Benign Breast Disease

What is benign breast disease?

If you feel a lump in your breast, your first thought may be that you have breast cancer. Fortunately, most breast lumps are benign, meaning they’re not cancerous.

Breasts are complex structures, filled with glands, tissue and fat. It’s relatively common to develop a breast lump, cyst or tumor in your breast. This is known as benign breast disease. While these breast conditions aren’t cancerous or life-threatening, they may increase your risk of developing breast cancer in the future.

Despite most breast conditions being noncancerous, the best way to know for sure is to contact a healthcare provider. It’s also a good idea to become familiar with the look and feel of your breasts so you’re better able to notice changes.

What are common types of benign breast disease?

There are many different types of benign breast disease. Benign breast disorders refer to any lump, cyst or other change in your breast tissue that isn’t cancerous.

Most of the following types don’t increase your cancer risk and don’t require treatment:

• Breast cysts: Up to 25% of breast lumps are fluid-filled cysts. Breast cysts can be tender and lumpy, but they don’t make you more prone to cancer. Cysts often go away without treatment.
• Fibroadenomas: These are the most common noncancerous solid breast tumors providers find in people with a vagina between the ages of 15 to 35. Fibroadenomas don’t increase cancer risk and often go away on their own.
• Fibrocystic breast changes: Fluctuating hormone levels can make breasts feel lumpy, dense and tender, especially right before menstruation. People with a vagina between the ages of 30 to 50 are more likely to experience fibrocystic breast changes, which go away without treatment.
• Hyperplasia: This condition occurs from an overgrowth of cells that line your mammary ducts or glands. A condition called usual (typical) hyperplasia slightly increases breast cancer risk, but doesn’t require surgery. If you have atypical hyperplasia, your healthcare provider may recommend surgically removing the affected breast tissue because the condition may make you more prone to breast cancer.
• Intraductal papilloma: These small, wart-like growths form inside your mammary duct near your nipple. Intraductal papilloma may cause nipple discharge. The condition most commonly affects people with a vagina between the ages of 30 to 50. Your risk of cancer goes up if you have five or more papillomas at one time. Surgery can remove these growths and reduce your cancer risk.
• Mammary duct ectasia: People who have reached menopause are more prone to mammary duct ectasia. It causes your milk ducts to swell, thicken and sometimes become blocked. Your nipple may turn inward or leak discharge. Also known as periductal mastitis, this condition doesn’t increase cancer risk. You may need antibiotics if a bacterial infection causes the inflammation and blockage. Otherwise, you don’t need treatment.
• Traumatic fat necrosis: These breast lumps form when scar tissue replaces breast tissue that’s been damaged by an injury, surgery or radiation therapy. Fat necrosis doesn't raise your cancer risk and doesn’t need treatment.
• Adenosis: This is when the lobules (milk-producing part of your breast) in your breast grow larger and contain more glands than usual.

How common is benign breast disease?

Benign breast lumps in women and people assigned female at birth (AFAB) are common. Up to half of all women will experience fibrocystic changes that cause noncancerous breast lumps at some point in their lives. Men and people assigned male at birth (AMAB) can also get benign breast disease, but it’s less common.

What are the symptoms of benign breast disease?

You may notice breast changes or a lump while doing a breast self-exam, showering or getting dressed. Sometimes, your healthcare provider detects these changes during a clinical breast exam or a mammogram. Besides a breast lump, other signs of benign breast disease include:

• Breast pain (mastalgia).
• Nipple discharge.
• Change in breast size, shape or contour.
• Inverted, creased or scaly nipple.
• Dimpled, puckered or scaly breasts.

What causes benign breast disease?

Common causes of noncancerous breast lumps include:

• Changes in breast tissue (fibrocystic breast changes).
• Breast infection (mastitis).
• Scar tissue from a breast injury.
• Hormone fluctuations, especially during menstruation, pregnancy or menopause.
• Medication use, such as hormonal contraceptives (birth control pills) and hormone replacement therapy.
• Consuming too much caffeine.

Men and people AMAB can develop enlarged, swollen breasts with lumps, a condition called gynecomastia. Gynecomastia happens due to hormone imbalance, having obesity and certain diseases or medications.

What are the risk factors for benign breast disease?

