Benign Breast Disease

Fibrocystic Breast Changes

This is a terminology that refers to a combination of changes and findings seen in women of all ages that include any combination of cysts, fibrous tissue, enlarged ducts, firmer glandular tissue mixed with fatty tissue that when stimulated by estrogen can cause pain and tenderness.

Breast cysts

Breast cysts are sacs of fluid that occur inside the breasts and are not cancerous.  These structures are usually round to oval, smooth, and can be soft or firm depending on their size.

Breast cysts are common in women as they age but usually do not occur until the mid 30’s until menopause.  They can be found in younger and older women but are much less common in those age ranges.

Treatment is symptom related.  Asymptomatic cysts do not require any treatment.  Symptoms can be pain and tenderness or inflammation, and drainage usually eases these symptoms. Cysts can also cause nipple discharge when they are closer to the nipple.

There is no increased risk of breast cancer with cysts.  It is important to know that a cyst can only be diagnosed with ultrasound or aspiration of the fluid to confirm cyst contents.

The exact cause of cysts is unknown.  This may be due to many reasons which include personal genetics, hormonal changes, and excess estrogen.

Women should get to know what areas of their breasts are different and when there are changes that are persistent, make an appointment to see your doctor.

Papilloma

Papillomas are noncancerous tumors that grow in the milk duct and include glandular tissue and a stalk that contains blood vessels.  These are found commonly near the nipple and for this reason are one the causes of nipple discharge. They can cause bloody discharge or clear yellow discharge.  The diagnosis of papilloma is done with biopsy and in most cases is removed at surgery.  This is done especially with papillomas that have atypical changes but also to get rid of the discharge that is bothersome to most women when it is persistent.

Papillomas with atypical changes increase the risk of cancer.

Symptoms that alert your physician to investigate include breast lumps, one duct discharge, spontaneous discharge (discharge that comes out without nipple compression) that is persistent.

Fibroadenoma

Fibroadenomas are benign masses that are solid and occur most of the time in younger women starting in their teen years through the early fertile years and less often later in life.

They are usually mobile, smooth, firm and can be small or much larger.  As time goes on, they may change size in both directions.  If they grow, biopsy may be indicated, and this may entail needle biopsy or removal to better evaluate their true diagnosis.

Fibroadenomas do not tend to have too many painful symptoms and in fact are usually painless.

No one knows for sure why some women get fibroadenomas and at least one theory is that it is a normal detour from normal breast development in some.

• There are different types of fibroadenomas:
• Simple- Most common and non-worrisome

Complex- Include changes of hyperplasia which is overgrowth of cells and can grow more rapidly

Juvenile-Girls and adolescents tend to have this kind most frequently and can become quite large over a short period of time.  They also can shrink and disappear, but this takes much longer.

• Giant-Grow very large and can cause problems with surrounding breast tissue.

Phyllodes tumor-thought to be a much less frequent subtype and are not very often malignant.  Should a previously biopsied fibroadenoma change and grow more quickly, repeat biopsy is indicated to make sure a phyllodes tumor is not present.  Phyllodes tumors usually grow.

Fibroadenomas are not a risk factor for breast cancer.