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Benign Breast Disease


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Description

Common benign breast changes fall into several broad categories. These include generalized breast changes, solitary lumps, nipple discharge, and infection or inflammation. From the time a girl begins to menstruate, her breasts undergo regular changes each month. Many doctors believe that nearly all breasts develop some lasting changes, beginning when the woman is about 30 years old. Eventually, about half of all women will experience symptoms such as lumps, pain, or nipple discharge.


Fibrocystic changes

These are fluid filled sacs. Fibrocystic changes are the most common benign breast condition. They are found in at least one out of three women during breast examinations. They occur most often in women 20 to 50 years of age, and cysts often enlarge and become tender and painful just before a woman"s menstrual period. Fibrocystics changes are an exaggerated response to the cyclic levels of ovarian hormones. Cysts are usually found in both breasts. Some cysts are so small they cannot be felt; rarely, they may be several inches in diameter. Cysts show up clearly on ultrasound, an examination that uses sound waves to produce a picture of tissues inside the breast. Management of cysts usually consists of observation or fine-needle aspiration, a procedure whereby fluid is withdrawn via a needle.


Fibroadenomas

These are benign tumors of the breast tissues. Usually, these solid, round lumps are painless and most often found by women themselves. Fibroadenomas feel rubbery and can be moved around easily. They are the most common type of tumors in adolescents and women in their twenties, and they occur twice as often in African-American women as they do in other American women. Although fibroadenomas do not become malignant, they can enlarge with pregnancy and breast-feeding. Fibroadenomas have a typically benign appearance on mammography (breast x-rays), and they can sometimes be diagnosed with fine-needle aspiration. Most surgeons believe that it is a good idea to remove fibroadenomas to make certain they are benign.


Fat necrosis

This is a firm, tender, indurated, ill-defined mass formed by damaged and disintegrating fatty tissues. This condition typically occurs in obese women with very large breasts. It often develops in response to a bruise or blow to the breast, even though the woman may not remember the specific injury. Fat necrosis can easily be mistaken for cancer, so such lumps are removed during a surgical biopsy.


Sclerosing adenosis

This condition involves the excessive growth of tissues in the breast"s lobules. It frequently causes breast pain. Usually the changes are microscopic. However, adenosis can produce lumps, and it can show up on mammography, often as calcifications, small deposits of calcium in tissue. Because adenosis is often difficult to distinguish from cancer, doctors usually perform a surgical biopsy to diagnose and treat this condition.


Intraductal papilloma

Intraductal papilloma is a small growth that projects into breast ducts near the nipple. The predominant symptom is spontaneous, bloody discharge from one nipple, although the discharge can be any color. Mammography is indicated in any patient with an intraductal papilloma, regardless of age. If the discharge becomes bothersome, the diseased duct can be removed surgically without damaging the appearance of the breast. If multiple ducts are involved, a diagnosis of carcinoma is more likely.


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