing to do with the type of clothing worn. Bras should be the lightest weight possible and should never constrict the chest or weigh down the shoulders.

Occasionally the breasts will become injured in some way by bumping or excessive pressure. Should an injury occur, it should be treated by alternating hot and cold compresses. Apply the hot compresses for 4 minutes and a cold compress for 45 to 60 seconds, the alternating compress being repeated three in a series and the treatment done as often as 4 times daily, until the injury has subsided.

Women should be taught to examine their own breasts. It is a good idea to set aside the first day of each new season—the first day of spring, summer, fall, and winter. There are several steps that should be taken in examining the breasts:

1. Stand with the breasts bare in front of a mirror and look for lumps, retractions or shadows, having the light fall on the chest from above one shoulder to provide highlights.
2. Lie on a bed, arms by side. Examine the left breast with the right hand. Divide the breast into two halves, examining the inner half first, beginning at the nipple, and extending from the nipple line to the breastbone centrally to the collar bone above and to the bottom of the breast. Use the last joint of all three long fingers, held flat against the breast, for examining. The proper motion for examination is to place the palm surface of the fingers flat against the breast and make a rotary motion to determine the presence of lumps or cysts in the breast tissue. Then move to the next area. To get an idea of what a lump would feel like, stick your tongue between your back teeth against the side of your jaw and place your fingers against your cheek to feel your tongue from the outside of your face. A lump in the breast feels just like feeling your tongue through your jaw tissues.
3. Next, raise the left arm above the head and examine the outer half of the breast. Again, start with the nipple, and examine all the tissue to the armpit on the outside and to the collarbone above.
4. The breasts naturally have a lumpy texture. Do not think this is abnormal. Further, the ribs can be rounded and be mistaken for a tumor. If you are in doubt whether you are feeling a rib or a lump, simply move the breast up or down and roll the tissue around again. Another way is to pull the breast toward the breastbone with one hand on the nipple, and with the other hand examine the outer half. Also, in some breasts there is a thick, semilunar ridge at the bottom margin of the breast, which should not cause concern. One quickly learns the normal anatomical structures of the breast.