Age-related changes in the breasts

Hormones, tissue and shape

After menopause, estrogen production falls. The milk-producing glands become smaller, while the amount and distribution of glandular tissue and fat can change. Breasts may lose volume and firmness.

The connective tissue that supports the breast also becomes less elastic. This can allow the breasts to sit lower and change their contour. These gradual changes vary from person to person; breasts do not all age in the same way.

Changes around the nipple and menopause

The areola, the darker area around the nipple, may become smaller and less noticeable. A nipple can turn inward slightly. A new or clearly increasing inward turn still needs assessment, especially if it affects one side or accompanies another change.

Lumps are relatively common around menopause, and many are benign fluid-filled cysts. You cannot reliably identify a cyst or rule out cancer by touch alone. The risk of breast cancer increases with age, so a newly found lump deserves a medical examination.

Knowing your breasts and planning screening

Being familiar with your breasts can help you describe what has changed. It does not replace screening: self-examination can miss early cancer, and the absence of a lump does not guarantee that everything is normal.

• Discuss your personal and family history with your clinician and agree on suitable examinations, mammography or other imaging.
• Keep scheduled screening appointments, even when you have no symptoms.
• If something changes, note when it began, which side is affected and whether there is discharge, discomfort or a visible skin change.

Changes that should be checked

Arrange an appointment for a new lump in the breast or armpit, persistent thickening, a new change in breast shape, nipple discharge unrelated to breastfeeding, or new nipple inversion. Persistent redness, scaling, dimpling or puckering of the skin also needs assessment.

Most breast changes are not cancer, but a recent normal mammogram does not make a new symptom unimportant. Do not wait for the next screening invitation or for pain to appear before contacting your clinician.