Breast Diseases – Dr. Celal Sağlam

Breast Cancer Screening

3 March 2026

by DrCelalSaglam Breast Diseases

Self-Examination (Manual, Visual, and Lying-Down Examination)

Every woman over the age of 20 should perform a self-examination within the first 10 days after the end of her menstruation. Women who do not menstruate can perform this practice on a specific day each month.

First, stand in front of a mirror and perform a visual examination. Place your hands on your hips and check the symmetry of your breasts. Observe whether there is a depression, discoloration, or visible lump in the breast. Repeat the same process with your hands raised. Then, proceed to the lying-down examination section. First, check the right breast. To facilitate the check, place a small pillow under your right shoulder and place your right hand behind your head. Using two fingers of your left hand, gently press and make circular movements around the nipple and into the breast tissue. This self-examination motion, performed clockwise, checks for tenderness and lumps. The same procedure is then repeated for the left breast.

Every person is their own doctor. Research has proven that women who know how to perform self-breast examinations and practice regularly discover and treat potential breast diseases early. This is because breast cancer diagnosed early is much easier to treat than breast cancer diagnosed late and therefore advanced.

Physical Examination

A physical examination is a clinical examination performed by a doctor specializing in breast diseases. The doctor performs the examination along with the patient’s history. If deemed necessary, they may request tests such as ultrasound or mammography. Even if a woman over 40 has no complaints about her breasts, she should consult a specialist doctor once a year. As mentioned above, the treatment process is much easier for cases diagnosed early.

Mammography

Mammography is the primary imaging method used in breast screenings. It is the earliest possible test for detecting breast cancer. The breast is compressed between two plates, essentially taking an X-ray. Every woman over 40 should have a mammogram once a year. Individuals with a family history of breast cancer should have mammograms at an earlier age.

Breast Ultrasound

Breast ultrasonography (US) provides a more detailed screening than mammography. By performing cross-sectional imaging, tissues do not overlap during the procedure, preventing potential diagnostic errors. Small cancer foci can be more easily diagnosed in this way. Breast ultrasound may also be requested in addition to mammography for women with dense breast tissue.

In breast ultrasound, a small, handheld device is moved across the breast. The device sends sound waves to the breast, and the formations within the breast are examined on a screen. It does not contain radiation, so it can be safely applied to pregnant and breastfeeding women. It is important that the person performing the ultrasound is experienced to avoid missing any findings.

PET

The PET method is the newest and most advanced diagnostic method. The patient receives a radioactive substance and enters the PET machine. Cancer cells, due to their structure, immediately absorb the radioactive substances. In this way, the locations of active cells are identified. Mammography and ultrasound are generally preferred among imaging methods used for diagnosis. The PET method is particularly preferred to check the condition of a patient undergoing cancer treatment after treatment. PET can also be used to check whether the cancer has spread elsewhere, especially to the lymph nodes. Although we have mentioned it among breast cancer screening methods, the PET method is not considered a breast cancer screening method.

Biopsy

If cancer is suspected after the screening methods mentioned above, cell and tissue samples are taken from the breast and a biopsy is performed. Pathologists carry out the examination using microscopic methods. In this way, both the definitive diagnosis and all the details of the disease are revealed.

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Breast Cancer

3 March 2026

by DrCelalSaglam Breast Diseases

Breast cancer is defined as a change and proliferation of cells in the genetic structure of the mammary glands or milk ducts. Although the exact cause of this disease, which can spread to organs outside the breast, is not known, it can be said that it is more common in women, in older women, and in those with a family history of breast cancer.

Breast cancer has its own classification. If the cancer originates from the mammary gland, it is called lobular carcinoma; if it originates from the milk duct, it is called ductal carcinoma. These two types are further divided into two groups. If lobular carcinoma is inside the mammary gland, it is called lobular carcinoma in situ (LCIS); if it has spread outside the mammary gland, it is called invasive lobular carcinoma. Similarly, ductal carcinoma is defined as ductal carcinoma in situ (DCIS) if it is inside the duct, and invasive ductal carcinoma if it is outside the duct.

