Benign Breast Conditions

Most people associate breast abnormalities with breast cancer. However, not all breast disorders are cancerous. There are many benign (non-cancerous) breast conditions.

What is a benign breast condition?

A benign breast condition refers to a lump, cyst, or nipple discharge (fluid) of the female or male breast that is not cancerous. For women, the most common ones are:

  • Fibrocystic breast changes. Fibrosis feels like scar tissue and can be rubbery and firm. Cysts are sacs filled with fluid. They may enlarge and feel tender right before your period.
  • These are the most common breast lumps in younger women and are usually small.
  • Your breast can become enlarged because of infection. This can happen to anyone but usually happens when breastfeeding.
  • Fat necrosis. These lumps form when areas of fatty breast tissue are damaged.
  • Small spots of calcium salts can show up anywhere in breast tissue. Usually, you can’t feel them and they’re not painful.
  • Nipple discharge. Your nipples may leak fluid for a variety of reasons.
  • These are made up of mostly fat tissue.

Less common types of benign breast conditions include:

  • This is an abnormal increase in cell growth in the breast.
  • The lobules in your breasts can become enlarged and contain more glands than usual.
  • Intraductal papillomas. Small tumors can form in your nipple’s milk ducts.

Female breasts are very complex. They’re filled with glands (organs that produce milk in women who have given birth), fat, and fibrous (connecting) tissue. Within each breast, there are 15 to 20 lobes (small sections) of glands and fibrous tissue.

Men can have breast issues, too, although they’re rare. The most common benign breast condition in men is gynecomastia. This condition causes enlarged breast tissue.

Symptoms of benign breast conditions

Some benign breast conditions will cause pain. Some will be undetectable unless you feel a lump or your doctor sees it in a routine mammogram (a test designed to X-ray breasts).

Here are common symptoms of each condition:

  • Fibrocystic breast changes: Your breasts will feel lumpy. These lumps are made up of a fibrous, rubber-like, thick tissue, or a fluid-filled cyst.
  • Cysts: These are fluid-filled lumps in your breasts that may be tender when you touch them. You may notice they appear and disappear each time you have your period.
  • Fibroadenomas: These will feel like a small, round, moving marbles in your breast.
  • Mastitis: You may feel a lump. The lump may appear red and warm. People diagnosed with mastitis typically have a fever.
  • Fat necrosis: This is a lump that may feel round and hard. It happens when fatty tissue turns hard. It’s common in women who are extremely overweight. Sometimes, these lumps are the result of an injury to your breast. It may be filled with fluid fat.
  • Calcification: You may or may not feel these tiny, hard spots. They are due to leftover, hardened calcium deposits in your breast. Eating or drinking too much calcium doesn’t cause it. Most are benign. However, some calcification can be a sign of cancer.
  • Nipple discharge: The fluid coming from your nipple may be different colors. A clear or milky color represents a problem with your hormones. If the discharge is green-black, it may represent a blocked milk duct. If the discharge is bloody, it could be related to an injury, infection, or benign tumor. It also can be associated with breast cancer.
  • Hyperplasia, adenosis, intraductal papilloma, and lipoma: You will likely feel breast pain and lumps with these less common, benign breast conditions.
  • Male gynecomastia: A man’s breast may feel swollen and tender when diagnosed with this condition. Often, though, they may have no symptoms.

What causes benign breast conditions?

Benign breast conditions are generally caused by a number of factors. Those factors include the makeup of your breasts (fatty tissue vs. dense or thick tissue), your age, hormone problems. Hormone therapy, birth control pills, pregnancy, menopause, being overweight, infection, and breastfeeding can also cause them. The exact cause can often be traced back to your specific diagnosis.

The male benign breast condition, gynecomastia, is caused by a hormone imbalance. It also can be caused by hormone therapy, some diseases, and being severely overweight.

How is a benign breast condition diagnosed?

You may notice a problem with your breast. Sometimes your doctor will detect the problem during a routine exam or screening. When you see your doctor, he or she will ask questions about what you’re experiencing. Your doctor will ask about your family history of breast cancer and non-breast cancer and conduct a physical exam of your breasts (with his or her hands).

