At some point in their lives, many women will experience a benign breast condition, a category that includes unusual growths or other changes in breast tissue. As the name implies, benign breast conditions are noncancerous. However, any change in the breasts could be a sign of cancer, so it’s important to see a doctor if you notice a difference in your breasts.
The most common signs of a benign breast condition, according to Emily Turzanski, DO, a breast surgeon with Sentara Breast Surgery Specialists in Harrisonburg, include the following:
•Unusual growths or lumps
•Pain or swelling
•Thick, dry or red skin
•Itchy or warm skin
Many of these conditions don’t require treatment, and it's normal to experience one or more of them over the course of your life, says Lynn Dengel, MD, MSc, a surgical oncologist at Virginia Breast Care in Charlottesville. However, if you experience discomfort or pain, or simply want a benign lump or cyst removed, a breast surgeon can help.
Types of Benign Breast Conditions
Some of the most common types of benign breast conditions include the following.
Breast cysts, which are fluid-filled sacs typically found in women of childbearing age or in the years leading up to menopause, may feel round and rubbery. They often appear suddenly and may go away on their own. Although cysts may not require any treatment, a doctor may use a thin needle to drain (aspirate) a cyst if it is large or painful.
Fibroadenomas of the breast are round, rubbery-feeling lumps. They can occur at any age but are most common in women in their 20s and 30s. Hormonal changes, including those that occur during pregnancy, can cause fibroadenomas to grow over time—or they may shrink or disappear completely.
A breast surgeon may recommend a watch-and-wait approach with fibroadenomas that don’t cause pain or produce uncomfortable symptoms. If a fibroadenoma increases in size or is painful, a breast surgeon may recommend a procedure to remove the affected breast tissue.
Clogged milk ducts
Breastfeeding mothers can get clogged or plugged milk ducts that prevent the flow of breast milk. Clogged ducts present as hard, often painful lumps. Women approaching menopause may also develop a form of clogged ducts called duct ectasia. Treatment typically involves the use of warm compresses or antibiotics. If symptoms don’t improve, in some cases a breast surgeon may remove the affected duct.
Mastitis is an inflammation of the breast tissue that primarily affects breastfeeding women. Symptoms include swelling, pain, warmth and redness. Mastitis also can result in an infection, accompanied by fever and chills. The condition is typically treated with antibiotics, pain relievers, massage and cool compresses. If an abscess forms, it can be drained as an outpatient procedure. Lactation consultants also can help provide support and techniques for mothers who are struggling with breastfeeding while coping with mastitis.
Mastitis also can affect menopausal women who aren’t breastfeeding—especially those who smoke or have diabetes. Compresses, good hydration and antibiotics may be used to treat mastitis at this stage of life.
Diagnosing and Treating Benign Breast Conditions
Many women discover benign breast conditions while examining their own breasts, notes Dr. Turzanski.
“Women may find a lump or change in their breasts, or their primary care doctor or OB/GYN may find a lump during an annual exam,” she says. “Cysts, fibroadenomas and clogged milk ducts can all feel like a lump in the breast.”
Breast surgeons can diagnose benign breast conditions with a core needle biopsy, adds Dr. Dengel. During this procedure, the doctor uses ultrasound imaging to guide the placement of a hollow tube that is used to extract a sample of breast tissue for evaluation. Due to the advancement of breast care in recent years, many diagnostics and treatments now can be performed in a doctor’s office.
“We can perform many more tests in our office today, without a trip to the operating room,” says Dr. Dengel. “If I feel a mass, I can put my ultrasound probe right on the mass and evaluate it.”
Seeing a Breast Surgeon
Breast surgeons like Dr. Turzanski and Dr. Dengel specialize in treating noncancerous breast conditions, as well as breast cancer. Primary care providers and OB/GYNs manage many breast conditions in their offices, but they may refer certain patients to a breast surgeon for additional assessment or treatment.
Patients over age 40 who receive regular mammograms may see a breast surgeon if they require a second opinion or need a breast ultrasound. Younger patients not receiving regular mammograms due to their age may see a breast specialist for ultrasound imaging and diagnosis. Patients also may see a breast surgeon if they’re experiencing anxiety about their symptoms or want a second opinion.
“These benign conditions still can provoke anxiety for many women,” says Dr. Dengel. “They may want reassurance or want us to remove the lump or aspirate it to make it go away.”
Each patient’s case is unique, notes Dr. Turzanski.
“Plenty of people will have a benign breast lump removed for a number of reasons, including anxiety or a family history of breast cancer,” she says. “Some people may want a breast lump removed so it doesn’t mask other findings on a mammogram or breast exam.”
Know Your Breasts
Both physicians emphasize the need for women to be aware of any changes in their breasts. The best way to do this is by performing regular monthly breast self-examinations at home. Regular examinations will help you notice changes in your breasts.
In addition, all women should get an annual breast exam from their primary care provider or OB/GYN. These exams should start once a woman reaches puberty and continue throughout her life.
“Although we’re talking here about noncancerous breast conditions, starting around age 40 most women also should have an annual mammogram to screen for cancer,” concludes Dr. Turzanski. “Younger women with risk factors for breast cancer should talk to their physician about when they should begin having mammograms.”
When to See a Doctor
Normal hormone fluctuations affect breast tissue and can cause breast tenderness, pain and other changes, but a doctor should look at any differences that last longer than two weeks—some signs of a benign breast condition are also similar to signs of breast cancer. See your family doctor or OB/GYN if you notice a lump that:
•Lasts longer than two weeks
•Doesn’t go away after your menstrual cycle
•Is accompanied by a fever or infection
Screening Mammogram versus Breast Ultrasound
A mammogram is an X-ray of your entire breast. All women over the age of 40 should get an annual screening mammogram to look for signs of breast cancer.
A breast ultrasound uses sound waves to examine a specific part of the breast. A breast ultrasound is typically used either to evaluate findings from a mammogram or assess a symptom such as discomfort or a lump.
Sentara Breast Surgeons in Charlottesville and Harrisonburg
Virginia Breast Care
595 Martha Jefferson Drive, Suite 320
Charlottesville, VA 22911
Sentara Breast Surgery Specialists
2275 Health Campus Drive
Harrisonburg, VA 22801