Ductal Carcinoma In Situ (DCIS)

Ductal carcinoma in situ is when cells in the milk ducts multiply before they spread outside. This type of cancer, which is the earliest stage of breast cancer, does not spread to other organs. The cancer can be completely cured by removing only this area. Tumors at this stage are too small to be detected by manual examination. They can be diagnosed with mammography. For early diagnosis, women over 40 should have a mammogram every year.

Invasive Ductal Carcinoma

Invasive ductal carcinoma is when cells in the milk duct spread outside the duct. It is the stage where the cancer has taken over the breast. This is the most common type.

Lobular Carcinoma In Situ (LCIS)

Lobular carcinoma in situ refers to the proliferation of cells in the mammary glands before they spread outside. This type is not considered cancer today because it does not have the potential to transform into invasive lobular carcinoma. However, it is a condition that increases the risk of breast cancer and should be monitored.

Invasive Lobular Carcinoma

Invasive lobular carcinoma refers to the spread of cells from the mammary glands outside. It is the second most common type after invasive ductal carcinoma.

Causes and Risk Factors of Breast Cancer

First of all, it should be noted that the risk factors listed here are, as the name suggests, factors that increase the risk. The exact cause of breast cancer is not known. Based on research and observations over the years, it has been observed that some factors increase the risk. Accordingly, having these factors does not mean that people will develop breast cancer. Similarly, it cannot be said that people without risk factors will not develop breast cancer. Now let’s look at the risk factors:

Advanced age… Approximately three-quarters of people diagnosed with breast cancer are over 50 years old.

Family factors… The risk increases if a first-degree relative has had breast cancer.

Having had breast cancer before… If you have been diagnosed with and treated for breast cancer, the likelihood of developing cancer in the other breast increases 3-4 times.

Benign masses… If a benign mass has formed previously and the biopsy result is reported as hyperplasia or papillomatosis, the risk increases 1.5-2 times. If atypical hyperplasia is diagnosed, the risk increases 5 times.

Lobular carcinoma in situ… We mentioned that this type is not actually considered a cancer. However, if a diagnosis of lobular carcinoma in situ is made, the risk of breast cancer increases tenfold.

Period of fertility… This can also be called the duration of menstruation. If a woman started menstruating early and entered menopause late, it means her fertile period was longer than normal. And this longer period increases the risk.

Late childbirth… Women who give birth to their first child after the age of 30 have a higher risk of breast cancer than women who give birth before the age of 20.

Socioeconomic level… Considering late childbirth and fertile period, it is revealed that the risk is also higher in women with a higher socioeconomic level. This is because people with a higher socioeconomic level have better nutrition and therefore start menstruating earlier. Also, because these individuals marry and have children later, the risk increases.

Estrogen hormone therapy… Women undergoing estrogen therapy have a higher risk.

Birth control pills… Long-term use of these pills increases the risk, although not significantly.

Alcohol… It has been observed that women who consume more than 15 grams of alcohol per day have an increased risk compared to those who do not consume alcohol at all.

Smoking… Recent studies have proven that women who smoke or are exposed to secondhand smoke have an increased risk of breast cancer.

Obesity… It increases the risk, especially in postmenopausal women.

Radiation… Radiotherapy to the breast area in young women increases the risk of developing cancer in later years.

Breast Cancer Diagnosis

The first step in diagnosis is self-examination. This can be done visually, manually, or while lying down. Then comes the physical examination by a physician. The physician takes a combination of the physical examination and the patient’s history. Mammography is the primary imaging method. Breast ultrasonography can provide more sensitive results than mammography. It does not involve radiation. Breast MRI and PET scans are also diagnostic methods. If there is a suspicious situation, a biopsy is performed by taking cell and tissue samples.

Breast Cancer Treatment

Breast cancer treatment is a multidisciplinary process carried out by different branches of medicine. Treatment methods roughly include surgery, chemotherapy (drug treatment), and radiotherapy (radiation therapy).

The first stage of treatment is surgery. The goal is to remove the cancerous tissue from the body. This can be done by removing the entire breast (mastectomy), removing the cancerous mass (lumpectomy), and removing part of the breast (quadranectomy).

