Detection of Benign Breast Conditions |
Benign Breast Tumors |
Breast Inflammation or Infection |
The majority of breast tumors detected by mammography are non-cancerous, or benign. Benign breast tumors include fibroadenomas, granular cell tumors, intraductal papillomas, and phyllodes tumors. A condition known as fat necrosis is frequently mistaken for a breast tumor upon initial examination, and is therefore also discussed in this section.
Fibroadenomas appear as marble-like lumps in the breast that can range in size from microscopic to several inches in diameter. They are composed of both glandular and connective tissue. These tumors may appear singly in some women, while other women develop multiple fibroadenomas. Although these benign tumors may appear at any age, they are more common in women in their twenties and thirties, and occur in African-American women more than in any other racial or ethnic group.
Fibroadenomas can be diagnosed by fine needle aspiration or core needle biopsy.
If fibroadenomas continue to grow or are large enough to distort the shape of a woman's breast, a physician may recommend surgical removal. In some instances, particularly in middle aged or older women, these tumors will stop growing or begin to shrink spontaneously, without treatment. When this happens, surgical removal may not be necessary, especially if a biopsy has been performed to rule out the presence of cancer. It is particularly important that women who do not undergo surgical
removal of fibroadenomas have regular breast examinations to monitor the rate of growth of the tumors.
The presence of fibroadenomas is not associated with an increased risk of developing breast cancer.
Granular cell tumors are uncommon masses that appear in the breast as movable, firm lumps that measure about ½ to 1 inch in diameter. These tumors occur more frequently in the skin or mouth than in the breast, although they are rare in any location. Granular cell tumors occur more frequently in African-American women than in any other racial or ethnic group and can be diagnosed by fine needle aspiration or core needle biopsy. The curative treatment for granular cell tumors is
surgical removal of the mass along with a margin of normal tissue.
Granular cell tumors are not associated with an increased risk of developing breast cancer.
Intraductal papillomas are small, wart-like, non-cancerous growths in the breast ducts that sometimes cause a bloody nipple discharge. These tumors are composed of glandular tissue, fibrous tissue, and blood vessels and are most often found in women 45 to 50 years of age. A core needle biopsy can be used to establish a diagnosis of intraductal papilloma if the tumor is large enough to be detected by touch.
Intraductal papillomas are treated by removing the tumor and a segment of the duct it is found in, usually through an incision at the edge of the areola (the dark area of skin surrounding the nipple).
If a woman has multiple intraductal papillomas, the risk of developing breast cancer is slightly increased.
Phyllodes tumor is a very rare type of tumor that forms in the connective tissue of the breast and is usually benign, although there are rare instances of malignancy. On physical exam or mammography, phyllodes tumor is indistinguishable from a benign fibroadenoma and it is essential to have these tumors removed for examination under the microscope.
In the benign form, a phyllodes tumor is treated by surgically removing the tumor along with a small margin of normal breast tissue. In the malignant form, a phyllodes tumor is treated by surgically removing the tumor along with a wide margin of normal tissue, or by mastectomy. Phyllodes tumors are not responsive to hormonal therapy and are less responsive than other breast cancers to chemotherapy or radiation. Less than 10 women a year die from this uncommon form of breast cancer.
Fat necrosis is a benign condition defined as the death of fat cells, usually following injury, which causes scar tissue to form at the site of the injury. Fat necrosis is more common in obese women with large breasts. This condition can cause a breast lump, pulling of the skin, or skin changes that can be confused with a breast tumor or breast cancer. Most physicians suggest a needle biopsy of the suspicious area to rule out cancer, although surgical excision is sometimes required
for a definitive diagnosis.
Sometimes, rather than forming scar tissue, an area of fat necrosis will form a sac-like collection of greasy fluid called an oil cyst. This type of cyst is formed when fat cells die and release their contents. Oil cysts can be diagnosed by fine needle aspiration, which also serves as a treatment.