Benign breast conditions
Not all conditions that occur in breasts are cancerous. In fact, most that are biopsied are benign (non-cancerous). But benign conditions need to be addressed, as they may put you at higher risk of developing breast cancer in the future.
Benign conditions include:
- Cysts—Cysts are fluid-filled round or oval-shaped sacs within the breast. These lumps are noncancerous. Women approaching menopause are most likely to develop these types of lumps. Cysts feel like hard bumps and can be very painful. Because a clinical examination can’t differentiate between a cyst and a mass, an ultrasound or a fine-needle aspiration is needed to confirm a diagnosis. At the same time, the fine needle aspiration will drain the cyst’s fluid. If there are any suspicions about the lump, the drained fluid will be tested for cancerous cells.
- Fibroadenomas—Fibroadenomas are benign tumors. They are most common in women in their 20s and 30s, but they may be found at any age. These noncancerous tumors tend to be movable and round and often feel like a marble within the breast. Fibroadenomas are diagnosed by fine needle aspiration or a core needle biopsy and can range in size from microscopic to the size of a lemon. Most fibroadenomas do not increase the risk of developing breast cancer, but some can. Generally, doctors recommend removing a fibroadenoma, especially if it keeps growing or changes the shape of the breast.
- Fibrocystic breast condition—Fibrocystic breast is defined as lumpy breast and usually causes discomfort. This condition is very common and is noncancerous. It generally affects women between the ages of 30 and 50. The diagnosis of a fibrocystic breast is complicated, as the characteristics of the lumps will vary from one person to another. A breast ultrasound is usually performed. At times a biopsy will also be performed. Caffeine has been shown to increase the pain caused by this condition, so doctors usually recommend reducing it or removing it from your diet.
- Phyllodes tumors—Phyllodes tumors are uncommon breast tumors that are usually benign. In very rare instances they may be cancerous. They are usually large enough to be felt, but painless. However, some may be painful and can grow quickly and stretch the skin. It is recommended to surgically remove these tumors. Because they have a high risk of growing back, normal breast tissue surrounding the tumor will also be removed. Close follow-up with frequent breast exams and imaging studies are recommended after treatment.
- Atypical ductal hyperplasia (ADH)—Atypical ductal hyperplasia is pre-cancerous cells that grow in the duct of the breast. It is a strong indicator that cancer may develop. There are no symptoms or signs associated with atypical ductal hyperplasia and it is usually diagnosed with mammography. Surgical intervention is advised.Patients will then be closely monitored and those at high risk may be prescribed tamoxifen, a drug used to prevent breast cancer.
- Atypical lobular dysplasia (ALD)—While not cancerous, atypical lobular dysplasia may indicate a potential for breast cancer. It doesn't have any signs or symptoms and is usually diagnosed by mammography. Because it may not become cancer, ALD does not need to be surgically removed in its entirety. But it is important to monitor this condition with additional testing and more frequent mammography. Tamoxifen may also be prescribed to very high-risk patients to help reduce the risk of developing breast cancer.
- Papilloma—A papilloma is a benign tumor that grows inside the breast tissue. It is a wart-like growth of gland tissue, along with fibrous tissue and blood vessels. Single tumors often grow in the large milk duct near the nipple and are a common cause of clear or bloody nipple discharge. They may be felt as a small lump behind or next to the nipple. They do not raise your risk of breast cancer. Papillomas may also be found in the small ducts in areas of the breast further from the nipple. In these cases, there are often several growths. These tumors are less likely to cause nipple discharge and, unlike single papillomas, multiple papillomas are linked to an increased risk of breast cancer.
- Mastitis—Mastitis is a breast infection that most often affects women who are breastfeeding, but it can occur in any woman. A break in the skin or an opening in the nipple can allow bacteria to enter the breast duct. This is a noncancerous condition that causes breast pain, redness, warmth, and swelling. Some women will also experience flu-like symptoms. Mastitis is treated with antibiotics. In some cases, a breast abscess may form and can be treated by first draining the pus, either by surgery or by using a needle, and then using antibiotics.
- Radical scars—A radical scar is a microscopic abnormality that is difficult to distinguish from breast cancer. It's a rare benign lesion where glands get caught in the fibrous tissue. This star-shaped mass can be found using X-ray or mammogram. Often a stereotactic biopsy will be done on this abnormality because it looks similar to cancer. It is recommended to surgically remove a radical scar because it may hide cancer and has a slight chance of becoming cancer.
- Sclerosing adenosis—Sclerosing adenosis is the thickening and hardening of the lobes in the breast, which are part of the milk producing system. It can sometimes cause pain or produce a small lump. The condition is not cancerous. A mammography or ultrasound will help diagnose sclerosing adenosis, but a biopsy is the only clear-cut way to be certain. Most times this condition won’t require treatment, but complex sclerosing adenosis lesions have a potential risk of cancer and are removed.
- Gynecomastia—Gynecomastia is an enlargement of a man’s breast. It isn't dangerous and men can live normal lives with the condition. Treatment is usually limited to monitoring. Gynecomastia can develop at any time in a man's life but most often happens during times of hormonal change like puberty and andropause. Often, it is a self-limiting problem and will get better on its own. Certain medications, marijuana, and excess alcohol can also cause gynecomastia. In that case, removing the stimulus can be all it takes to resolve the condition. But some men are embarrassed by gynecomastia and choose to have it surgically removed. It is suggested to wait at least a year before deciding on such surgery.