Chemotherapy may be administered depending on the patient’s and tumor’s characteristics. In some cases, it may be given as an additional treatment after surgery. Chemotherapy aims to destroy cancer cells with toxic drugs. Hormone therapy may require stopping the estrogen hormone.

Radiotherapy aims to destroy proliferating cells by disrupting their DNA. However, the destruction of some healthy cells during this process can cause side effects. Radiation therapy and X-rays are the same as radiotherapy.

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Breast Infection

3 March 2026

by DrCelalSaglam Breast Diseases

When a breast infection occurs, symptoms such as pain, localized warmth, redness, fever, and chills may occur. Sometimes, a palpable lump may also be present. A painful mass may be observed in the armpit. This mass is a lymph node that tries to prevent the infection from spreading throughout the body.

Infections most commonly occur during breastfeeding. This is because bacteria from the baby’s mouth can pass into the milk ducts. Outside of breastfeeding, the most significant cause of breast infections is smoking. Fungal infections should be investigated, especially in cases of infections that do not respond to antibiotic treatment. Women experiencing breast infections should consult a doctor immediately. Otherwise, an abscess may develop, the infection may spread to the body, and if it is a fungal infection, the entire breast may need to be removed. One of the underlying causes could be breast cancer.

Breast Infection Treatment

If an infection develops during breastfeeding, the first thing to do is stop breastfeeding. If the infection is in only one breast, the baby can be fed from the other breast. Milk should be continuously expressed using a pump. Breast infections are usually treated with antibiotics and anti-inflammatory drugs. The antibiotic used during breastfeeding must be of a type that will not cause side effects in the baby.

One of the important points in treatment is that smoking must be stopped during treatment. Smoking causes constriction in the blood vessels of the surrounding tissues and slows the blood flow to the infection site. Therefore, since the body’s defense mechanism and the antibiotics used cannot reach this area, the bacteria cannot be fully fought.

If an abscess has developed in the breast, the inflammation inside should be surgically drained.

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Nipple Discharge

3 March 2026

by DrCelalSaglam Breast Diseases

The breast is a gland. Therefore, discharge from the breast may occur from time to time. Although this is usually insignificant, it can sometimes be a symptom of breast cancer. Therefore, it is beneficial to see a doctor just in case.

If a woman experiences fluid discharge from her nipple outside of breastfeeding, it is considered breast discharge. There are approximately 10 openings in the nipple where milk ducts open. The discharge may come from a single opening or from several. The fluid may sometimes discharge spontaneously. It can occur in both breasts or only one.

Breast discharge may increase with age. It is more common in women who have given birth.

Color of Breast Discharge

The fluid from the nipple can be yellow, green, dark green, dark brown, blood-colored, watery, or milky. Its consistency can be runny or slightly thick. Yellow, green, and brown discharges are usually insignificant. However, if the discharge is red or clear like water, it could be a sign of breast cancer. This possibility is not high, but it is necessary to consult a doctor just in case.

What Symptoms to Watch Out For When Fluid Comes Out of the Breast

1. It is important whether the discharge comes from one breast or both breasts. If it comes from one breast, it is likely a breast-related problem; if it comes from both breasts, it is likely a general problem in the body.
2. If the discharge comes from one breast, it should be determined how many milk duct openings it comes from. If it comes from more than one opening, it may be a systemic problem.
3. If the discharge is red or clear like water, the possibility of breast cancer should be investigated.
4. Many women may experience discharge when their breasts are squeezed.

However, it is more important if it occurs spontaneously.

Causes of Nipple Discharge

Dilatation of the milk ducts is the most common cause of nipple discharge.
Any blow to the breast area can cause discharge. It usually resolves spontaneously within a few weeks, depending on the effect of the trauma.
Increased prolactin hormone can cause milk to come from the breast. Prolactin hormone is a necessary hormone for milk production after childbirth and is secreted by the pituitary gland in the brain. Benign masses in the pituitary gland can cause it to overwork.
Inflammatory discharge from the nipple may occur as a result of an abscess in the breast. The abscess should be removed with antibiotics or surgically.
Some medications can cause discharge.
Benign tumors in the duct are among the most common causes of watery and blood-colored discharge.
Breast cancer is also one of the causes of discharge. Even if not every bloody discharge is a sign of breast cancer, it should definitely be investigated.

