Benign (Noncancerous) Breast Lumps

Benign breast lumps

Most changes women notice themselves as a palpable breast lump or detected on mammography are not cancer. Many changes (adenosis, cysts, fat necrosis, fibroadenoma and intraductal papilloma) arebenignand do not increase breast cancer risk. Atypical hyperplasia (ALH) or atypical ductal hyperplasia (ADH) or lobular carcinoma in situ (LCIS) are considered breast cancer risk factors. Some conditions, such as ductal carcinoma in situ, can become cancerous. Below, individualbenignchanges and recommended follow-up steps are shown.

Noncancerous breast changes

Adenosis

• Small round lumps, sometimes too small to feel.
• Enlarged breast lobules (rounded projections)
• Scar-like fibrous tissue indicates sclerosing adenosis, which may be painful. Some studies find a slightly increased breast cancer risk.

Possible tests: Core needle or surgical biopsy may be needed for diagnosis.

Breast calcifications (microcalcifications):

• Calcium deposits resemble tiny white spots on mammograms
• Usually occur with aging
• May not be palpable
• Generally benign (not cancer)
• Common in women over 50

Possible tests and treatment: Another mammogram or biopsy may be needed for closer examination. Treatment is usually unnecessary.

Breast cysts

• Fluid-filled lumps
• Often in both breasts
• May cause pain just before menstruation
• Some are palpable; others too small to feel.
• Common at ages 35-50, before menopause and in women receiving menopausal hormone treatment.

Possible tests and treatment:

• Because cysts may disappear spontaneously, your doctor may prefer observation.
• Ultrasound shows whether a lump is solid or fluid-filled.
• Fine needle aspiration can remove cyst fluid.

Fat necrosis

• A round, hard, usually painless lump
• May follow breast injury, surgery or radiotherapy
• Consists of damaged fat tissue
• Surrounding skin may be red, bruised or dimpled
• A benign (noncancerous) breast condition

Possible tests and treatment:

• Because it often resembles cancer, biopsy may be needed to diagnose and remove fat necrosis.
• It usually needs no treatment.

Fibroadenoma

• Hard, round, easily movable, usually painless lumps
• Often noticed by women themselves
• Appear on mammograms as round, smooth lumps with clear edges
• The most common benign breast tumors
• Common in women under 30
• Most do not increase breast cancer risk, but heterogeneous fibroadenomas slightly increase it.

Possible tests and treatment:

• Biopsy may be needed for diagnosis.
• Under ultrasound guidance, cryoablation or minimally invasive techniques such as excisional or vacuum biopsy may remove the lump.
• Because it may disappear spontaneously, your doctor may prefer observation.

Intraductal papilloma

• Wart-like growth inside a milk duct, usually near the nipple
• May form a lump and cause pain
• May cause clear, sticky or bloody discharge
• Common at ages 35-55
• Unlike a single papilloma, multiple papillomas increase breast cancer risk

Possible tests and treatment: Biopsy may be needed for diagnosis and removal.

- Related article: Noncancerous Breast Lumps That Increase Cancer Risk