Breast Asymmetry: Causes and Diagnosis

Are asymmetric breasts a sign of cancer?

Annual or biennial mammograms are essential to a woman’s breast health because they detect early signs of cancer or abnormalities. A common abnormality seen on mammogram results is breast asymmetry.

Breast asymmetry is usually no cause for concern. However, if there’s a large variation in asymmetry or if your breast density suddenly changes, this could be an indication of cancer.

Breast asymmetry occurs when one breast has a different size, volume, position, or form from the other.

Breast asymmetry is very common and affects more than half of all women. There are a number of reasons why a woman’s breasts can change in size or volume, including trauma, puberty, and hormonal changes.

Your breast tissue can change when you’re ovulating, and can often feel more full and sensitive. It’s common for the breasts to look bigger because they actually grow from water retention and blood flow. However, during your menstrual cycle, they’ll return to normal size.

Another cause for asymmetrical breasts is a condition called juvenile hypertrophy of the breast. Though rare, this can cause one breast to grow significantly larger than the other. It can be corrected with surgery, but it may lead to a number of psychological issues and insecurities.

It’s common for two breasts to be different sizes, but they’re usually similar in density and structure. Doctors use mammograms, a type of breast exam, to evaluate the internal structure of the breast.

If your mammogram shows you have asymmetrically dense breasts, the difference in density could be classified into one of four categories if a mass is found:

1. Asymmetry. Your breasts are only evaluated using one projection. These images aren’t reliable because they are one-dimensional. Overlapping dense structures in the breast could be difficult to see. If your doctor finds a lesion or abnormality, they’ll call for another three-dimensional imaging test.
2. Global asymmetry. This finding shows there’s more volume or density in one breast than the other. Global asymmetry findings are normally the result of hormonal changes and normal variation. If a mass is found, your doctor will request additional imaging.
3. Focal asymmetry. These images show a density on two mammographic views, but your doctor can’t fully tell if it’s a true mass. They’ll request further imaging and evaluation to rule out cancerous or abnormal masses.
4. Developing asymmetry. This asymmetry type indicates a significant change between past and current exams. The density may be new, or could have increased. These findings are enough to raise suspicion of potentially malignant cells.

If your mammogram indicates asymmetry, your doctor will need additional images to determine if the change in shape or density is normal.

The first step is to compare past mammogram images for changes in shape or density. If you’ve never had asymmetric breasts or if your asymmetry has increased over time, your doctor will request extra tests.

Breast ultrasound

Your doctor may request a breast ultrasound. This method helps to diagnose abnormal findings from obscure mammogram images. A breast ultrasound uses sound waves that produce pictures of your breasts’ internal structure.

The breast ultrasound images can help determine if the mass is benign, a fluid-filled cyst, or if it’s potentially a cancerous tumor. In some cases, a mass can be both solid and fluid-filled.

Breast MRI

Magnetic resonance imaging (MRI) of the breast is a test used to help detect breast cancer or other abnormalities. While in some cases this test is used after a biopsy has confirmed cancer, breast MRIs can be used alongside mammograms to screen for breast cancer.

This is specifically helpful for women with a high risk of breast cancer from family history or heredity.

Biopsy

If your imaging test results come back abnormal, or if your doctor suspects the abnormality is cancerous, the next step is to have a biopsy. During this procedure, a portion of your affected breast tissue is removed for further testing and to check for cancer.

If the biopsy comes back negative, doctors recommend regular breast exams to monitor any change. If the biopsy comes back positive, your doctor will talk with you about treatment options.

Breast asymmetry is a common characteristic for women, and is often no cause for concern. However, if the size of your breasts change or the density variation becomes larger over time, these changes could indicate something is wrong.

Research is still being conducted on the relationship between asymmetric breasts and cancer risk. Some studies have shown women with breast cancer had a greater breast asymmetry, combined with other risk factors such as heredity and age, than women who were healthy. Further research is still needed.

If you have a predisposition to cancer from family history or if you notice irregular changes in your breasts, you should discuss your concerns and options with your doctor.

Kids Health Information : Unequal breast size

It is quite common for one breast to be bigger than the other as development occurs during puberty. Usually the breasts become the same size over time and do not need any treatment. However, if the breasts have not become more or less an equal size by the age of about 16 years old (or near
the end of puberty), they will probably remain unequal. About one in four adult women have some degree of asymmetry of the breasts.

In some adolescents the problem is that one breast is overdeveloped, whereas in others the smaller breast is underdeveloped.

When to see a doctor

There is no need to see a doctor for unequal breast size during puberty (when the breasts are still developing). However, you may wish to see a GP for advice if the breasts are of unequal size at the end of puberty. You may be referred to an endocrinologist (doctor specialising in
conditions related to hormones).

Treatment for unequal breast size

There is no medical need for treatment for uneven breast size.

