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The purpose of this guide is to teach and inform both women and men about female breast anatomy and physiology (functioning). The guide includes information on breast anatomy, breast development, breast size & shape, lactation (the making of milk), and breast diseases.
Though the sole function of the breast is to produce and distribute milk to the newborn(lactation), in our society the breast has also taken on major significance as a sexual symbol. As a sexual symbol, the breast can be both stimulating and a nuisance. For many women (and men), breasts can be an intensely pleasurable part of sexual activity. Some women can even reach orgasm from breast and nipple stimulation alone. At other times breasts can be an inconvenience or worse (e.g., running, unwanted attention, sexual harassment).
Fears relating to the breast are common. From simple fears about breast size and shape to the often overwhelming fears of cancer and disease. In our society, the female breast is a complex and important part of a woman’s body. Breasts come in all shapes and sizes – small, large, saggy, lumpy, firm, etc. It is normal (and quite common) for one breast to be a different size and shape than another breast on the same woman as shown in the 1906 painting by Picasso, Nu sur le fond rouge (click on the image for more information). Nipples also come in all shapes and sizes. Similarly, the areola (the darker area surrounding the nipple) can be big or little, light or dark, and differ from one breast to another on the same woman.
A breast’s shape is essentially determined by the amount of Fatty Tissue it contains. Under the skin, a breast is made up of Fatty Tissue, Milk Glands (where milk is made by specialized cells), and Milk DuctsNipple. (lactiferous ducts) that carry the milk from the gland to the
Milk glands do not usually make milk unless they are triggered by the hormones of pregnancy. Once triggered, the glands produce as much milk as is needed by the baby (often more than a quart a day)! Therefore, during pregnancy and nursing, a woman’s breast become much larger than when not pregnant because it is literally full of milk and bigger glandular tissue.
Click on the drawing or photo of the breast to see other views. When you are ready to move on, click the Breast Development button in the left frame.
The preadolescent breast (known medically as stage 1 per Tanner’s sex maturity ratings) consists of a small elevated nipple with no significant underlying breast tissue. (Tanner’s stages are based on studies of white English girls. An American survey found that black girls tended to advance more quickly.) Genital and pubic hair development is also classified by Tanner.
Puberty begins (usually between ages of 8 and 13, average age is 11) with the development of breast tissue and pubic hair. With the hormonal changes of puberty, breast buds form. This second stage of breast development is the breast bud stage. Here, there is elevation of the breast and nipple as a small mound; the areola begins to enlarge. Milk ducts inside the breast begin to grow.
In stage 3, there is further enlargement and elevation of the breast and areola (with no separation of their contours) The areola begins to darken in color. The milk ducts give rise to milk glands that also begin to grow.
Next, there is projection of the areola and nipple to form a secondary mound (stage 4).
In the mature adult breast (stage 5), there is projection of the nipple only (though in some woman the areola continues to form a secondary mound).
The breasts of an aging woman diminish in size as the milk glands degrade. The breasts often become more saggy as this occurs and as the effects of gravity pull the breast tissue downwards.
SIZE & SHAPE
Breast come in all shapes and sizes depending on the amount of fatty tissue contained within. One’s breast size and shape are generally described based on the classifications of the Bra & lingerie industry. Use our standardized technique to determine your correct bra and cup size.Prior to World War I, women breasts were stuffed into corsets and other single-fabric contraptions. The precursor of the two cup bra was designed by a woman named Caresse Crosby. She sold the patent for her concept -two handkerchiefs sewn together with attached ribbon straps- in 1913, and the beginning of the 11.3 billion lingerie business was born. Caresse’s flimsy bras slowly evolved to more constrictive undergarments. Bra manufacturer’s (run by men) began to sew the bras to girdles, thus tightly binding the woman wearer. These slowly evolved into pointy bras in the 1950s. (Is it any wonder why the woman’s liberation movement began with folk burning their bras?)
