Breast conditions other than breast cancer

The vast majority of breast changes are not breast cancer. If a woman finds a lump or another change in her breast or nipple, it may be caused by one of the conditions described below. Even so, you should always see your doctor if you notice any change in your breasts.

Breast x-rays (mammograms) often pick up conditions other than breast cancer. Some of these are harmless and need no treatment. Others are not cancerous themselves but might indicate an increased risk of developing breast cancer in the future.

Hormonal changes#

Hormones produced by glands in the body make a woman’s breasts feel different at various times during her menstrual cycle. These changes can cause swollen, painful or tender breasts at different points in the cycle. They are not a sign of breast cancer and usually do not need treatment, although treatments for hormonal breast pain are available from your doctor if needed.

Women who have been through menopause and are not taking hormone replacement therapy, or who have had their ovaries removed, no longer have breast changes due to hormonal activity. It may be useful to keep a record of breast changes over a couple of months before menstruating, to see whether there is any pattern.

Cysts#

A cyst is a fluid-filled sac. Fluid is produced and absorbed by the breast as part of the usual cycle of hormonal breast changes. We don’t know why some women are more prone to breast cysts than others, but they are common in women aged 35 to 50 and in women taking hormone replacement therapy.

Simple cysts are not cancer and do not turn into cancer. However, in rare cases a cyst may have a cancer growing within it or close to it. These changes can be seen on an ultrasound or found after a cyst is aspirated (drained).

Many women have one or more cysts without knowing it, and they do not usually need treatment. Some women first notice a cyst as a painful lump and may choose to have it drained if it is painful or troublesome. This is done by inserting a fine needle into the cyst to draw out the fluid, and is usually a simple and fairly painless procedure.

Fibroadenomas#

A fibroadenoma is a smooth, firm breast lump made up of fibrous and glandular tissue. We do not know the cause of fibroadenomas, but they are not cancer and rarely change into breast cancer. They are more common in younger women and may become tender in the days before a period or grow bigger during pregnancy.

Women have a choice about whether to have a fibroadenoma removed. If it is monitored and continues to enlarge, it should be removed. Most often, younger women or those with smaller fibroadenomas will not have them taken out. The operation to remove a fibroadenoma is relatively simple and a general anaesthetic is usually required.

Radial scar#

This is a star-shaped abnormality in the breast tissue. No one knows why radial scars form, but they are thought to be benign (non-cancerous) changes caused by normal ageing. A small tissue sample needs to be taken, because some radial scars contain small cancers or show pre-cancer changes. In some cases the sample can be removed with a needle instead of during an operation.

Microcalcifications#

Microcalcifications are spots of calcium salts that show up on a mammogram as white spots. They can be scattered throughout the breast tissue or clustered together. Most are of no concern, and common causes include normal ageing or benign cysts.

Sometimes calcification can indicate early breast cancer, so you may need further x-rays or other tests. Microcalcifications can flag the presence of ductal carcinoma in situ (DCIS).

Ductal carcinoma in situ (DCIS)#

In DCIS, the cells lining the milk ducts have turned cancerous. This means you are at high risk of developing an invasive breast cancer – one that spreads through the breast tissue – if the DCIS is not treated. The DCIS areas in the breast need to be surgically removed. In most cases DCIS is completely curable, but some increased risk remains even after the area has been removed, so you will need regular care after your treatment.

Atypical ductal hyperplasia (ADH)#

Atypical ductal hyperplasia means that the cells lining the milk ducts are growing in an unusual way. To confirm the diagnosis, a small tissue sample is taken from the breast and examined under a microscope. ADH is harmless for most women. For others, it might mean an increased risk of developing cancer in that particular breast at some time in the future. In this case, breast screening every year is recommended.

Lobular carcinoma in situ (LCIS)#

This is a benign condition, even though the word ‘carcinoma’ usually means cancer. LCIS is a growth change in the cells lining the very ends, or lobules, of the milk ducts. It doesn’t show up on x-ray and is usually discovered during the examination of a small tissue sample removed for another reason.

LCIS is not cancerous, but it means you are at an increased risk of developing breast cancer in the future. Women with LCIS should discuss it with their doctor or a breast specialist, and regular examination is recommended.

Key points#

• Some of these conditions are harmless and don’t need any treatment.
• Others aren’t cancerous themselves, but might indicate an increased risk of developing breast cancer in the future.
• Treatments are available for hormonal breast pain from your doctor, if needed.
• Many women have a cyst or a number of cysts without knowing it, and they do not usually require treatment.
• We do not know the cause of fibroadenomas, but they are not cancer and rarely change into breast cancer.

Where to get help#