Benign Breast Lumps
An understanding of benign breast disorders is essential to help relieve unnecessary apprehensions.
Benign breast problems are of several types; but in general, they are classified according to the predominant symptom as - lumps, pain, nipple problems, and infection of the breast. The majority of breast lumps are benign.. Fibroadenomas, cysts, and the areas of localized nodularity are the usual causes of a benign breast lump.
Triple Testing, a combination of clinical examination, imaging, and nonsurgical biopsy, is used to diagnose the cause of clinical findings such as an asymmetrical thickening or a discrete palpable mass.
Fibroadenomas
Fibroadenomas are harmless lumps of glandular and fibrous tissue and found in up to 9% of the female population. They are most common in young women. Breasts are made up of lobules (milk-producing glands) and ducts (tubes that carry milk to the nipple), and are surrounded by glandular, fibrous and fatty tissue. Typically, a fibroadenoma develops from a lobule and later the glandular tissue and ducts grow over the lobule, forming a solid lump. Fibroadenomas in breasts may feel firm and rubbery and will have a smooth texture. This condition is characterized by lumps that move around when pressed, also referred to as "a breast mouse". They are hormone sensitive and will become more tender during the latter part of the menstrual cycle or during pregnancy. One third of fibroadenomas will grow. Fibroadenomas should be considered for removal if they are larger than 3 cm, painful, increasing in size or showing any abnormal features on imaging or biopsy.
Papillomas
An intraductal papilloma is a tiny polyp like growth that sometimes grows within the breast tissue. They can occur as solitary lumps or multiple groups of lumps.
They are often only seen on ultrasound but can be the cause of a breast lump or nipple discharge.
Treatment is normally surgical excision to treat the symptoms and to exclude associated abnormalities including small early cancers. A small incision is usually made along the edge of the areola and the papilloma is removed. The resulting scar will blend into the areola and can be nearly undetectable.
Cysts
Cysts are fluid entrapments in the breast tissue, which are common in women in the age group of 35-50. They usually cease with menopause, but are common in women taking Hormone Replacement Therapy (HRT).
Less common benign breast lumps:
Fat Necrosis
Fat necrosis occurs due to trauma (sudden injury) or a specific injury to the breast. Breasts are made up of lobules, ducts, glandular, fibrous, and fatty tissue. The damaged area of breast tissue can lead to a lump formation known as fat necrosis. Necrosis refers to cell death. The damage to the fatty breast tissue commonly occurs following breast surgery, including breast reduction and breast reconstruction, or radiotherapy to the breast. It can also occur after trauma to the breast such as in a car accident.
Lymphocytic Lobulitis (also known as Diabetic Mastopathy) and Pseudo-Angiomatous Stromal Hyperplasia (PASH) are other unusual causes of benign breast lumps.
Surgical Procedures for Benign Lumps or for Diagnosis:
Excision Biopsy:
This procedure is done to remove a lump from the breast which is either known to be benign or for diagnostic purposes. It is usually done as a day stay procedure and can be done under local or general anaesthetic although general is more common. If the lesion is not palpable, it will need to be localised before surgery either with a wire or with an marker injection under ultrasound guidance. This will either be done the day before or on the morning of surgery. (please see information on day surgery)
