Benign 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. There are numerous benign breast conditions. 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.
  • Fibroadenomas. These are the most common breast lumps in younger women and are usually very small.
  • Mastitis. 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.
  • Calcification. Small spots of calcium salts can show up anywhere in breast tissue. Usually, you can’t feel them and they are not painful.
  • Nipple discharge. Your nipples may leak fluid for a variety of reasons.

Less common types of benign breast conditions include:

  • Hyperplasia. This is an abnormal increase in cell growth in the breast.
  • Adenosis. 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.
  • Lipoma. These are common and are made up of mostly fat tissue.

These are rare in men. Men do have undeveloped milk ducts. The most common benign breast condition in men is called gynecomastia. This condition causes enlarged breast tissue.

Female breasts are very complex. The female breast is filled with parts called 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. Most people associate breast abnormalities with breast cancer. However, not all breast disorders are cancerous.

Symptoms of benign breast conditions

  • Fibrocystic breast changes: Your breasts will feel lumpy and Inside your breasts, the lumps are made up of a fibrous, rubber-like, thick tissue, or a fluid-filled cyst.
  • Fibroadenomas: This will feel like a small, round, moving marble in your breast.
  • Cysts: These are fluid-filled lumps in your breasts that may be tender when you touch them. You may notice that they appear and disappear each time you have your period.
  • Mastitis: You may feel a lump in your breast. 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 fat.
  • 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.
  • Calcification: You may or may not feel these tiny, hard spots in your breast. They are due to leftover, hardened calcium deposits in your breast. Eating or drinking too much calcium does not cause it. Most are benign. However, some calcification can be a sign of 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 will feel swollen and tender when diagnosed with this benign breast condition.

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).

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. 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?

Sometimes you will notice a problem with your breast. Sometimes your doctor will detect the problem during a routine physical exam or screening. When you see your doctor for the problem, he or she will ask you questions about what you are experiencing, 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. That might involve a mammogram, an ultrasound (technology that allows your doctor to look inside your breast by moving a small wand-like device around the outside of your breasts), surgery to remove the lump, or a fine needle biopsy or aspiration (a procedure that involves injecting a thin needle connected to a syringe into the lump to remove a sample of tissue or fluid from the lump) or a combination of all 3. 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 American Academy of Family Physicians (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 cannot 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, losing weight can reduce your risk. If it is due to taking hormones or taking birth control pills, talk to your doctor about options to reduce your risk. 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 birth control pills to reduce the fluid build up of this type of benign breast condition.
  • Fibroadenomas: Since this is often related to the use of birth control pills, your doctor may recommend an alternative birth control method. If it’s painful, your doctor may surgically remove it. If it is not painful or growing, your doctor may leave it alone.
  • Cysts: Your doctor may use a fine needle aspiration to draw out some of the fluid that is making it painful. If it is a chronic problem, your doctor may surgically remove the cyst.
  • Mastitis: Since this is an infection, your doctor will prescribe antibiotics, recommend an over-the-counter pain reliever for fever, such as acetaminophen, and suggest you apply a warm cloth to the lump to soothe the tenderness in your breast.
  • Fat necrosis: Usually, fat necrosis does not 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.
  • Nipple discharge: Treatment will depend on the underlying cause of your nipple discharge (lump, infection, or cancer).
  • Calcification: Your doctor may look at these tiny, white spots on your mammogram. If the spots don’t look like cancer, he or she will probably not do anything further. If it looks like cancer, your doctor may do (or recommend) a surgical or fine needle biopsy.
  • Hyperplasia, adenosis, intraductal papilloma, and lipoma: Based on your pain and discomfort, your doctor may recommend surgically removing it.
  • Male gynecomastia: This does not 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 noncancerous lump will turn into cancer. While that is not the case in most instances, there is a small chance it could increase your risk of breast cancer. Your doctor may recommend regular screenings of your benign breast condition. That might increase your worry and anxiety. It also can be expensive. Regular mammograms increase your exposure to radiation.

Questions

  • How long should I wait to see my doctor after I feel a lump?
  • Are benign breast conditions hereditary?
  • Are there genetic tests I should consider?
  • Does mammography expose me to significant radiation?
  • 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?