Benign Breast Changes
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The term benign breast conditions, also known as benign breast disease, is used to describe a number of benign (noncancerous) disorders that can affect the breast. Some cause discomfort or pain and require treatment, while others are of little concern and need no medical attention. Unfortunately, many breast conditions mimic the symptoms of cancer and so require tests and sometimes surgical biopsy to diagnose. Though the prospect of cancer is certainly scary, most biopsies find a benign breast condition instead of cancer (for more on detecting and diagnosing breast disease, see the Early Detection and Screening and Diagnosis sections).
Some of the more common benign breast conditions are hyperplasia, cysts and fibroadenomas [4]. The term "fibrocystic changes" is used by some health care providers to describe a broad range of benign breast conditions. There are many types of benign breast conditions that differ from each other in their cellular appearance under a microscope. If “fibrocystic changes” is used to describe someone’s condition, it’s important to ask about the specific type of fibrocystic change that was identified (for example, whether it is a cyst or hyperplasia). While benign breast conditions are not cancer, certain types do actually increase the risk of breast cancer.
Hormonal factors, such as the use of postmenopausal hormones, can increase the risk of benign breast conditions. Similar to the risk of breast cancer, risk of benign breast conditions is increased among women with inherited genetic susceptibilities including BRCA1 or BRCA2 mutations [10,11].
Hyperplasia
Hyperplasia is a term describing the excessive accumulation or build up (sometimes called proliferation) of cells. It is usually found on the inside of the lobules or ducts in the breast tissue. Hyperplasia usually occurs among women in their 20s and often is associated with breast pain [11]. There are two main types of hyperplasia—usual and atypical. Both raise the risk of breast cancer, though atypical hyperplasia does so to a greater degree [12-14]. For more on this, see the Risk Factors and Prevention section.
Cysts
Cysts are fluid-filled sacs that are almost always benign. Often they can be left alone, or if painful, they can be drained of the fluid (aspirated). They may also be drained if they are palpable (can be felt) and could potentially interfere with clinical exams. Up to a third of women between the ages of 35 and 50 have cysts in their breasts, though most cysts are too small to feel and can be detected only by examination with ultrasound.
If cysts are large enough, they may feel like lumps in the breast. Breast pain and nipple discharge may also be present [11]. In a small proportion of patients, the cysts will recur after being aspirated. If this happens repeatedly, patients may want to have them removed. Cysts are more common in women as they approach menopause, but they are not associated with an increased risk of cancer. After menopause, cysts occur much less frequently [4].
It is unknown exactly what causes cysts to develop. Although certain dietary factors, such as caffeine intake, have been discussed as possible risk factors for developing breast cysts, there are currently very little data backing up any link between cyst development and either dietary or lifestyle factors [15,16]. For more information on detecting and diagnosing cysts, see the Early Detection and Screening section.
Fibroadenomas
Fibroadenomas, another type of benign lump, are most common in younger women. They are usually not removed because they pose no risk. Sometimes they are uncomfortable and produce a lump that can be felt in the breast. If a fibroadenoma is large, a woman will probably want it removed. In older women, fibroadenomas are generally removed to be certain they are not cancerous. Fibroadenomas are not generally associated with an increased risk of cancer [1,4]. For more information on detecting and diagnosing fibroadenomas, see the Early Detection and Screening section.
Sclerosing adenosis
Sclerosing adenosis most commonly occurs in women in their 30s [11]. It is characterized by small breast nodules that are composed of distorted, elongated glandular cells [10]. Sclerosing adenosis may increase the risk of atypical hyperplasia, lobular carcinoma in situ and ductal carcinoma in situ [10].
Radial scars
Radial scars are discovered most often during a biopsy on a breast tumor removed for other reasons [10,17]. They can look like breast cancer on a mammogram, but they are not actual cancer. Although some studies have found that radial scars increase the risk of breast cancer, this may be because they are typically identified alongside existing disease [11,18].
Intraductal papillomas
Intraductal papillomas occur in the lactation ducts of the breasts. These small masses may appear with or without nipple discharge [10]. There are two types of intraductal papillomas—solitary and multiple (or peripheral). Solitary intraductal papillomas usually occur among women in their 30s and 40s and do not increase the risk of breast cancer unless atypical cells are present [11]. Multiple intraductal papillomas, occur among even younger women and are associated with a small increase in breast cancer risk [10,11].
Benign phyllodes tumor
Phyllodes tumors are very rare, comprising less than one percent of all breast tumors in women. There are several sub-types. Benign phyllodes tumor is most common, accounting for more than 50 percent of all phyllodes tumors, and the least aggressive of these sub-types [10]. These benign tumors are similar to fibroadenomas and typically occur among women younger than 50 [10]. Because phyllodes tumors are so rare, it is unclear whether or not they increase the risk of breast cancer [10].
Sclerosing lymphocytic lobulitis/ductitis (diabetic mastopathy, lymphocytic mastitis)
Sclerosing lymphocytic lobulitis (also called diabetic mastopathy and lymphocytic mastitis) are benign breast masses that most often appear in women with insulin-dependent (type 1) diabetes [10,19]. These tumors are typically small, hard masses and can appear in the ducts (lymphocytic ductitis) or in the lobules (lymphocytic lobulitis) [10]. This type of benign breast condition does not appear to increase the risk of breast cancer [19].
For information on male breast health, click here.
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