Further testing may be necessary to rule out cancer. These tests may involve a mammogram or an ultrasound. Ultrasound technology allows your doctor to look inside your breasts by moving a small wand-like device around the outside of them. Your doctor may also suggest surgery to remove the lump, or a fine needle biopsy or aspiration. That’s a procedure where a thin needle connected to a syringe is inserted into the lump to remove a sample of tissue or fluid from the lump. Surgery and biopsies are done at a hospital. Your biopsy will be sent to a lab to be examined. All test results will be sent to your doctor. He or she will call you with the results.

The Operaminis (AAFP) recommends the following:

  • A routine mammography every other year for women between the ages of 50 and 74.
  • The use of ultrasound instead of a mammogram in young women with dense breast tissue and a lump.
  • Mammograms in women older than 40 if a fine needle biopsy shows a lump is solid. If a cyst can be drained successfully with a fine needle biopsy, no further evaluation of that cyst is needed.

If the results from a physical exam and fine needle biopsy diagnose the breast condition as benign, a follow-up physical exam should occur in 4 to 6 weeks.

Can benign breast conditions be prevented or avoided?

Benign breast conditions can’t be prevented or avoided. Your family genes have the greatest impact on your breast health. However, you can lower your risks for certain conditions. For example, if your benign breast condition is due to being overweight, consider losing weight. If it’s due to taking hormones or taking birth control pills, talk to your doctor about other medicine options. In some cases, your doctor may suggest you take birth control pills to reduce a certain type of benign breast condition.

Benign breast condition treatments

  • Fibrocystic breast changes: Your doctor may recommend you take birth control pills to reduce fluid buildup.
  • Fibroadenomas: Since this is often related to the use of birth control pills, your doctor may recommend an alternative birth control method. If the condition is painful, your doctor may surgically remove the lump. If it’s not painful or growing, your doctor may leave it alone.
  • Cysts: Your doctor may use a fine needle aspiration to draw out some fluid that is making the cyst painful. If it’s a chronic problem, your doctor may surgically remove the cyst.
  • Mastitis: Since this is an infection, your doctor will prescribe medicines, recommend an over-the-counter pain reliever for fever, and suggest applying a warm cloth to the lump to soothe the tenderness.
  • Fat necrosis: Usually, fat necrosis doesn’t require further treatment. If it contains fluid (called an oil cyst), your doctor will likely drain the fluid from the cyst with a fine needle aspiration.
  • Calcification: Your doctor may look at these tiny, white spots on your mammogram. If the spots don’t look like cancer, he or she probably won’t do anything else. If they looks like cancer, your doctor may do (or recommend) a surgical or fine needle biopsy.
  • Nipple discharge: Treatment will depend on the underlying cause of your nipple discharge (lump, infection, or cancer).
  • Hyperplasia, adenosis, intraductal papilloma, and lipoma: Based on your pain and discomfort, your doctor may recommend surgically removing it.
  • Male gynecomastia: This doesn’t need to be treated unless it causes pain. Some men choose to have the tissue reduced surgically or with hormones.

Living with benign breast conditions

The pain and tenderness of a benign breast condition can be uncomfortable. Your sleep position and clothing can affect your pain level.

Living with benign breast conditions can be emotionally hard, as well. Many women are worried that a non-cancerous lump will turn into cancer. While that’s not likely, there is a small chance it could happen. Your doctor may recommend regular screenings of your breasts. That might increase your worry and anxiety. It also can be expensive. Regular mammograms increase your exposure to radiation.

Questions to ask your doctor

  • Does a mammogram expose me to significant radiation?
  • Are benign breast conditions hereditary?
  • Are there genetic tests I should consider?
  • Should I be concerned if the area around my biopsy is red and hurts days later?
  • Can a breast reduction reduce your risk of benign breast conditions?
  • How do you detect lumps if you have breast implants?

Resource

National Institutes of Health, MedlinePlus: Breast Diseases

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