The difference in breast size is usually caused by the fat layers, not the ducts that produce milk. Therefore, a mother with unequal breast size should be able to breastfeed as usual from both breasts. The amounts of milk produced should be the same from each breast. 

Because the difference in breast size is usually due to the fat layers, uneven breast size has no effect on the risk of breast cancer. If you have any concerns, you should discuss this with your doctor.

There are three treatment options for uneven breast sizes that can improve the cosmetic appearance of the breasts:

External breast prosthesis

An external breast prothesis is worn with a special bra. The prothesis has a hollow on the inside where the smaller breast fits comfortably. They are filled with a skin-coloured gel and feel just like a breast. The prosthesis can be matched to the size and shape of the
other breast. 

The prosthesis can be held in place with tape that can be left on the skin for several days at a time. Some breast prostheses can be inserted into special pockets in swimsuits or active wear.

There is no health risk associated with the breast prosthesis as it is worn outside the body. 

Breast reduction

Surgery to reduce breast size is done as an operation under general anaesthetic (where you are put to sleep) by a plastic surgeon.

Breast reduction can affect milk production if breast tissue is removed. Nipple placement is also important to ensure future breast feeding goes well. Discuss all risks and benefits carefully with a plastic surgeon.

Breast implant

Breast implants are done as an operation under general anaesthetic by a plastic surgeon. Implants are now filled with saline (salt water), which is considered harmless to the body. Silicone implants are no longer used because of fears that small amounts of silicone
could leak and damage the immune system. Breast enhancement should not cause any problems with breast feeding. Discuss all risks and benefits carefully with a plastic surgeon.

Key points to remember

• It is quite common for breast size to be unequal during puberty. If they are different sizes near the end of puberty, they are likely to stay unequal. 
• There is no medical need for treatment for unequal breast size. Unequal breasts won’t affect breastfeeding or increase breast cancer risk.
• An external breast prothesis looks and feels realistic and has no associated health risks.
• A breast reduction or breast implant are plastic surgery options that can improve cosmetic appearance. 

For more information

• See your GP, paediatrician  or endocrinologist.
• Talk to a plastic surgeon to discuss treatment options.

Common questions our doctors are asked

Which is the safest option: breast reduction or breast
implant?

This is something that should be discussed at length with
your plastic surgeon. It will depend on the shape and size of each breast, as
well as your desired outcome.

I have read that unequal breast size is linked with
increased risk breast cancer. Is this true?

This is not true. The asymmetry is usually caused by
differences in the fat layers, not the breast tissue. It is important to
perform regular self-checks for breast changes, as part of a healthy lifestyle.
You can discuss and learn these self-checks with your GP or paediatrician.

My baby has developed breast tissue, which is uneven, what
should I do?

There are many hormone changes that occur to
young babies, especially those who are breastfed. May babies will develop small
amounts of breast tissue, and some may even start to make breastmilk! If this
is happening with your baby, there is often no cause for concern, but have them
seen by your GP or paediatrician.

Developed by The Royal Children’s Hospital Endocrinology and Plastic and Maxillofacial Surgery departments. We acknowledge the input of RCH consumers and carers.

Reviewed June 2018.

This information is awaiting routine review. Please always seek the most recent advice from a registered and practising clinician.

Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit

www.rchfoundation.org.au.

Is one breast larger or smaller than the other? Bust getting bigger?

Quite often women can observe details in their appearance that they do not suit. It can be the nose, eyes, ears, etc., but the chest is especially emphasized, as it emphasizes the figure and is the subject of sexuality. But it often happens that one breast is larger than the other.

Unfortunately, all women have breast asymmetry. For some, the difference can be a matter of millimeters, which is not considered a cause for concern. But for some, one breast may be 1-2 sizes larger than the other. This aesthetic defect is quite rare. As a rule, such a difference is due to resection (removal or partial removal) of the mammary gland. This, as a rule, causes embarrassment and anxiety for one’s health. There can be several reasons for breast asymmetry, as well as ways to solve this problem. In this article, we will look at common causes of changes in the size of the breast, as well as ways to solve them.

There may be several reasons why one breast is smaller than the other. But all of them can be divided into two groups: congenital and acquired. The first option may occur due to hormonal failure, genetic disorders or trauma at birth. Also in adolescence, girls can observe such a problem that one breast has become larger than the other. At the age of 13-16, there is no reason to worry about this, but if by the age of 17-20 the asymmetry has remained, then this is a reason to see a doctor.

As for acquired asymmetry, there are many more reasons. Mainly found:

• breast deformity during pregnancy and childbirth;
• serious damage to the mammary gland;
• disorders in the spine;
• oncology;
• consequences of surgical intervention in the chest area;
• cyst;
• fat necrosis;
• changes in hormone levels.

