Though technically a Stage 0 cancer, lobular carcinoma
in situ (LCIS, also called lobular neoplasia) is not usually classified as
a cancer. Instead, LCIS is considered a pre-cancerous condition. It signals a significantly increased risk of cancer anywhere
in the breast. LCIS begins in the lobules (the milk-producing glands of the breast) but does
not penetrate the lobular walls. Many times, physicians encounter LCIS serendipitously
(by chance) on breast biopsy while investigating an area of concern.
While the microscopic features of LCIS are
abnormal and are similar to malignancy, LCIS does not behave as a cancer (and therefore is
not treated as a cancer). However, a mastectomy (breast removal) may be occasionally
performed if LCIS patients have a strong family history of breast cancer. More likely,
LCIS patients are closely monitored with physician performed clinical breast examinations and mammograms.
Some LCIS patients are eligible to take
the drug tamoxifen to help prevent breast cancer. In 1998, the Food and Drug
Administration approved the drug tamoxifen to prevent breast cancer in
high risk patients. Tamoxifen is an "anti-estrogen"
and works by binding to estrogen receptors. Research has shown that tamoxifen can reduce breast cancer risk
in some women.
Click here to learn more about tamoxifen.
Fibrocystic Breast Condition
Fibrocystic breast condition (sometimes referred
to as fibrocystic disease, fibrocystic change, cystic disease, chronic cystic mastitis or mammary dysphasia)
is not a disease, but rather, it describes a variety of changes in the glandular and
stromal tissues of the breast. Symptoms of fibrocystic breasts in the breast include cysts
(accumulated packets of fluid), fibrosis (formation of scar-like connective tissue), lumpiness,
areas of thickening, tenderness, or breast pain. Though sometimes painful, fibrocystic
breast condition is not cancer. However, fibrocystic breasts can sometimes make breast cancer
more difficult to detect with mammography. Therefore, ultrasound
may be necessary in some cases if a breast abnormality is detected in a woman with fibrocystic breasts. According to the American Cancer Society, fibrocystic breasts affect at least
half of all women at some point in their lives. Fibrocystic changes are the most common
cause of breast lumps in women between 30 and 50 years old.
Symptoms of fibrocystic changes in the breast include:
- cysts (packets of fluid)
- fibrosis (formation of scar-like connective tissue)
- lumpiness
- areas of thickening
- tenderness
- pain
Women who suffer from fibrocystic
changes typically have cyclic breast pain since the cause of the condition is related to
the way breast tissue responds to monthly changes in the bodys levels of the
hormones estrogen and progesterone. During each menstrual cycle, breast tissue sometimes
swells because hormonal stimulation causes the breasts milk glands and ducts to
enlarge, and in turn, the breasts retain water. During menstruation, breasts may feel
swollen, painful, tender, or lumpy. Breast swelling usually ends when menstruation is
over. Symptoms of fibrocystic change usually stop after menopause but may be prolonged if
a woman undergoes hormone replacement
therapy.
Fibrocystic breast condition is often first
noticed by the woman and further investigated with clinical
breast exam, mammogram, or in some instances, biopsy.
Fibrocystic changes are typically discovered in both breasts in the upper outer quadrant
and the underside of the breast where a ridge may sometimes be felt.
Often, physicians may recommend that the symptoms of fibrocystic breasts be treated
with self-care. Depending on the individual situation, several measures may be recommended
to relieve the symptoms of fibrocystic breasts. The following chart summarizes treatment options for fibrocystic breasts:
Treatment of Fibrocystic Breasts May Include: |
- Wearing extra support bras
- Avoiding caffeine (controversial recommendation)
- Taking oral contraceptives (controversial recommendation)
- Taking over-the-counter medications such as aspirin, acetaminophen or Motrin
- Maintaining a low fat diet rich in fruits, vegetables, and grains
- Applying heat to the breasts
- Reducing salt intake
- Taking diuretics
- Taking vitamin E, vitamin B6, niacin, or other vitamins
- Taking prescription drugs such as bromocriptine or danazol
- Surgically removing breast lumps
|
Occasionally, doctors may surgically
remove non-cancerous breast lumps. For women with painful cysts, draining the fluid
by fine needle aspiration biopsy may help relieve
symptoms of fibrocystic breasts.
Click here to learn more about fibrocystic breasts.
Simple Cysts
Simple breast cysts are accumulations of fluid in the breast. Simple cysts are non-cancerous and
typically present themselves in the form of smooth, rounded lumps. They are often moveable within the
breast, although they can also appear deep within the breast tissue. While the cause of simple cysts
is unknown, experts do know that such cysts respond to the body's hormone levels. For instance, simple
cysts may appear a week or two before a woman's menstrual period and disappear afterwards. These cysts
are most common in pre-menopausal women, especially when they are approaching menopause. However, simple
cysts can occur in women after menopause as well, especially if they are taking hormone replacement
therapy (HRT). Existing simple cysts may also persist or enlarge in women on HRT. Some research
has suggested that caffeine can cause simple breast cysts, although this is controversial among
members of the medical community. Nevertheless, some women find that reducing caffeine
consumption decreases breast discomfort.
Most women only develop one or two simple cysts at a time, but in some cases, multiple simple cysts
may appear throughout the breast. These cysts are usually confirmed with mammography and
ultrasound (sonogram). In particular, ultrasound is excellent at quickly identifying whether a
breast abnormality is in fact a simple cyst or a solid mass. After the abnormality is found to
be a simple cyst with ultrasound, it is usually left alone unless:
- The diagnosis is uncertain. Most simple cysts are well-defined, have distinct borders, and ultrasound
signals are able to easily pass through them. If radiologists detect an area with fluid that does not
meet the criteria of a simple cyst, they may term the area "a complex cyst." Complex cysts can be
cancerous because they are actually not cysts but tumors that have necrosed, or bled into themselves.
- The simple cyst is causing discomfort. In some instances, simple cysts can be painful. Draining the cysts with a thin
needle (fine needle aspiration) collapses them and reduces discomfort. Some radiologists inject air into the area
after drainage to help minimize the chances that the cyst will return.
When cysts are drained, the fluid is usually discarded unless it is bloody or looks suspicious. In these cases, it
is sent to a pathology laboratory for analysis under a microscope. Normal cystic fluid can be a number of colors
including yellow, brown, green, black, amber, or milky.
CONTINUED
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