Benign Breast Disease

What is benign breast disease? If you feel a lump in your breast, your first thought may be that you have breast cancer. Fortunately, a majority of breast lumps are benign, meaning they’re not cancerous. Both women and men can develop benign (noncancerous) breast lumps. This condition is known as benign breast disease. While these breast changes aren’t cancerous or life-threatening, they may increase your risk of developing breast cancer later on.

How common is benign breast disease? Benign breast lumps in women are common. Up to half of all women will experience fibrocystic changes that cause noncancerous breast lumps at some point in their lives. Fluctuating hormone levels often cause these breast tissue changes.

Who might get benign breast disease? Benign breast disease affects all genders. Men can develop enlarged, swollen breasts with lumps, a condition called gynecomastia. Your risk for benign breast disease increases if you: Have a family history of breast cancer or benign breast disease. Use hormone replacement therapy. Have a hormonal imbalance.

What are the types of benign breast disease?

There are many different types of benign breast disease. Most of the following types don’t increase cancer risk and don’t require treatment:

Breast cysts: Up to a quarter of breast lumps are fluid-filled cysts. Breast cysts can be tender and lumpy, but they don’t make you more prone to cancer. Cysts often go away without treatment.

Fibroadenomas: These are the most common noncancerous solid breast tumors found in women ages 15 to 35. Fibroadenomas don’t increase cancer risk and often go away on their own.

Fibrocystic breast changes: Fluctuating hormone levels can make breasts feel lumpy, dense and tender, especially right before menstruation. Women ages 30 to 50 are more likely to experience fibrocystic breast changes, which go away without treatment.

Hyperplasia: This condition occurs from an overgrowth of cells that line mammary ducts or glands. A condition called usual hyperplasia doesn’t increase cancer risk and doesn’t require treatment. If you have atypical hyperplasia, your healthcare provider may recommend surgically removing affected breast tissue because the condition may make you more prone to breast cancer.

Intraductal papilloma: These small, wart-like growths form inside the mammary duct near the nipple. Intraductal papilloma may cause nipple discharge. The condition most commonly affects women ages 30 to 50. Your risk of cancer goes up if you have five or more papillomas at one time. Surgery can remove these growths and reduce your cancer risk.

Mammary duct ectasia: Menopausal and postmenopausal women are more prone to mammary duct ectasia. You may experience an inverted nipple or nipple discharge when swollen, inflamed milk ducts are blocked. Also known as periductal mastitis, this condition doesn’t increase cancer risk. You may need antibiotics if a bacterial infection caused the inflammation and blockage. Otherwise, you don’t need treatment.

Traumatic fat necrosis: These breast lumps form when scar tissue replaces breast tissue that’s been damaged by an injury, surgery or radiation therapy. Fat necrosis doesn't raise your cancer risk and don’t need treatment.

What causes benign breast disease?

Common causes of noncancerous breast lumps include:

- Changes in breast tissue (fibrocystic breast changes).

- Breast infection (mastitis)

- Scar tissue from a breast injury.

- Hormone fluctuations, especially during menstruation, pregnancy or menopause.

- Medication use, such as hormonal contraceptives (birth control pills) and hormone replacement therapy.

- Caffeinated beverages.

What are the symptoms of benign breast disease?

You may notice breast changes or a lump while doing a breast-self exam, showering or getting dressed. Sometimes a mammogram detects these changes. Besides a breast lump, other signs of benign breast disease include:

- Breast pain (mastalgia).

- Nipple discharge.

- Change in breast size, shape or contour.

- Inverted, creased or scaly nipple.

- Dimpled, puckered or scaly breasts.

How is benign breast disease diagnosed?

If you feel a lump or notice breast changes, see your healthcare provider immediately. Sometimes a mammogram or your healthcare provider first detects a change. Your provider may order one or more of these tests:

- Imaging scans, including mammogram, ultrasounds or magnetic resonance imaging (MRI).

- Lab test of nipple discharge to check for cancer cells.

- Image-guided core needle breast biopsy, fine-needle aspiration biopsy or excisional biopsy to test cells for cancer.

How is benign breast disease managed or treated?

Most types of benign breast disease don’t require treatment. Your healthcare provider may recommend treatment if you have atypical hyperplasia or a different kind of benign breast disease that increases your future risk of breast cancer. If you experience pain or discomfort or have an increased cancer risk, these treatments can help:

- Fine needle aspiration to drain fluid-filled cysts.

- Surgery to remove lumps (lumpectomy).

- Oral antibiotics for infections like mastitis.

Can I get benign breast disease more than once?

Benign breast lumps are fairly common and can occur many times throughout your life. Your breasts may feel lumpy or tender when hormone levels change due to menstruation or menopause. You should contact your healthcare provider anytime you feel a lump or notice a breast change.

What are the complications of benign breast disease?

Certain types of benign breast disease, such as atypical hyperplasia, make you more prone to breast cancer. Sometimes, benign breast lumps hurt. Your healthcare provider may recommend surgery to remove painful lumps. Unfortunately, some fibroadenoma lumps come back after surgery.

How does pregnancy affect benign breast disease?

Changes in hormone levels during pregnancy can cause breast lumps, tenderness and nipple discharge. You’re also more likely to experience benign breast changes or develop a breast infection called mastitis while breastfeeding. Breast changes during pregnancy or breastfeeding are rarely cancerous. Still, you should reach out to your healthcare provider when you notice any breast change.

How can I prevent benign breast disease?

There isn’t much you can do to lower your risk of benign breast disease. These actions may lower cancer risk and help detect disease early when it’s most treatable:

- Get regular mammogram screenings.

- Perform self-exams to get familiar with how your breasts look and feel.

- Maintain a healthy weight.

- Exercise regularly.

- Eat a nutritious diet.

- Drink alcohol in moderation or not at all.

- Quit smoking.

- Reconsider the use of hormone replacement therapy.

- Switch to a non-hormonal birth control option.