At the same time, breast asymmetry can be expressed in several ways:

• one breast has become lower than the other;
• significant difference in size between the right and left mammary glands;
• different location and size of nipples;
• lack of breast volume, etc.

If one breast is enlarged, you should immediately visit a mammologist to determine the cause of the deformity. At the appointment, the doctor will examine the mammary glands, prescribe an examination and, if necessary, treatment. It should also be taken into account that it is not worth delaying a visit to a specialist, because more serious diseases may occur.

Sign up for a consultation with experienced clinic specialists who have helped thousands of patients:

• Sergey Vasilievich Sidorov, oncologist-mammologist, plastic surgeon, with 40 years of experience, the author of several techniques for breast reconstruction after removal;
• Nogaytseva Ekaterina Sergeevna, oncologist-mammologist, plastic surgeon, talented doctor, helps patients to preserve their breasts, correct their shape and size;
• Ishchenko Elena Mikhailovna, oncologist-mammologist, 25 years of experience, will help maintain the health of the breast, detect the disease at an early stage, specializes in the diagnosis of malignant tumors of the mammary glands.

Correction of breast asymmetry

If one breast has become larger, and no diseases have been identified, then you can contact a plastic surgeon who will perform mammoplasty and eliminate all defects.

Today there are several ways to correct breast asymmetry:

• Breast augmentation with implants. In this way, almost any kind of asymmetry of the mammary glands can be corrected. Based on the problem, as well as the wishes of the patient, one or two implants can be installed, but of different sizes.
• Lipolifting is an excellent option for a slight increase in one breast. This procedure involves the fact that fat, which is taken from other parts of the body, is transplanted into the chest.
• Reduction mammoplasty – reduction of one breast. This operation is performed if there is a significant increase in one of the mammary glands with the normal development of the second. In this case, the installation of an implant is not required.
• Mastopexy is an excellent solution when one breast has become lower than the other. Thanks to a lift, it is possible to correct such a defect as sagging breasts, especially after breastfeeding.
• Correction of the size and shape of the nipple and areola. This procedure allows you to eliminate various defects of the nipples.
• Reconstruction of the breast after removal of the mammary gland or one-stage operation to remove a malignant tumor and restore shape and size.

If you notice that one of your breasts is smaller than the other, then this is a reason to visit a mammologist. Modern medicine will help you identify the causes of asymmetry, as well as find ways to eliminate it. Pasman Clinic employs experienced plastic surgeons who will help you restore your breasts. The plastic surgeon will offer several correction methods and recommend the best option, taking into account the state of health and characteristics of the mammary glands, the shape of the breast and the desired result.

Sign up for a consultation with experienced plastic surgeons:

• Sergei Vasilievich Sidorov, oncologist-mammologist, plastic surgeon, with 40 years of experience, the author of several techniques for breast reconstruction after removal;
• Irina Vladimirovna Shmarina, plastic surgeon, doctor with 20 years of experience, will select the best option, knows all methods of correcting the shape and size of the mammary glands;
• Nogaytseva Ekaterina Sergeevna, oncologist-mammologist, plastic surgeon, talented doctor, helps patients to preserve their breasts, adjust their shape and size.

Why patients choose the clinic and trust surgeons

Medical approach to beauty. Surgeons will help you become more confident, solve the problem and make your dream come true.

• Honest medicine – health comes first. Our doctors do not perform aesthetic surgeries if it could be harmful to health. Services are not forced. Based on the individual characteristics of the patient – use a personalized approach.
• In complex cases, we convene consultation . The internist, hematologist, gynecologist or anesthetist will discuss the patient’s health status. This will help to see the situation from different angles, which means to properly prepare the patient, draw up a safe operation plan, and choose anesthesia.
• We reduce risks – our own operating room, intensive care unit and hospital. After the operation, the patient is under the supervision of an anesthesiologist-resuscitator and a nurse in a special intensive care unit.

Breasts of different sizes (breast asymmetry): how to fix it, what to do?

Asymmetrical breasts of different sizes are one of the most common phenomena. According to statistics, 90% of girls have a difference between the right and left mammary gland, and in 45% the size of the bust differs by half a standard cup. Another question is how to deal with it? Someone notices this difference and complexes, while others perceive it as a common occurrence and do not pay attention.

So what should you do if your breasts are of different sizes? Let’s figure it out.

Why do breasts come in different sizes?

Real asymmetry, when the breasts are of different sizes and differ from each other by one cup. The reasons can be very diverse. They can be divided into 2 groups.