Treatment of Nipple Discharge

Most breast discharge does not require treatment. It should be investigated whether there is cancer or a structural abnormality underlying the discharge, and a treatment plan should be developed accordingly. For example, if the cause of the discharge is high prolactin levels, hormonal disorders, or medications used, treatment is given for these. If there is a mass in the duct, it is surgically removed. If the cause of the discharge is breast cancer, treatment is applied accordingly.

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Breast Pain

3 March 2026

by DrCelalSaglam Breast Diseases

Almost every woman has experienced breast pain at some point in her life. Breast pain can occur in young women who are menstruating and, to a lesser extent, in post-menopausal women. In some individuals, the pain can be severe enough to significantly reduce their quality of life. Some pain may originate from the joints and muscles in the rib cage. However, the cause of this pain could also be breast cancer. The common saying, “If there is pain, there is no cancer,” is completely wrong. Pain that persists in the same area and does not disappear even during menstruation may be indicative of breast cancer. Of course, not everyone who meets these criteria has cancer. However, it is beneficial to consult a doctor. Breast pain can sometimes be a burning sensation, sometimes a throbbing pain, and sometimes a stabbing pain. The pain may radiate to the armpit and arm.

Breast Pain Related to Menstrual Cycle (Cyclic Pains)

Pain that increases in the second half of the menstrual cycle and subsides with menstruation is called cyclic breast pain. It is seen due to hormonal changes that occur during menstruation. It usually affects both breasts, spreading from the outer and upper parts towards the armpit. As the menstrual period approaches, the pain increases, accompanied by swelling, tension, and tenderness.

Breast Pain Not Related to Menstrual Cycle (Non-cyclic Pains)

These pains, unrelated to the menstrual cycle, manifest as burning and stinging. They usually occur in only one breast. They can be seen at any stage of the menstrual cycle. They are more common in women over 40 and in menopause.

Causes of Pain

Hormonal changes are one of the most important causes of pain. Chest pain is very common in people undergoing estrogen and progesterone hormone therapy. These hormone-related pains end during pregnancy and menopause.
Breast cysts can cause pain. Especially cysts larger than 2 cm cause pain, and it is observed that the pain subsides after the cyst is drained.
Trauma to the chest area can cause pain.
Osteoarthritis of the joint between the rib bone and the sternum causes pain.
Stiffness in the chest muscles can cause temporary pain.
Pain is a common occurrence in people with irregular periods.
Fibrocystic changes are among the most important causes of pain.
An imbalance in the fatty acid ratio in the cells can cause breast pain.
Thyroid gland diseases, diabetes, and pituitary gland tumors can be causes.
Large breasts can lead to pain in both the breasts and the back and neck.
Those undergoing infertility treatment and those using birth control pills may experience pain.
The development of an abscess or infection in the breast causes pain, and symptoms such as redness, increased heat, and swelling may also be added.
Even psychological conditions are among the important causes of breast pain.

Breast Pain Treatment

Treatment for breast pain should be directed at the underlying cause. In other words, the problem causing the pain should be corrected. For example, if medications are causing the pain, these medications are discontinued; if the cause is an infection, antibiotic treatment is applied; if it’s an abscess, it’s drained; if it’s menstrual irregularity, it’s regulated; and if it’s a disease such as thyroid gland problems, pituitary tumor, or diabetes, treatment for these diseases is applied.

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Benign Breast Lumps and Cysts

