Benign Breast Disease

Young women are susceptible to a type of lump called a fibroadenoma often seen in the late teens/ early twenties. They are made up of a combination of connective tissue and active breast tissue (epithelium) and are completely benign. They can be removed or left alone once diagnosed.

Very rarely, the lump is a phyllodes tumour in which the connective tissue is found to be abnormal. The majority of phyllodes tumours are benign but they can be borderline or completely malignant.

Breast cysts are very common and are typically seen after the age of 40. They can be identified on mammograms but have characteristic features on ultrasound. Large cysts may be uncomfortable and are drained in the breast clinic. Small cysts can be safely left alone.

Some benign conditions of the breast such as atypical ductal hyperplasia and radial scars are indeterminate. That means that they may have a malignant potential in the future or they may be associated with pre-invasive breast cancer cells. They tend to be found only on mammograms and we advise that these types of lesions be thoroughly sampled either by surgery or a vacuum assisted excision with ultrasound.

Nipple discharge comprises 5-10% of all referrals to the breast clinic. 90% of nipple discharge will be benign. Many women will have physiological over-production of breast secretions. Most women with an underlying carcinoma are over 50 years of age so nipple discharge under 50 years of age is usually benign secretions. The nature of the discharge often gives the diagnosis away. Coloured discharge, which is white, green or yellow and originates from multiple ducts, is usually benign. Nipple discharge can also result from inflammation of the nipple ducts called duct ectasia and this is more frequent in smokers. Another cause of nipple discharge is a papilloma, which is a polyp within a nipple duct. A breast specialist should see all patients with a new symptom of nipple discharge as, in rare cases, this may indicate a cancerous process within the breast.

Breast pain can often be a troubling symptom and there are many causes for persistent discomfort. It is unusual for breast pain to be a symptom of breast cancer and it is often associated with fibrocystic or hormonal changes in the breast. Sometimes the pain originates from the muscles and cartilage of the chest wall.