Today’s bras are more functional and comfortable. They provide support while “helping” a woman’s figure to conform to current societal norms. Brassiere manufacturers have come up with nomenclature to allow standardization of their products. The chest size is actually determined by measuring the diameter of the rib cage below the breasts and adding 5. The cup Size is a measure of the volume of the breast, and is denoted by the first letters of the alphabet. Click here to calculate your correct breast and bra size.
The photographs below show examples of varying breast and cup sizes. (Please note, sizes labeled below are estimated and may not be correct.)
Breasts are usually asymmetrical, meaning that one woman’s breast may be a different size or shape than her other breast. Interestingly, a woman’s left breast is usually a little larger then her right breast, though this is only a generalization. (It is also quite common for men to have one testicle that is a different size or shape than the other – see our Male Genitalia Kit for more details.) The woman shown has a left breast that is larger than her right breast, in fact, many of the photos above show breast asymmetry.
Inverted nipples are also quite common and are not a problem unless they cause difficulty during nursing. Special nipple cups can be used to help during lactation. A nipple that previously was not inverted but then became inverted is a warning sign of breast cancer and needs to be brought to the attention of a doctor (see the Breast Disease section).
Nipple hair is also quite common for some woman, and is usually not abnormal. In these women, a number of straight strands of dark hair grow from the outer border of the areola. Occasionally, the amount of nipple hair is excessive (and usually associated with an increase in total body hair). When there is excessive hair on a woman, it is called hirsuitism (see photo). Hirsuitism is usually due to hormonal influences, though in rare circumstances it can be caused by a hormone-producing tumor. Excessive hair growth should therefor be discussed with your family physician.
Breast and bra classification is as follows (from smallest to largest): A, B, C, D, and DD F, G, H (and larger) also exist. These biggest bra sizes are often needed by very large-breasted women, or women whose size increases with pregnancy and nursing. A training bra for developing girls (usually Tanner stage 2, 3, or 4) is also available and is smaller than the A cup. This is sometimes called AA. (also known as Double D or sometimes called E). Though less common, the larger cup sizes of (double A)
Cup Size: AA
Cup Size: A
Cup Size: B
Cup Size: C
Cup Size: D
Cup Size: DD (E) or larger
LACTATION & NURSING
Despite its role as object of human sexuality, the biological purpose of the breast is to nourish one’s child. Lactation (the act of producing and releasing milk) is a complicated process that begins during pregnancy when increased levels of estrogen and progesterone cause the milk glands (see anatomy of breast) to grow and gear-up for making milk. After birth, a hormone from the brain (prolactin) causes the milk glands to make milk. When the newborn baby then sucks the nipple, a nerve impulse travels from the breast to the brain and causes another chemical (oxytocin) to be released. Oxytocin then causes the milk glands and milk ducts to contract and milk is released into the sucking baby’s mouth.
The milk produced by the breast is one of a kind, and attempts by pharmaceutical companies to duplicate it have been only partially successful. Not only does nursing allow a special bond and closeness between mother and infant, breast milk also has the exact proportions of fats, proteins, carbohydrates, vitamins, minerals, and water that the newborn child requires. Breast milk also contains thousands of different antibodies to protect the baby from potential infections (formula has none). Studies have shown that infants who are nursed (compared with those that are fed formula) have a lower risk of ear infections, diarrheal illnesses, allergies, and SIDS (Sudden Infant Death Syndrome). Breast fed babies also have been shown to have a higher IQ then those fed formula (though we don’t yet know the reason)!
So why do some people bottle feed instead of nurse? There are many reasons including personal discomfort (though when done correctly it shouldn’t hurt) to embarrassment, to the need to go back to work (though breast pumps have made pumping and storing milk quite easy). In addition, millions of advertising dollars encourage woman to use formula instead of nursing despite the proven benefits of the latter. Very rarely, a medical reason will require a mother to bottle-feed instead of nurse. For more information on nursing, be sure to check out our links in the conclusion section.
Like any part of the body, the breast can be affected by disease. Mastitis and breast abscesses are relatively common infections that are usually cured with antibiotics and/or surgical drainage (pictured). The dry itchy skin of eczema can affect the breast skin as it can anywhere else on the body, and is treated the same way (with moisturizer and possibly topical steroids).
