Benign Breast Tumors & Conditions - Intraductal Papilloma
- Overview: Breast Tissue Changes
- How Are Benign Breast Conditions Detected?
- Nipple Discharge
- Lobular Carcinoma in Situ (LCIS)
- Fibrocystic Breast Condition
- Simple Cysts
- Phyllodes Tumors
- Intraductal Papillomas
- Granular Cell Tumors
- Duct Ectasia
- Fat Necrosis
- Breast Inflammation: Mastitis
- Additional Resources and References
Galactoceles are milk-filled cysts that can occur in women who are pregnant or lactating. As with other cysts, galactoceles are always non-cancerous. They often appear as smooth, moveable lumps, although they can also be hard or unmoveable. Galactoceles are treated the same way as cysts: usually by leaving them alone. If the diagnosis is uncertain or the galactocele is causing discomfort, it can be drained with a thin needle (fine needle aspiration).
Fibroadenomas are common benign breast tumors often too small to feel by hand, though occasionally, they may grow to be several inches in diameter. Fibroadenomas are made up of both glandular and stromal (connective) breast tissue and usually occur in women between 20-30 years of age. According to the American Cancer Society, African-American women are affected with fibroadenomas more often than women of other racial or ethnic groups. The tumors tend to be round and have borders that are distinct from the surrounding breast tissue, so they often feel like a marble within the breast. Some women have only one fibroadenoma while others may have multiple tumors. Fibroadenoma are usually diagnosed by fine needle aspiration or core needle biopsy.
Fibroadenomas often stop growing or even shrink on their own without any treatment. In these cases, doctors may recommend not having the tumors removed. Fibroadenoma surgery may involve removing a margin of surrounding breast tissue. The risk of surgery is that scarring could occur that could distort the shape and texture of the breast and make future physical examination and mammography more difficult to interpret. On the other hand, if fibroadenomas do not stop growing, they usually need to be surgically removed. Sometimes one or more new fibroadenomas will grow after one is removed.
Phyllodes tumors (also spelled as phylloides) are also benign breast tumors in the glandular and stroma (connective) breast tissues but are far less common than fibroadenomas. The difference between phyllodes tumors and fibroadenomas is that there is an overgrowth of the fibro-connective tissue in phyllodes tumors. Phyllodes tumors are usually benign but on very rare occasions, they may be malignant (cancerous) and could metastasize (spread).
Treatment of phyllodes tumors involves removing the mass and a one-inch margin of surrounding breast tissue. Cancerous phyllodes tumors are also surgically removed by either lumpectomy or mastectomy, but do not typically respond well to chemotherapy or radiation therapy.
Intraductal papillomas are non-cancerous wart-like growths with a branching or stalk that has grown inside the breast. A papilloma often involves the large milk ducts near the nipple, causing bloody nipple discharge. Occasionally, multiple papillomas may be found further from the nipple.
Papillomas are usually diagnosed by imaging the breast duct with a galactogram (also called ductogram) or removing a portion of the affected duct (duct excision). Typically, surgeons remove the papilloma and a segment of the duct where the papilloma is found, usually through an incision at the edge of the areola (the pigmented region surrounding the nipple).
Of the benign conditions that cause suspicious nipple discharge, approximately half are due to papillomas, and the other half are a mixture of fibrocystic conditions or duct ectasia, the widening and hardening of the duct due to age or damage (See the section on duct ectasia for more information).
Granular cell tumors are usually found in the mouth or skin but may rarely be detected in the breast. Most granular cell tumors of the breast are identified as movable, firm lumps, measuring between one-half and one inch in diameter. Doctors typically diagnose granular cell tumors by a fine needle or needle core biopsy and then surgically remove the tumors along with a surrounding margin of breast tissue. Granular cell tumors do not indicate higher risk for developing breast cancer.
Duct ectasia, widening and hardening of the duct, is characterized by a thick green or black nipple discharge, typically affecting women in their forties and fifties. The nipple and surrounding tissue may be red and tender. Duct ectasia is a benign condition but can sometimes be mistaken as cancer if a hard lump develops around the abnormal duct. Opalescent (clear) nipple discharge is often due to duct ectasia or cyst.
Often, duct ectasia does not need treatment, or improves with the application of heat or antibiotic drugs. Occasionally, the affected duct is surgically removed by an incision at the border of the areola (the pigmented region around the nipple).
Fat necrosis, a benign condition where fatty breast tissue swells or becomes tender, can occur spontaneously or as the result of an injury to the breast. When the body attempts to repair damaged breast tissue, the affected area may sometimes be replaced with firm scar tissue. Fat necrosis may be mistaken as cancer on a mammogram; however symptoms of fat necrosis usually subside within a month. Biopsy can confirm fat necrosis.
According to the American Cancer Society, some areas of fat necrosis can have a different response to injury. Instead of forming scar tissue, the fat cells die and release their contents, forming a sac-like collection of greasy fluid called an oil cyst. Oil cysts can be diagnosed by fine needle aspiration, which also serves as a treatment. While fat necrosis itself is a non-cancerous condition, its appearance can sometimes draw attention to another suspicious area of the breast that had not previously been discovered.
Mastitis, another non-cancerous condition, most commonly affects women while they are breast-feeding. Cracking of the skin around the nipple allows bacteria from the skin surface to enter the breast duct where it grows and attracts inflammatory cells. Inflammatory cells release substances to fight the infection, but also cause breast tissue swelling and increased blood flow. Breasts infected with mastitis often swell, become red in color, and feel warm to the touch. Most of the time, mastitis is treated with antibiotics. However, if a collection of pus (an abscess) from inflammatory cells and fluid results, the pus may have to be drained.
This article describes a variety of benign breast conditions and typical treatments. Women should discuss all breast concerns with their physicians. Treatments will vary depending on specific cases, family history, and other factors.
- More information on both benign and malignant nipple discharge.
- The American Cancer Society provides detailed information on benign breast conditions.
- More information on high risk factors for breast cancer.