Most benign breast changes do not increase a woman’s risk
for getting cancer.
Over her lifetime, a woman can encounter a broad variety of
breast conditions. These include normal changes that occur
during the menstrual cycle as well as several types of benign
lumps. What they have in common is that they are not cancer.
Even for breast lumps that require a biopsy, some 90 percent
prove to be benign.
Each breast has 15 to 20 sections, called lobes, each with many
small lobules. The lobules end in dozens of tiny bulbs that can
produce milk. Lobes, lobules, and bulbs are all linked to thin
tubes called ducts. These ducts lead to the nipple, which is
centered in a dark area of skin called the areola. The spaces
between the lobules and ducts are filled with fat. There are no
muscles in the breast, but muscles lie under each breast and
cover the ribs.
These normal features can sometimes make the breasts feel
lumpy, especially in women who are thin or who have small
breasts. In addition, from the time a girl begins to menstruate,
her breasts undergo regular changes each month around the time
of menses. Eventually, about half of all women will experience
symptoms such as lumps, pain, or nipple discharge. Generally
these disappear with menopause.
Some studies show that the chances of developing benign breast
changes are higher for a woman who has never had children,
has irregular menstrual cycles, or has a family history of breast
cancer. Benign breast conditions are less common among women
who take birth control pills or who are overweight. Because
they generally involve the glandular tissues of the breast, benign
breast conditions are more of a problem for women of child-
bearing age, who have more glandular breasts.
TYPES OF BENIGN BREAST CHANGES
Generalized Breast ChangesGenerlized breast lumpiness
is known by several names,
including fibrocystic breast changes and benign breast changes.
Such lumpiness, which is sometimes described as “ropy” or
“granular,” can often be felt in the area around the nipple and
areola and in the upper-outer part of the breast. Such lumpiness
many become more obvious as a woman approaches middle
age and the milk-producing glandular tissue of her breasts
increasingly gives way to soft, fatty tissue. Unless she is taking
replacement hormones, this type of lumpiness generally goes
away after menopause.
The menstrual cycle also brings cyclic breast changes. Many
women experience swelling, tenderness, and pain before and
sometimes during their periods. At the same time, one or more
lumps or a feeling of increased lumpiness many develop because
of extra fluid collecting in the breast tissue. These lumps normally
go away by the end of the period.
During pregnancy, the milk-producing glands become swollen
and the breasts may feel lumpier than usual. Although very
uncommon, breast cancer has been diagnosed during pregnancy.
If you have any questions about how your breasts feel or look,
talk to your doctor.
Solitary Lumps Benign breast conditions also include several types of distinct,
solitary lumps. Such lumps, which can appear at any time, may be
large or small, soft or rubbery, fluid-filled or solid.
Fibroadenomas are solid and round benign tumors that are
made up of both structural (fibro) and glandular (adenoma)
tissues. Usually, these lumps are painless and found by the
woman herself. They feel rubbery and can easily be moved
around. Fibroadenomas are the most common type of tumors
in woman in their late teens and early twenties, and they occur
twice as often in African-American women as in other American
women. Fibroadenomas have a typically benign appearance on
mammography (smooth, round masses with a clearly defined
edge), and they can sometimes be diagnosed with fine needle
aspiration. Although fibroadenomas do not become malignant,
they can enlarge with pregnancy and breast-feeding. Most
surgeons believe that it is a good idea to remove fibroadenomas
to make sure they are benign.
Cysts are fluid-filled sacs. They occur most often in women ages
35-50, and they often enlarge and become tender and painful
just before the menstrual period. They are usually found in both
breasts. Some cysts are so small they cannot be felt; rarely,
cysts may be several inches across. Cysts are usually treated by
observation or by fine needle aspiration. They show up clearly
on ultrasound. Cysts are so rarely associated with cancer that the
fluid removed from a cyst is not usually tested unless it is bloody
or the woman is older than 55 years of age.
Fat necrosis is the name given to painless, round, and firm
lumps formed by damaged and disintegrating fatty tissues. This
condition typically occurs on obese women with very large
breasts. It often develops in response to a bruise or blow to the
breast, even though the woman may not remember the specific
injury. Sometimes the skin around the lumps looks red or bruised.
Fat necrosis can easily be mistaken for cancer, so such lumps are
removed in a surgical biopsy.
Nipple Discharge
Nipple discharge accompanies some benign breast conditions.
Since the breast is a gland, secretions from the nipple of a mature
woman are not unusual, nor even necessarily a sign of disease.
For example, small amounts of discharge commonly occur in
women taking birth control pills or certain other medications,
including sedatives and tranquilizers. If the discharge is being
caused by a disease, the disease is more likely to be benign than
cancerous.
Nipple discharges come in a variety of colors and textures. A
milky discharge can be traced to many causes, including thyroid
malfunction and oral contraceptives or other drugs. Women
with generalized breast lumpiness may have a sticky discharge
that is brown or green. Bloody discharge always needs further
evaluation.
The doctor will take a sample of the discharge and send it to a
laboratory to be analyzed. Benign sticky discharges are treated
chiefly by keeping the nipple clean. A discharge caused by
infection may require antibiotics.
One of the most common sources of a bloody or sticky discharge
is an intraductal papilloma, a small, wartlike growth that projects
into breast ducts near the nipple. Any slight bump or bruise
in the area of the nipple can cause the papilloma to bleed.
Single (solitary) intraductal papillomas usually affect women
nearing menopause. If the discharge becomes bothersome, the
diseased duct can be removed surgically without damaging the
appearance of the breast. Multiple intraductal papillomas, in
contrast, are more common in younger women. They often occur
in both breasts and are more likely to be associated with a lump
than with nipple discharge. Multiple intraductal papillomas, or
any papillomas associated with a lump, need to be removed.
CHIDAMBARAM HOSPITAL
चिदंबरम अस्पताल,
ചിദംബരം ഹോസ്പിറ്റൽ
சிதம்பரம் மருத்துவமனை,
திசையன்விளை.627657
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Dr.M.I. கிறிஸ்டோபர் சாமுவேல் MBBS,MS.,FIAGES.,லேப்ராஸ்கோப்பி அறுவை சிகிச்சை நிபுணர்.,
DR.அலெக்ஸ் J கிறிஸ்டோபர் MBBS,MS,MCH.,(PAEDIATRIC SURGEON),லேப்ராஸ்கோப்பி அறுவை சிகிச்சை நிபுணர்.,
DR.அருண் G கிறிஸ்டோபர் MBBS,MD(Anaesthesia)மயக்க மருந்து நிபுணர்,Pain Management., Dip.Diab., சர்க்கரை வியாதி மருத்துவர்.,
PT.அந்தோணி றீகன் B.P.T
(பிசியோதெரபி நிபுணர்)MCSE,COPA,D.Pharm.,
