Breast conditions

background

There are a number of benign (non-cancerous) breast conditions that a woman may experience during her lifetime. It is estimated that 50-90% of all women experience some symptoms such as breast pain, lumps, or nipple discharge by the time they reach menopause.
Common benign breast conditions generally fall into several broad categories and include: breast pain or mastalgia, benign breast tumors, solitary lumps, fibrocystic changes, nipple problems and discharge, infections, and inflammation. It is important to note that most women have normal physiological changes, such as minor tenderness, swelling, and lumpiness that they experience before or after their menstrual periods.
A benign breast condition is any non-cancerous breast abnormality. According to the American Cancer Society, when breast tissue is examined under a microscope, some type of abnormality is common in nine out of every 10 women. Though not life-threatening, benign conditions may cause pain or discomfort for some patients. Some (not all) benign conditions can signal an increased risk for breast cancer. The most common benign breast conditions include fibrocystic breast condition, benign breast tumors, and breast inflammation. Depending on the type of benign breast condition and the patient's medical situation, treatment may or may not be necessary.
Malignant breast conditions are those that are cancerous, including breast cancer (see Breast Cancer condition monograph).
Each breast has 15-20 sections, called lobes, each with many smaller lobules. The lobules end in dozens of tiny bulbs that can produce milk. Lobes, lobules, and bulbs are all linked by thin tubes called ducts. These ducts lead to the nipple, which is centered in a dark area of breast skin called the areola. The areola also has oil-producing glands that secrete a lubricant to make breastfeeding easier. The spaces between the lobules and ducts are filled with fat. There are no muscles in the breast, but muscles lie under each breast and cover the ribs.
These normal features can sometimes make the breasts feel lumpy. This is especially true in women who are thin or who have small breasts
Breasts may also be altered surgically, as in breast reduction and breast enlargement procedures.

Related Terms

Areola, atypical ductal hyperplasia, atypical lobular hyperplasia, breast augmentation, breast cysts, breast enlargement, breast pain, breast reduction, breast self-examination, BSE, CBE, clinical breast exam, cyclic mastalgia, cyclical breast pain, ductal lavage, fat necrosis, fibroadenomas, fibrocystic breast disease, fine needle aspiration, galactorrhea, intraductal papilloma, magnetic resonance imaging, malignant, mammary duct ectasia, mammography, mammoplasty, mastalgia, mastitis, microcalcifications, MRI, nipple, noncyclical breast pain, stereotactic biopsy.