Perhaps the most common problem, previously called fibrocystic “disease”, is actually not a disease at all (photo, arrow). Fibrocystic breasts have small lumps, bumps, swellings, and occasional discomfort. These changes generally occur during the 20s or 30s, though some woman will get it with their first period (usually around age 12). Contrary to previous medical opinion, recent studies have shown that the fibrocystic condition does not increase ones chance of developing breast cancer or other problems. This fibrocystic change (or condition) has been found to affect 60% to 90% of woman.
Fibroadenomas and larger breast cysts (fluid-filled pocket) pose a more difficult problem since they can cause discomfort and need to be proven that they are not cancer before they can be ignored.
The most serious and concerning breast disease is breast cancer. Afflicting 1 out of every 9 woman (at some time during their life), this is a common cancer that can cause severe disability and death if not diagnosed and treated early. Breast cancer is curable if detected and dealt with early. Click here to learn how to detect breast cancer early.
Some risk factors for developing Breast Cancer
GEOGRAPHY: For reasons that are unclear, breast cancer is 5 times more common in the United States than in Japan and Taiwan.
FAMILY HISTORY: There is a strong genetic component to this disease, so woman whose mother or sister (e.g., a first degree relative) has had breast cancer are at increased risk.
LENGTH OF REPRODUCTIVE LIFE: Risk increases with early menarche (one’s first period) and late menopause (last period).
CHILDBIRTH: Breast cancer occurs more commonly in woman who have NOT had any children during their life, than in somebody who has had children. Risk also increases if you were older than 30 when you had your first child.
OBESITY: An increased risk of breast cancer has been found in woman who are more than 30% overweight.
PREVIOUS BREAST CANCER: Having had a cancer in one’s breast (or uterus) increases the risk of getting a new breast cancer.
DIET: Some studies have shown that high-fat diets and moderate alcohol use increases the risk of breast cancer slightly.
BREAST SELF EXAM (BSE)
Breast cancer can be a deadly disease if not caught early and treated appropriately (medicine, surgery, radiation, or some combination of these). Currently, there are three ways that, when combined, can significantly improve your chance of catching breast cancer while it is easily treatable. These three ways are 1. Breast Self-Exam, 2. Annual breast exam by your physician, and 3. Annual mammograms usually beginning at age 40.
1. Breast Self-Exam
Examining your own breasts each month is important. Finding a new lump and bringing it to the attention of your physician can help you catch breast cancer before it can spread. Because most breasts are lumpy and bumpy, the real benefits of breast self-exam only occur once you have “learned” which lumps and bumps are normally in your breast. Usually you can determine which bumps are always in the same spot and not growing after you have done breast self-exams for about 6 months in a row. (Please feel free to print this page and use it as a reminder.)
When to do it.
The best time to do a breast self-exam is about a week after your period ends since at other times during your cycle your breasts may be more tender and lumpy (from the effects of hormones in your blood). If your periods are irregular, do a breast self-exam on the same day of each month. It is important to get in the habit of doing it each and every month.
Where to do it.
It doesn’t matter where you do the breast self-exam, as long as you do it. Many women find it convenient and easy to do it while taking a shower: soapy hands glide better over wet skin and make it easier to feel the lumps and bumps.
How to do it.
” Place your right arm above your head as shown in the drawing. Use the tips of your three middle fingers on your left hand to feel for lumps in your right breast.
” Press firmly enough to know how your breast feels. A firm ridge in the lower curve of each breast is normal.
” Always examine your breasts the same way. As pictured, going around your breast in a circular pattern from the outside to the inside (nipple) is one technique. Another way is to feel from your nipple outwards, like spokes on a wheel. Ask your doctor to show you how to do it if you have questions. Be sure to feel on the side of your breast, as well as the upper part of the breast. Many people forget this tissue, and nearly 60% of breast cancers form here.
” Work to remember how your breast feels from month to month. The goal is to become familiar with what lumps and bumps are there from month to month so you can tell if a new one is forming or if one seems to be getting bigger.