Benign breast disease can affect anyone. Your risk for benign breast disease increases if you:

• Have a family history of breast cancer or benign breast disease.
• Use hormone replacement therapy.
• Have a hormonal imbalance.

What are the complications of this condition?

Certain types of benign breast disease, such as atypical hyperplasia, make you more prone to breast cancer. Sometimes, benign breast lumps hurt or become large. Your healthcare provider may recommend surgery to remove painful or large lumps. Unfortunately, some fibroadenoma lumps come back after surgery.

How is benign breast disease diagnosed?

If you feel a lump or notice breast changes, see your healthcare provider immediately. Your provider may order one or more of these tests:

• Imaging scans, including mammogram, ultrasound or magnetic resonance imaging (MRI).
• Image-guided core needle breast biopsy, fine-needle aspiration biopsy or excisional biopsy to test cells for cancer. Excisional (or surgical) biopsy involves removing a larger piece of tissue from your breast.

How is benign breast disease managed or treated?

Most types of benign breast disease don’t require treatment. Your healthcare provider may recommend treatment if you have atypical hyperplasia or a different kind of benign breast disease that increases your future risk of breast cancer. This may include surgical excision or certain pills to decrease your risk. If you experience pain or discomfort or have an increased cancer risk, these treatments can help:

• Fine needle aspiration to drain fluid-filled cysts.
• Surgery to remove lumps
• Oral antibiotics for infections like mastitis.

Can I get benign breast disease more than once?

Yes. Benign breast lumps are fairly common and can occur many times throughout your life. Your breasts may feel lumpy or tender when hormone levels change due to menstruation or menopause. You should contact your healthcare provider anytime you feel a lump or notice a breast change.

How does pregnancy affect benign breast disease?

Changes in hormone levels during pregnancy can cause breast lumps, tenderness and nipple discharge. You’re also more likely to experience benign breast changes or develop a breast infection called mastitis while breastfeeding (chestfeeding). Breast changes during pregnancy or breastfeeding are rarely cancerous. Still, you should reach out to your healthcare provider when you notice any breast changes.

Do benign breast tumors need to be removed?

Sometimes. It depends on the results of any diagnostic tests, your risk for cancer and if the tumor is painful or large. Your healthcare provider can discuss removing a benign tumor with you.

How can I prevent benign breast disease?

You may not be able to prevent benign breast disease, but you can take steps to reduce your risk. These steps may lower your risk of some benign breast disease:

• Decreasing caffeine intake (coffee, tea, soda or chocolate, for example).
• Wearing well-fitted bras and avoiding underwire bras.
• Not smoking or quitting smoking.
• Avoiding drinking beverages containing alcohol.

These steps may lower cancer risk and help detect disease early when it’s most treatable:

• Get regular mammogram screenings.
• Perform self-breast exams to be familiar with how your breasts look and feel.
• Maintain a weight that’s healthy for you.
• Exercise regularly.
• Eat a nutritious diet.
• Drink alcoholic beverages in moderation or not at all.
• Quit smoking cigarettes or using other tobacco products.
• Reconsider the use of hormone replacement therapy.
• Switch to a non-hormonal birth control option.

What can I expect if I have benign breast disease?

Most people with benign breast disease don’t develop breast cancer. If you have a disease type that increases your cancer risk, your healthcare provider may recommend more frequent cancer screenings. Certain breast diseases can make you more prone to developing lumps. You should notify your healthcare provider anytime you notice changes in how your breasts look or feel.

Can benign breast disease turn cancerous?

Certain benign breast conditions increase your risk for cancer. If your healthcare provider diagnoses you with one of these conditions, it’s possible for a benign condition to change to cancer in the future. Your healthcare provider is the best person to discuss possible outcomes with. They can help you decide what treatment option is best based on your unique situation.

When should I call my healthcare provider?

You should call your healthcare provider if you experience:

• Newly discovered lump.
• Nipple discharge.
• Changes in the way your breast or skin looks or feels (like dimpling or other texture changes).
• Inverted nipple.
• Breast pain.

What questions should I ask my healthcare provider?

If you have benign breast disease, you may want to ask your healthcare provider:

• What’s the best treatment for me?
• Am I at risk for more breast lumps?
• How frequently should I get a mammogram or other cancer screenings?
• How can I lower my risk of breast cancer?
• Should I use a different birth control method?
• Can I use hormone replacement therapy?
• Should I look out for signs of complications?