Benign
Breast Conditions
Common benign breast changes fall into several
broad categories. These include generalized breast changes, solitary
lumps, nipple discharge, and infection and/or inflammation.
Generalized Breast Changes
Generalized breast lumpiness is known by several names,
including fibrocystic disease changes and benign breast
disease. Such lumpiness, which is sometimes described as "ropy" or
"granular," can often be felt in the area around the nipple and
areola and in the upper-outer part of the breast. Such lumpiness may
become more obvious as a woman approaches middle age and the
milk-producing glandular tissue of her breasts increasingly gives
way to soft, fatty tissue. Unless she is taking replacement
hormones, this type of lumpiness generally disappears for good after
menopause.
The menstrual cycle also brings cyclic breast changes. Many women
experience swelling, tenderness, and pain before and sometimes
during their periods. At the same time, one or more lumps or a
feeling of increased lumpiness may develop because of extra fluid
collecting in the breast tissue. These lumps normally go away by the
end of the period.
During pregnancy, the milk-producing glands
become swollen and the breasts may feel lumpier than usual. Although
very uncommon, breast cancer has been diagnosed during pregnancy. If
you have any questions about how your breasts feel or look, talk to
your doctor.
Solitary Lumps Benign breast
conditions also include several types of distinct, solitary lumps.
Such lumps, which can appear at any time, may be large or small,
soft or rubbery, fluid-filled or solid.
Cysts are fluid-filled sacs. They occur most often in women ages
35 to 50, and they often enlarge and become tender and painful just
before the menstrual period. They are usually found in both breasts.
Some cysts are so small they cannot be felt; rarely, cysts may be
several inches across. Cysts are usually treated by observation or
by fine needle aspiration. They show up clearly on ultrasound.
Fibroadenomas
are solid and round benign tumors that are made up of both
structural (fibro) and glandular (adenoma) tissues. Usually, these
lumps are painless and found by the woman herself. They feel rubbery
and can easily be moved around. Fibroadenomas are the most common
type of tumors in women in their late teens and early twenties, and
they occur twice as often in African-American women as in other
American women.
Fat necrosis is the name given to painless, round, and
firm lumps 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.
Sometimes the skin around the lumps looks red or bruised. Fat
necrosis can easily be mistaken for cancer, so such lumps are
removed in a surgical biopsy.
Sclerosing adenosis is a benign condition involving the
excessive growth of tissues in the breast's lobules. It frequently
causes breast pain. Usually the changes are microscopic, but
adenosis can produce lumps, and it can show up on a mammogram, often
as calcifications. Short of biopsy, adenosis can be difficult to
distinguish from cancer. The usual approach is surgical biopsy,
which furnishes both diagnosis and treatment.
Nipple Discharge Nipple
discharge accompanies some benign breast conditions. Since the
breast is a gland, secretions from the nipple of a mature woman are
not unusual, nor even necessarily a sign of disease. For example,
small amounts of discharge commonly occur in women taking birth
control pills or certain other medications, including sedatives and
tranquilizers. If the discharge is being caused by a disease, the
disease is more likely to be benign than cancerous.
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