3 March 2026

by DrCelalSaglam Breast Diseases

Breast Cyst

Lumps felt in the breast can be a sign of breast cancer. Therefore, women become worried when they encounter such a situation. Most lumps appear in the second half of the menstrual cycle and shrink and disappear with menstruation. These lumps are most likely what we call breast cysts. However, any lump detected in the breast should definitely be investigated due to the possibility of breast cancer. A breast cyst is a fluid-filled sac. It may appear in the second half of the menstrual cycle and can cause pain. Their size can sometimes reach 3-5 cm in diameter. The fluid inside growing cysts is drained with a syringe needle to relieve pain. The structure of the cysts is determined by breast ultrasound. Simple Breast Cyst: In these cysts, the breast is smooth. The fluid inside has the same structure; it is regular. There is no vascular structure. There is no possibility of it turning into cancer. Complicated Breast Cyst: This refers to several cysts clustered together to form a grape-cluster appearance, or several divided structures within a single cyst. Cyst with Breast Wall Protrusion: There may be a protrusion from the cyst wall into the cyst itself. In such a case, a cancer investigation should be performed. Breast Cyst with Dense Content: Sometimes the fluid inside a breast cyst can be very dense. These types of masses are called dense breast cysts. It is not possible to determine whether it is filled with fluid or a solid mass filled with cells. Therefore, it should be monitored at short intervals. Breast Cyst with Irregular Internal Structure: This type of breast cyst may contain bleeding or tissue remnants. The fluid inside is irregular. It should be monitored.

Diagnosis of Breast Cysts

The most important information to obtain about any mass detected in the breast is whether it is filled with fluid (i.e., a cyst) or cells (i.e., a solid). This information is easily obtained with a breast ultrasound. If an ultrasound cannot be performed, the mass is inserted with a syringe and the structure inside is extracted. If fluid comes out, it means there is a cyst inside the mass; if not, it is a solid mass.

Treatment of Breast Cysts

Most cysts do not require treatment. If it is a simple cyst, it does not even need to be monitored. If it is a complicated or dense cyst, it is monitored with ultrasounds at approximately 6-month intervals. If the fluid inside the cyst is irregular, granular, or bloody, the fluid is drained with a syringe and examined in pathology. If necessary, the cyst should be surgically removed and examined.

Solid Mass in the Breast

Some masses seen in the breast are filled with cells, as mentioned above. These types of masses are called solid mass. Some solid masses carry a risk of cancer, while others do not. They are divided into two types in this way. Those containing atypical cells have a higher risk of cancer. The normal appearance of these cells is altered. In other words, it is the last stage before turning into cancer cells. Atypical cells do not necessarily turn into cancer, but they carry a higher risk than normal cells. For example, in women with an increase in atypical cells and a first-degree relative with breast cancer, the risk is 20 percent, while in those without a family history of breast cancer, this rate is 8 percent. There is also a very small risk in solid masses that do not contain atypical cells.

Fibroadenoma

Fibroadenoma is the most common solid mass in the breast. It is mostly seen in young women. It manifests itself as a palpable mass in the breast. It usually does not cause pain. Although sources show that a very small number of them turn into cancer, they are considered masses that do not turn into breast cancer. Fibroadenomas are on average 1-2 cm in size. Rarely, they can grow up to 15 cm. They tend to grow during pregnancy and shrink during menopause. In other words, they are sensitive to hormonal changes.

Fibroadenoma Diagnosis

Fibroadenomas can be diagnosed with mammography and ultrasound. The content of the mass is examined with breast ultrasound. However, a definitive diagnosis is made by taking a biopsy from the mass in the breast.

Fibroadenoma Treatment

Fibroadenoma is either monitored or treated with surgery. There is no drug treatment. If the mass has irregularities in its appearance, a cauliflower-like appearance, excessive vascularization, or an irregular (homogeneous) internal structure, it can be surgically removed or broken up with a needle. If there are no such irregularities, checking every 6 months or 1 year is sufficient.

Phylloid Tumor

Phylloid tumors clinically present with symptoms similar to fibroadenoma, but grow faster. They are usually diagnosed during examination or on mammography, but this is not definitive. Definitive diagnosis is made with surgically removed tissue. It is painless. Its borders are regular. It is divided into two types: benign and malignant tumors. Both types have a high probability of recurrence. Malignant phylloid tumors, which have a higher risk of recurrence than benign ones, can sometimes spread to the lungs.

Radial Scar

The radial scar, which forms in the wall of the milk duct, has extensions that spread into the breast tissue. Although it may appear similar to cancer on a mammogram, it is usually not cancer. However, the risk of cancer can be eliminated by surgical removal. The risk of breast cancer is higher in individuals with radial scarring. Therefore, patients should be monitored frequently.

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