Congenital causes :

• hypoplasia (developmental delay) of glandular tissue
• Poland’s syndrome is a congenital disease characterized by atrophy of the pectoralis major muscle
• hormonal problems during puberty
• micromastia – one mammary gland is significantly reduced in size compared to the other
• problems with the endocrine system
• Prolonged malposition of the body resulting in poor posture
• hereditary predisposition
• special feature

Usually congenital breast asymmetry is noticeable in girls aged 9-10 years. During this period, the ovaries already produce the hormones estrogen and progesterone, which are responsible for the development of glandular tissue. The bust can become disproportionate if hormones are in short supply or excess. If there is disproportion, then you need to contact an endocrinologist or mammologist. Usually this problem is leveled by 18-19years. If it persists at an older age, then it can only be corrected by a plastic surgeon.

Acquired causes :

• Breastfeeding. In this case, breast asymmetry is the so-called post-lactational involution of the mammary gland, which manifests itself, among other things, in disproportion. It depends on hormonal changes, and not on the duration of lactation, as many young mothers think. However, asymmetry can indeed develop if the baby is fed only on one side.
• Mastopathy (fibroadenomatosis). Benign breast tumor. A characteristic sign of mastopathy is palpable seals in the chest. The main reason is hormonal imbalance. Often, all types of mastopathy lead to the appearance of visible asymmetry.
• Neoplasms. After their removal, the breast requires restoration.
• Sagging and drooping of the chest. With age, the mammary gland loses elasticity, volume, and the muscles become less elastic. Because of this, the bust loses its former attractiveness and symmetry. Often this happens when a woman crosses the threshold of menopause.
• Injuries of the chest. At risk are athletes who play basketball, volleyball and other sports where there is a possibility of physical injury.

Classification of breast asymmetry

It is important to understand: there is no absolute symmetry – people are asymmetrical. We have different right and left parts of the face, legs, arms and, of course, the chest. This is absolutely normal. Pathological fixation on symmetry often turns into complexes and self-doubt.

You can talk about asymmetry when it is visible to the naked eye. Differ:

• bust shape and volume
• position and outline of the nipple and areola.

Doctors distinguish 3 degrees of breast asymmetry:

• mild. Breasts practically do not differ from each other. They come in one bra size;
• medium. The difference between the mammary glands reaches 0.5 size. Visually, this is noticeable, but usually does not interfere with everyday life;
• heavy. One breast can be 1.5-2 times larger than the other. In this case, there are problems with the selection of underwear and clothing.

Note that there is no exact way to measure the asymmetry, so in this matter you should rely only on the experience of the selected specialist.

Prevention of breast asymmetry

Is it possible to prevent breast disproportion? Yes, if we are talking about acquired asymmetry. Here are some examples:

• When breastfeeding, apply the baby alternately to both breasts. Avoid “preferring” one breast. If the baby loves one breast more, then be sure to pump the second;
• wear a corrective bra to prevent sagging breasts after lactation;
• do a contrast shower to improve blood circulation;
• physical exercises will strengthen your posture and pectoral muscles.

What if the breasts are of different sizes?

It is necessary to start with an objective analysis and answer the questions: how asymmetrical are the breasts and does this affect the aesthetic appearance?

If there is a slight difference in the size of the bust, it can be corrected with underwear. It is also worth trying conservative methods – correcting posture, physical exercises to strengthen the pectoral muscles.

If the asymmetry is pronounced and causes discomfort to the girl, then it is worth contacting a plastic surgeon for surgical correction.

Can I fix the defect myself?

There are no general recommendations and universal methods for eliminating asymmetry. Everything is individual and depends on the degree of disproportion. The main methods of correction at home:

• correctly selected underwear
• drug therapy (only on the recommendation of the attending physician)

Surgical methods for correcting breasts of various shapes

Surgical correction methods differ depending on the degree of asymmetry. In such cases, the plastic surgeon offers a lift, breast augmentation or reduction.

• Breast augmentation. The most popular plastic surgery, which solves not only asymmetry issues, but also gives ideal forms. It is carried out using silicone implants. The size and volume are selected individually at the consultation. The following are taken into account: the height and weight of the patient, the initial state of the mammary gland. A plastic surgeon can install identical implants if the asymmetry is slight. With a significant difference in breast size, implants of different sizes are installed. Breast augmentation surgery lasts about 1 hour. No longer a consultation, the patient sees the result of the upcoming operation thanks to the fitting of sizers and 3D modeling.

How breast augmentation works – all stages

• Mastopexy (breast lift). Asymmetry, which is caused by significant sagging of the breast, is eliminated by removing and tightening excess skin and glandular tissue. The bust is not only tightened, but a new symmetrical shape is also created. If the difference between the mammary glands is insignificant, then a breast lift is performed using a periareolar approach around the areola. Please note: in this case, the scar is located on the border of dark and light skin, and is as invisible as possible, and there are no additional scars on the chest. With severe ptosis, either vertical mastopexy is performed (the scar runs from the areola to the inframammary fold) or anchor (the scar is located along the areola, vertically to the inframammary fold and along the line of this fold).