” Repeat the process on your left breast, using the fingers of your right hand.
” If you find any lump, thickening, or changes in your breast tissue, tell your doctor.
2. Annual Exam (by your physician)
Beginning around age 20, your doctor will begin to do a yearly breast exam. This is done to feel for suspicious lumps or bumps. Doctors also look for other hints of cancer, including breast symmetry (though as noted previously, some degree of asymmetry is normal). After feeling each breast in a circular motion, the doctor may have you sit up to look for asymmetry. The doctor may ask you to raise your hands above your head, then put your hands on your hips. Other maneuvers can also help the doctor find a potential problem.
3. Mammography (pictured)
You should have an X-ray of your breasts (mammogram) each year beginning at age 40 (earlier if you have certain other risk factors such as a family history of breast cancer). Many studies have shown that annual mammograms can detect tiny cancers that are too small to be seen or felt, and long before they have a chance to spread. Despite the recommendations of most doctors and health-care organizations, 1 out of 2 women don’t get this X-ray! Fear of breast discomfort and fear that something might be found are two major reasons why so many women have not had this test. Though the test is somewhat uncomfortable, the potential benefits (catching a deadly cancer before it can kill you) far outweigh the minor discomfort.
This online guide has answered some of the many questions afraidtoask.com has been asked about the female breast. Its purpose is to serve as an introduction and a basic guide to the anatomy and physiology of this organ, while alerting you to some of the warning signs and ways to avoid disease. If you have other questions or concerns about your health and body, we recommend asking your own physician. Most doctors discuss these “personal” questions on a daily basis, so don’t be afraid to ask.
Much of the information in this guide is from an excellent book called Our Bodies, Ourselves: a book by and for women. In addition to anatomy and physiology, this book contains detailed information on sexuality, including masturbation, heterosexuality, homosexuality, pregnancy, and contraception.
Other recommended readings include:
Our Bodies, Ourselves for the older woman. Dr. Susan Love’s Breast Book has received much critical acclaim. It is up to date and informative. What’s Happening to My Body? A Book for Girls, A Growing Up Guide for Parents and Daughters. Changes in You and Me A Book About Puberty, Mostly for Boys Getting Breastfeeding Right for You An Illustrated Guide on nursing.
Good website links that give more detailed and accurate information are listed below.
CancerNet has detailed information on essentially all cancers, including breast, ovary, uterine, and more. A good handbook with details on the breast can be found at the EduCare website. Yahoo has a good listing of other breast cancer related links. The American Academy of Family Physicians has information as well as a list of qualified physicians in your area. An in-depth and moving photo essay of a woman’s experience with mastectomy and breast cancer. And, of course, our Sexually Transmitted Disease Guide is an excellent resource for information and photographs.
We hope you have enjoyed your online experience at AfraidToAsk.com. Thank you again for supporting our site!
During the pubertal years (usually between ages of 8 and 13, average age is 11), the vulva and internal genitals grow and change to their adult size. Just as breast development is staged, the medical way to gauge the level of development is to use Tanner ‘s sexual maturity rating. Tanner’s classification of sexual maturity looks at pubic hair growth to determine development leve.
|Stage 1||Stage 2||Stage 3||Stage 4||Stage 5|
The stage 1 preadolescent has no pubic hair except for a fine “peach fuzz” body hair.
In stage 2, there is sparse growth of long, slightly darkened, downy hair mostly along the labia. This hair is usually straight or only slightly curled.
In stage 3, the pubic hair becomes darker, coarser, and curlier. It now grows sparsely over the mons veneris area.
In stage 4, the hair grows in more densely. It becomes as coarse and curly as in the adult, but there is not as much of it.
The mature adult, stage 5, has the classic coarse and curly pubic hair that extends onto the inner thighs.
The final amount, color, and distribution of pubic hair surrounding the vagina is quite variable. About 90% of woman aged 18 and older have a “horizontal” pattern diagrammed below (far left). Other hair patterns are also depicted.
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