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Non-Cancerous (Benign) Breast Conditions

cross-sectional of breast

Non-cancerous breast conditions are very common. Further, most breast changes that are biopsied and viewed under a microscope produce benign results.

Although benign breast conditions are not life-threatening, they may cause bothersome symptoms and are occasionally associated with a higher risk of developing breast cancer in the future. Management of such findings should be directed by your primary health care provider.

Fibrocystic Changes

Fibrocystic changes (FCCs), a term used by physicians, describe a number of non-cancerous conditions occurring in the breast. These conditions are found in the breast as lumps or masses that often change with the menstrual cycle and may be accompanied by pain and tenderness. Previously, the term "fibrocystic disease" was used to describe the process and was falsely implicated as a risk factor for breast cancer. However, at least 50 percent of all women have lumpy, irregular-feeling breasts. These changes are a normal response to the hormonal stimulation of the breast tissue and do not represent a "disease" process. The term fibrocystic change is commonly applied to any change that is not cancerous. Because there is no exact clinical definition, ask your physician precisely what types of changes have been found in your breast tissue if you receive the diagnosis of fibrocystic changes.

Breast Pain

Pain in the breast is referred to as mastalgia or mastodynia. Pain may be characterized as cyclic or noncyclic. Your health care provider’s examination and a mammogram can most often determine the cause of the pain. Breast pain may be uncomfortable and annoying, but it is rarely caused by cancer. Most pain is due to hormonal or benign breast conditions. In studies of women diagnosed with breast cancer, less than 10 percent had any pain. Pain with breast cancer is characterized by focal constant discomfort (pain in one area independent of palpation). However, all breast pain needs evaluation to determine its cause.

Nipple Discharge

Breast discharge is a common complaint with three possible causes: 1) a hormonal imbalance, 2) a response to medications, or 3) a lesion or diseased breast. Studies have shown that nipple discharge can be found in 50 to 80 percent of women with no disease being present. Most women have a small amount of discharge when their breasts are squeezed. This is normal, but all discharge needs to be evaluated by your health care provider to determine the primary cause.

Duct Ectasia

Duct Ectasia is a benign condition that occurs most frequently around the time of menopause. The large ducts near the nipples enlarge and become filled with cellular waste that accumulates or is blocked in the duct. The nipple may discharge gray or greenish fluid. Antibiotics usually relieve the condition.

Mastitis

Mastitis is a condition of inflammation or infection of the breast. It occurs when bacteria enter the ducts through an open area of the nipple. The bacteria move to the ducts and begin to grow in the milk. The breast becomes swollen, tender and warm. Breastfeeding women are most likely to develop mastitis, but the condition can occur in women who are not lactating (producing milk) and rarely in men. Your health care provider should be notified at the first sign of any symptoms.

Atypical Hyperpalsia

Hyperplasia is an overgrowth of the cells within the breast that line either the ducts or the lobules. Hyperplasia is classified as mild (no increased risk of breast cancer), usual (slightly higher risk of breast cancer), or atypical (4 to 5 times greater risk of developing breast cancer).

Hyperplasia is generally diagnosed through biopsy. A diagnosis of hyperplasia (particularly atypical hyperplasia) may require more frequent breast exams and mammograms, as it is linked to a higher risk of breast cancer in the future. In some cases, breast MRI scans may be recommended along with screening mammograms. Management of such findings should be directed by your primary health care provider.

Sclerosing Adenosis

In adenosis, the breast lobules are enlarged and contain more glands than usual. If several enlarged lobules are within close proximity, they may be large enough to be felt as a mass or nodule. However, a biopsy is usually necessary to confirm adenosis, as the lumps are difficult to distinguish from cancer during a breast exam.

Breast Cysts

Breast cysts are a common, benign finding found in women 25 to 50 years of age. Cysts are most likely to occur during the years right before menopause. Cysts may vary in size, ranging from microscopic (microcyst) to large (macrocyst). Cysts tend to occur in both breasts, with more than one cyst appearing in each breast and with a combination of both microcysts and macrocysts. The cysts fill with fluid and often develop quickly into large lumps that can be felt. They range from spongy-soft to firm in consistency. The outside surface feels smooth, and is usually round or oval in shape. When feeling the cyst, it will move freely in the breast, as if it could slip from under your fingers. When cysts are identified by touch or mammography, they are often confirmed by ultrasound.

Papillomas

Papillomas are benign, usually tiny, wart-like growths found in the large ducts of the breast near the nipple area. They may occur as a single growth or in groups. Often, a bloody discharge is seen coming from one nipple and not the other. These most often appear in women 35 to 50 years of age and are usually painless. If multiple papillomas come together to form a mass, they may cause pain.

Fibroadenoma

Fibroadenomas are benign tumors most commonly found in women 20 to 40 years old. The use of birth control pills before age 20 may increase a woman's risk of fibroadenomas. Fibroadenomas tend to be round and firm, and may feel like a marble within the breast.

Most fibroadenomas are simple, meaning they are uniform when viewed under a microscope, and they do not increase the risk of breast cancer. However, complex fibroadenomas carry a slightly increased risk of breast cancer.

Many doctors recommend the removal of fibroadenomas, especially if they are growing. For women with multiple fibroadenomas that are not growing, a better option may be to carefully monitor the situation, since full removal can potentially change the shape and size of the breast. It is important for women with fibroadenomas to have breast exams regularly.