selected breast conditions

Mastalgia (breast pain): Mastalgia is breast pain and is generally classified as either cyclical (associated with menstrual periods) or noncyclical. Noncyclical pain may come from the breast or come from somewhere else, such as the nearby muscles or joints, but may be felt in the breast. Pain can range from minor discomfort to severely incapacitating pain in some cases. Many women with mastalgia worry more about the consequences of cancer than about the pain itself.
Cyclic breast pain is the most common type of breast pain and is associated with the menstrual cycle as well as hormonal changes not associated with the menstrual cycle, such as during chronic stress. Some women begin to have pain around the time of ovulation, which continues until the beginning of their menstrual cycle. The pain may be barely noticeable or so severe that the woman cannot wear tight-fitting clothing or tolerate close contact of any kind. The pain may be felt in only one breast or may be felt as a radiating sensation in the under-arm region.
Noncyclical breast pain is fairly uncommon, feels different than cyclical mastalgia, and does not vary with the menstrual cycle. Generally, the pain is present all the time and is in only one specific location.
One cause of noncyclical breast pain is trauma, or a blow to the breast. Other causes can include arthritic pain in the chest cavity and in the neck that can radiate down to the breast.
Fibrocystic breast disease: Fibrocystic breast disease or benign breast disease is a condition of the breasts that involves inflammation of breast tissue, causing lumps. Although some breast lumps are cancerous (malignant), most (80-85%) are benign (non-cancerous). Approximately 33% of all women between the ages of 30-50, and 50% of women of all ages, may at some point develop fibrocystic breast disease or another benign breast condition. Other familiar terms include benign breast disease, chronic mastitis (inflammation), and mammary dysplasia. Breast 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 the woman is taking replacement hormones, this type of lumpiness generally disappears completely after menopause.
There are times when breast lumpiness becomes more noticeable. During the menstrual cycle, 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. Pregnancy also can bring changes. During pregnancy, the milk-producing glands become swollen and the breasts may feel lumpier than usual.
Breast cysts: Breast cysts (fluid filled sacs) occur most often in women ages 35-50. Breast cysts often enlarge and become tender and painful just before the menstrual period and are usually found in both breasts. Some cysts are so small they cannot be felt; rarely, cysts may be several inches across.
Although a cyst is not cancerous, it is important for a woman who notices any lump or change to see a healthcare provider.
Fat necrosis: 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. Fat necrosis often develops in response to trauma, such as 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.
Fibroadenomas: Fibroadenomas are solid and round benign tumors that are made up of both structural and glandular tissues. Usually, these lumps are painless and found by the woman herself. Fibroadenomas 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. Fibroadenomas tend to occur twice as often in African-American women.
Galactorrhea: Galactorrhea occurs when a woman's breast makes milk even though she is not breastfeeding a baby. Galactorrhea may occur spontaneously or when the breasts are touched. Men may also have galactorrhea, but it is much less common. Causes can include hormonal imbalances, pregnancy, pituitary tumor, or medications such as hormones, antidepressants, or blood pressure medicines.
Hyperplasia/atypical hyperplasia: Recent studies show that certain types of microscopic changes put a woman at higher risk of developing breast cancer. These changes include excessive cell growth or hyperplasia. Hyperplasia can increase the risk of developing breast cancer. Approximately five percent of benign breast biopsies reveal both excessive cell growth, such as hyperplasia, and cells that are abnormal. The location of these abnormal cells can be in the lobules (atypical lobular hyperplasia) or the milk ducts (atypical ductal hyperplasia). A diagnosis of atypical hyperplasia moderately increases breast cancer risk. If a biopsy finds hyperplasia, surgery can remove the abnormal cells.
Intraductal papilloma: One of the most common sources of a bloody or sticky discharge is an intraductal papilloma, a small, wart-like growth that projects into breast ducts near the nipple. Any slight bump or bruise in the area of the nipple can cause the papilloma to bleed. Single intraductal papillomas usually affect women nearing menopause.
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 with a lump than with nipple discharge. Multiple intraductal papillomas, or any papillomas associated with a lump, need to be removed.
Mammary duct ectasia: Mammary duct ectasia is a disease of women nearing menopause. Ducts beneath the nipple become inflamed and can become blocked. Mammary duct ectasia can become painful, and it can produce a thick and sticky discharge that is gray to green in color. A woman who notices pain or discharge should see her doctor.
Mastitis: Mastitis is an infection most often seen in women who are breastfeeding. A duct may become blocked, allowing milk to pool, causing inflammation, and setting the stage for infection by bacteria. Bacteria can also enter via cracked nipples. The breast appears red and feels warm, tender, and lumpy. In its earlier stages, mastitis can be treated effectively by antibiotics. If a pus-containing abscess forms, it will need to be drained or surgically removed.
Breast augmentation: In breast augmentation surgery (or medical augmentation mammoplasty), an individual is able to enhance the size and shape of her breast tissue through the implementation of breast implants. Augmentation of the breast consists of insertion of a silicone bag under the breast or under the breast and chest muscle and then filling the bag with saline (salt water). This expands the breast area to give a fuller breast (increased cup size), give a better contour, and give more cleavage. Breast implants are predominantly obtained by women who want to change their appearance.
Many women seek breast implants to correct a perceived flaw in their body. Some women want to correct the disproportionate shape and/or size between their breasts. Others undergo this surgical treatment to give their bodies an overall more proportional shape. Breast augmentation surgeries have increased by 476% since 1992, the largest increase in plastic surgery procedures.
Breast reduction surgery is for women who have large breasts and want to resolve one or more of the following associated problems: chronic back, neck, and shoulder pain; poor posture; skin rash under the breasts; deep grooves in the shoulders from bra strap pressure; restricted levels of activity; low self-esteem; and difficulty wearing or fitting into certain bras and clothing.