If you have ever discovered one or more lumps (a change in the
density of an area of the breast), you were probably concerned. Such
lumps often are caused by changes that can occur with the natural
menstrual cycle of a woman's body.
Generalized breast lumpiness is one common type of benign (not
cancerous) breast change. Benign breast conditions also include several
types of distinct, solitary (single) lumps. Such lumps, which can
appear at any time, may be large or small, soft or rubbery,
fluid-filled or solid.
Generalized breast lumpiness is known by several names, including
fibrocystic changes, fibrocystic disease, and benign breast disease.
Such lumpiness, which is sometimes described as "ropy" or "granular,"
can often be felt in the area around the nipple and areola and in the
upper outer part of the breast. During pregnancy, the milk-producing
glands become swollen and the breasts may feel lumpier than usual. It
can be difficult for a woman to examine her breasts when she is
pregnant, but she should continue to do so; although very uncommon,
breast cancer has been diagnosed during pregnancy. Lumpiness may become
more obvious as a woman approaches middle age and the milk-producing
glandular tissue of her breasts increasingly gives way to soft, fatty
tissue.
Most often, women who find lumps in their breasts are between the
ages of 30 and 50. The same hormones that control the menstrual cycle -
estrogen and progesterone-also can cause the breasts to become lumpy or
"fibrocystic." The incidence tends to decrease with menopause.
Cysts are fluid-filled sacs and they often enlarge and become tender
and painful just before the menstrual period. They are usually found in
both breasts. Some cysts are so small they cannot be felt; rarely,
cysts may be several inches across. Cysts are usually treated by
observation or by fine needle aspiration. They show up clearly on
ultrasound. The pain and tenderness usually subside after your period.
The pathologist's diagnosis of the removed tissue enables your
doctor to estimate what risk, if any, you have of developing a cancer.
A woman whose biopsy shows one of the breast changes listed below is
at no greater risk for developing invasive breast cancer as compared
with a woman who has no known significant breast abnormality:
- Apocrine metaplasia
- Duct ectasia
- Fibroadenoma
- Fibrocystic change
- Hyperplasia, mild
- Mastitis (inflammation)
A woman whose biopsy shows one of the changes listed below has a
slightly increased risk (1.5 to 2 times) for developing breast cancer
as compared with a woman who has no known significant breast
abnormality:
- Sclerosing adenosis
- Hyperplasia, moderate or severe (florid)
- Papilloma
A woman whose biopsy shows the change listed below has a moderately
increased risk (5 times) for developing breast cancer as compared with
a woman who has no known significant breast abnormality:
- Atypical hyperplasia of ductal or lobular type
The information provided here is only to educate women about
fibrocystic changes and other benign conditions of the breast. If you
discover any lumps in your breasts, consult your physician. Use this
information to help you understand what you may be experiencing and to
assist you in knowing what questions to ask your doctor.
