Benign Breast Conditions
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Benign Breast Diseases
These are benign conditions as part of the ANDI spectrum (Aberrations of Normal Development and Involution), relating to the normal processes of breast development and changes during reproductive life.FibroadenomaThis is the most common diagnosis in patient presenting with breast lump. Fibroadenoma are benign breast lumps that are predominant in the 15-25 age group. It often grows to 1-2 cm then usually maintains a stable size. ~30% will decrease in size or disappear and <10% will enlarge.Fibroadenoma commonly presents as a single lesion but up to 15% patients can develop multiple fibroadenoma. There is no increased risk of breast cancer. Multiple fibroadenoma can be associated with some rare cancer syndromes including Cowden, Maffuci and Carney and should be removed in these circumstances.Fibroadenoma can enlarge rapidly during pregnancy or when there’s increase of hormone influence. A biopsy to prove the benign nature of the lump is required, then observation is the common pathway. Giant fibroadenoma is fibroadenoma larger than 5 cm.
An operation would generally be indicated if the lump is >4cm, enlarging rapidly or has a suspicious biopsy result. Surgery for fibroadenoma is usually performed with a small incision and does not leave any deficit in breast volume or distort appearance of the breast
PhylloidesThese are larger than fibroadenomas but similar clinically. They are a rare type of breast tumour that develops in connective tissue (stroma) of the breast and usually presents as a painless, rapidly growing lump in the breast. These can be classified as benign, borderline, or malignant. Surgery is the main treatment with wider excision for malignant Phylloides. There is a small risk of malignancy. In instance of malignancy, adjuvant therapy such as radiation might be recommended.
CystThese are common in pre-menopausal women. ~ 30 % of women age between 20-50 have cysts in their breasts. Only 7% present with a palpable lump in the breast. These can be painful (tension cyst) and can be aspirated for symptomatic relief. A simple cyst will need no intervention however if the cysts have an atypical appearance on ultrasound, a biopsy or excision will often be recommended.
Mastalgia (Breast pain)Experienced by ~70% of women. Less than 5% women with breast cancer actually present with breast pain. There are several theories of mastalgia causes, such as too much oestrogen, not enough progesterone, too much prolactin, abnormal fatty acids/increased receptor sensitivity. Treatment is generally conservative.
Nipple dischargeA common clinical presentation. The cause is benign in most cases, including medication induced, physiologically, ductal ectasia or intraductal lesion such as papilloma.
Breast Abscess/ MastitisMastitis is the inflammation of the breast tissue with or without bacterial infection. Presenting symptoms include breast pain, swelling, redness and possible flu-like symptoms such as fever, lethargy, nausea, and muscle pain. It is a common sequelae of breast feeding (lactational mastitis). Other causes include trauma, unresolved blocked duct, overall poor health and nutrition. Breast abscess is a collection of pus in the breast which can be a complication of mastitis. It is important to differentiate mastitis with inflammatory breast cancer, a rare but aggressive form of breast cancer that can mimic signs and symptoms of mastitis. Therefore, you must seek medical attention as soon as possible to initiate investigation and appropriate treatment. Large Breasts and Reduction Mammoplasty Some patients suffers from the side effects of their large breasts beside the inconvenience of having to order special expensive bra. The follwing symptoms are common: Bra strap shoulder indentation Neck pain/Back pain Restricting activity/ sport activity Under breast skin rash/ ulceration Poor self image Breast reduction or Reduction mammoplasty can be considered once underlying causes for large breast has been excluded. The procedure removes excess tissue from both breast and often involves reposition of the nipple to create a better breast shape. However, there are contraindations to the procedures such as keloid scarring (excessive thickened scarring), diabetes, mobidly obese and smoking.
PhylloidesThese are larger than fibroadenomas but similar clinically. They are a rare type of breast tumour that develops in connective tissue (stroma) of the breast and usually presents as a painless, rapidly growing lump in the breast. These can be classified as benign, borderline, or malignant. Surgery is the main treatment with wider excision for malignant Phylloides. There is a small risk of malignancy. In instance of malignancy, adjuvant therapy such as radiation might be recommended.
CystThese are common in pre-menopausal women. ~ 30 % of women age between 20-50 have cysts in their breasts. Only 7% present with a palpable lump in the breast. These can be painful (tension cyst) and can be aspirated for symptomatic relief. A simple cyst will need no intervention however if the cysts have an atypical appearance on ultrasound, a biopsy or excision will often be recommended.
Mastalgia (Breast pain)Experienced by ~70% of women. Less than 5% women with breast cancer actually present with breast pain. There are several theories of mastalgia causes, such as too much oestrogen, not enough progesterone, too much prolactin, abnormal fatty acids/increased receptor sensitivity. Treatment is generally conservative.
Nipple dischargeA common clinical presentation. The cause is benign in most cases, including medication induced, physiologically, ductal ectasia or intraductal lesion such as papilloma.
Breast Abscess/ MastitisMastitis is the inflammation of the breast tissue with or without bacterial infection. Presenting symptoms include breast pain, swelling, redness and possible flu-like symptoms such as fever, lethargy, nausea, and muscle pain. It is a common sequelae of breast feeding (lactational mastitis). Other causes include trauma, unresolved blocked duct, overall poor health and nutrition. Breast abscess is a collection of pus in the breast which can be a complication of mastitis. It is important to differentiate mastitis with inflammatory breast cancer, a rare but aggressive form of breast cancer that can mimic signs and symptoms of mastitis. Therefore, you must seek medical attention as soon as possible to initiate investigation and appropriate treatment. Large Breasts and Reduction Mammoplasty Some patients suffers from the side effects of their large breasts beside the inconvenience of having to order special expensive bra. The follwing symptoms are common: Bra strap shoulder indentation Neck pain/Back pain Restricting activity/ sport activity Under breast skin rash/ ulceration Poor self image Breast reduction or Reduction mammoplasty can be considered once underlying causes for large breast has been excluded. The procedure removes excess tissue from both breast and often involves reposition of the nipple to create a better breast shape. However, there are contraindations to the procedures such as keloid scarring (excessive thickened scarring), diabetes, mobidly obese and smoking.