A breast indentation is a visible dip, dimple, or change in the natural contour of the breast. While many are harmless and result from common, non-serious conditions, they can sometimes signal a more significant underlying issue. Understanding the various reasons these changes occur is important for breast health.
Understanding Breast Indentations
Breast indentations present as dimpling, puckering, or retraction of the skin or nipple. These changes occur when underlying breast tissues pull on the skin, altering the smooth surface. The appearance can resemble the pitted skin of an orange, often described as “peau d’orange.”
These changes often involve Cooper’s ligaments, fibrous bands of connective tissue within the breast. These ligaments extend from the chest muscles through breast tissue to the skin, providing structural support and maintaining breast shape. When these ligaments or surrounding fatty and glandular tissues are affected, they can contract or be pulled, leading to the inward tug on the skin that creates an indentation.
Common Benign Causes
Many breast indentations are linked to non-cancerous conditions. One common benign cause is fat necrosis, which occurs when fatty breast tissue is damaged, often from trauma, surgery, or radiation therapy. This damaged tissue can form a firm lump or, as it heals and contracts, create a noticeable dimple on the breast surface.
Scar tissue formation after breast surgery, such as a lumpectomy or breast reduction, can also lead to skin retraction. As scar tissue matures and contracts, it pulls on the surrounding skin, resulting in an indentation. Similarly, natural changes related to aging can contribute; as breast tissue loses elasticity and Cooper’s ligaments may shorten, contour changes or sagging can develop.
Fibrocystic changes, a common benign breast condition, can sometimes cause lumps or slight alterations in breast contour, though they are less frequently associated with distinct indentations. Additionally, external factors like an ill-fitting bra or prolonged pressure on the breast can temporarily indent the skin, which typically resolves once the pressure is removed. Fluctuations in body weight can also alter breast volume and shape, leading to contour variations.
When Indentations Indicate Concern
While many indentations are benign, some can indicate a more serious condition. Breast cancer is a concern, as a growing tumor can infiltrate and shorten Cooper’s ligaments or directly pull on the skin. This pulling action results in dimpling, puckering, or retraction of the breast skin. Such changes can be a sign of various types of breast cancer, including invasive ductal carcinoma (the most common type) or inflammatory breast cancer, a more aggressive form where cancer cells block lymph vessels in the skin, leading to a swollen, red appearance often accompanied by peau d’orange.
Inflammatory conditions, though not cancerous, can also cause skin changes that resemble indentations due to swelling and inflammation. Mastitis, an infection of the breast tissue often seen in breastfeeding individuals, can lead to redness, swelling, pain, and sometimes skin thickening or dimpling. A breast abscess, a localized collection of pus, can also cause similar symptoms and localized skin changes.
Less common is Mondor’s disease, a rare, benign condition involving inflammation of a superficial vein just under the skin of the breast or chest wall. This inflammation can cause a visible, sometimes tender, cord-like indentation that typically resolves on its own. Any new or unexplained breast indentation, particularly if it persists or is accompanied by other symptoms like a new lump, nipple discharge, persistent pain, redness, or changes in skin texture, warrants prompt medical assessment.
Actions to Take
Discovering a breast indentation necessitates consulting a healthcare professional for a thorough evaluation. Seeking timely medical attention from a general practitioner, gynecologist, or breast specialist is an important first step for any new, persistent, or changing breast indentation. Only a medical professional can accurately diagnose the underlying cause through a detailed medical history, physical examination, and appropriate diagnostic imaging.
Diagnostic procedures are often necessary. A clinical breast exam (CBE) allows the doctor to visually and manually assess the breast for abnormalities. Imaging tests may include a mammogram (X-rays) or an ultrasound (sound waves) to produce images and differentiate between solid masses and fluid-filled cysts. An MRI scan may be used for more detailed imaging.
If initial evaluations indicate a suspicious finding, a biopsy (taking a small tissue sample for microscopic examination) may be performed for a definitive diagnosis. Avoid self-diagnosis and rely on professional medical advice for accurate assessment and guidance.