changes are common. Women experience various kinds of breast lumps
and other breast changes. These changes include those that normally
occur during the menstrual cycle, during pregnancy, and with aging,
as well as several types of breast lumps and other changes. Most
breast lumps and other changes are not cancer. Among breast
conditions for which biopsies are often done, the results show that
some 80 percent are not cancer. But only a doctor can tell for sure
whether a condition is malignant (cancer) or benign (not cancer).
breast has 15 to 20 sections, called lobes, each with many smaller
lobules. The lobules end in dozens of tiny bulbs that can produce
milk. The lobes, lobules, and bulbs are all linked by thin tubes
called ducts. These ducts lead to the nipple in the center of the
dark area of skin called the areola. Fat fills the spaces between
lobules and ducts. There are no muscles in the breasts, but muscles
lie under each breast and cover the ribs. These normal structures
inside the breasts can sometimes make them feel lumpy. Such lumpiness
may be especially noticeable in women who are thin or who have small
the time a girl begins to menstruate, her breasts undergo regular
changes each month. 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 a woman's period. Eventually,
about half of all women will experience symptoms such as lumps,
pain, or nipple discharge. Generally, these symptoms disappear with
studies show that the chances of developing benign breast changes
are higher for women who have never had children, have irregular
menstrual cycles, or have a family history of breast cancer. Benign
breast changes are less common among women who take birth control
pills or who are overweight. Because they usually involve the glandular
tissues of the breast, benign breast conditions are more of a problem
for women of child-bearing age, whose breasts are more glandular.
are several types of benign breast changes and conditions. Some
benign breast conditions cause a discharge from the nipple.
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. Discharge may be clear or milky.
discharge should be mentioned to the doctor. If the discharge is
being caused by a disease, the disease is more likely to be benign
than cancerous. The doctor will take a sample of the discharge and
send it to a laboratory to be analyzed. Benign sticky discharges
are treated chiefly by keeping the nipple clean. A discharge caused
by infection may require antibiotics.
breast lumpiness is one common type of benign breast change.
Benign breast conditions also include several types of distinct,
solitary (single) lumps. Such lumps, which can appear at any time,
may be large or small, soft or rubbery, fluid-filled or solid.
Generalized breast lumpiness is known by several names, including
fibrocystic changes, fibrocystic disease, 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. During pregnancy, the milk-producing glands become
swollen and the breasts may feel lumpier than usual. It can be difficult
for a woman to examine her breasts when she is pregnant, but she
should continue to do so; although very uncommon, breast cancer
has been diagnosed during pregnancy. 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 a woman is taking replacement hormones, this type of lumpiness
generally disappears after menopause.
are fluid-filled sacs. They occur most often in women 35 to 50 years
of age, and cysts often enlarge and become tender and painful just
before a woman's menstrual period. Cysts are usually found in both
breasts. Some cysts are so small they cannot be felt; rarely, they
may be several inches across. Cysts show up clearly on ultrasound,
an exam using sound waves to produce a picture of tissues inside
the breast. Cysts are usually handled by observation or by withdrawing
fluid with a needle. This procedure is called a fine-needle aspiration.
are benign tumors made up of both structural (fibro) and glandular
(adenoma) 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 women in their late teens and early 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.
necrosis refers to painless, round, firm lumps formed by damaged
and disintegrating fatty tissue. This condition typically occurs
in obese women with very large breasts. Fat necrosis often develops
in response to a bruise or blow to the breast, even though a woman
may not remember having been injured. Sometimes, the skin around
the lumps looks red or bruised. Because fat necrosis can easily
be mistaken for cancer, lumps are surgically removed so the tissue
can be checked under a microscope.
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. 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.
papilloma is a small wartlike growth that projects into breast
ducts near the nipple. Solitary intraductal papillomas usually affect
women nearing menopause. As any slight bump or bruise around the
nipple can cause the papilloma to bleed, this condition is a common
source of bloody or sticky discharge from the nipple. If the discharge
becomes bothersome, the diseased duct can be removed surgically
without damaging the appearance of the breast. Multiple intraductal
papillomas, in contrast, are more common in younger women. They
often occur in both breasts and are more likely to be associated
a lump than with nipple discharge. Multiple intraductal papillomas,
or any papillomas associated with a lump, need to be removed.
benign breast conditions are characterized by infection and/or
inflammation. Mastitis, sometimes called postpartum
mastitis, is an infection most often seen in women who are breast-feeding.
A duct may become blocked, causing milk to pool and allowing for
infection by bacteria and inflammation. The breast appears red and
feels warm, tender, and lumpy. In its early stages, mastitis can
by cured by antibiotics. If a pus-containing abcess forms, it may
need to be drained or surgically removed.
duct ectasia is a disease of women nearing menopause. Ducts
beneath the nipple become inflamed and can become clogged. Mammary
duct ectasia can be painful, and it can produce a thick and sticky
discharge that is gray to green in color. Treatment consists of
warm compresses, antibiotics, and, if necessary, surgery to remove
show that certain very specific types of microscopic changes put
a woman at higher risk for breast cancer. These changes feature
excessive cell growth, or hyperplasia. It is important to understand,
however, that most benign breast changes and conditions do not
increase a woman's risk of getting cancer.
70 percent of the women who have a biopsy showing a benign condition
have no evidence of hyperplasia and are at little or no
increased risk of developing breast cancer. About 25 percent
of benign breast biopsies show signs of hyperplasia, including conditions
such as intraductal papilloma and sclerosing adenosis. In these
cases, the risk of developing breast cancer is slightly increased.
The remaining 5 percent of benign breast biopsies reveal both excessive
cell growth (hyperplasia) and cells that are abnormal (atypia).
A diagnosis of atypical hyperplasia, as it is called, moderately
increases breast cancer risk.
fact sheet provides important information about benign breast lumps
and other benign breast changes. Only a doctor can determine the
nature of any breast lump or change. It is important for all women
with breast lumps or changes to consult with a doctor.
NCI Fact Sheets: Cancer Facts
also see -> All
About Breast Lumps
on the Web:
Breast Lumps - Information from WebMD