A benign breast condition is any non-cancerous breast abnormality.

According to the American Cancer Society, when breast tissue is examined under a microscope some type of abnormality is common in nine out of every ten women. Though not life-threatening, benign conditions may cause pain or discomfort for some patients. Some (not all benign conditions can signal an increased ris! for breast cancer. The most common benign breast conditions include fibrocystic breast condition, benign breast tumors, and breast inflammation. "epending on the type of benign breast condition and the patient#s medical situation, treatment may or may not be necessary. Main menu: $verview% &reast Tissue Changes 'ow Are &enign &reast Conditions "etected( )ipple "ischarge *obular Carcinoma in Situ (*C+S ,ibrocystic &reast Condition Cysts -alactoceles ,ibroadenomas .hyllodes Tumors +ntraductal .apillomas -ranular Cell Tumors "uct /ctasia ,at )ecrosis &reast +nflammation% 0astitis Conclusion Additional 1esources and 1eferences

Overview: Breast Tissue Changes The breast is composed of two main types of tissues% glandular tissues and stromal (supporting tissues. The glandular tissues house the mil!-producing lobules and the ducts (the mil! passages . The stromal tissues include fatty and fibrous connective tissue. Any changes in the glandular or stromal areas may cause symptoms of benign breast conditions. Some women experience changes to their breast tissue over their lifetime. These changes can include an increase in the number of breast cells (hyperplasia or the emergence of atypical breast cells (atypical hyperplasia . +n some instances, a portion of breast tissue that exhibits abnormal characteristics can eventually develop into a cancerous tumor. That is why physicians carefully monitor patients with abnormal breast cells, to ensure that if cancer develops at a later date, it is detected and treated early. Some patients with atypical hyperplasia may also be recommended to ta!e the drug tamoxifen to help prevent breast cancer. 2hile the appearance of atypical hyperplasia increases the ris! of breast cancer, not all women with abnormal breast cells go on to develop breast cancer. The following chart summari3es the typical progression of breast tissue from 4normal4 to 4cancer%4

Courtesy of the American Medical Association.

2hile many cases of breast cancer arise from the above se5uence some breast tumors may s!ip one or more intermediate steps (for example, cells may proceed from 4normal4 directly to 4carcinoma in situ4 . +n general, anything farther along than atypical hyperplasia is usually classified as a cancer. Abnormalities beginning with ductal carcinoma in situ ("C+S , usually re5uire treatment as cancers. The treatment of benign breast conditions varies depending on a number of factors including the exact diagnosis, potential for developing breast cancer, and a woman6s discomfort.How Are Benign Breast Conditions Detected? &enign breast lumps are often first detected by physicians during clinical breast examination, routine mammogram or by patients practicing breast self-examination (&S/ . ,ocal pain (pain confined to one spot in the breast or nipple discharge (other than mil! may also alert a woman to have her condition chec!ed by a doctor. &enign breast lumps are usually confirmed by imaging tests (mammogram, ultrasound7sonogram , observing the lump over a period of time, or doing fine needle aspiration biopsy (,)A& , core needle biopsy (C)& or surgical biopsy. Nipple Discharge

)ipple discharge, fluid coming from the nipple(s , is the third most common breast complaint for which women see! medical attention, after lumps and breast pain. The ma8ority of nipple discharges are associated with noncancerous changes in the breast such as hormonal imbalances or papillomas (see section below on intraductal papilloma for more information . 'owever, because a small percentage of nipple discharges can indicate breast7nipple cancer, any persistent discharge from the nipple(s should be evaluated by a physician. 9p to :;< of women may experience spontaneous mil!y, opalescent, or clear fluid nipple discharge. "uring breast self-exam, fluid may normally be expressed from the breasts of =;< to >;< of Caucasian (2hite and African-American women and ?;< of Asian-American women. 9sually, a discharge that is clear, mil!y, yellow, or green, and is noted from both nipples, is not associated with breast cancer. &loody or watery nipple discharge, especially if limited to one side and7or a single breast duct, is considered abnormal@ however, only around A;< of abnormal discharges are found to be cancerous. )ipple discharge may be a concern if it is% &loody or watery (serous with a red, pin!, or brown color Stic!y and clear in color or brown to blac! in color (opalescent Appears spontaneously without s5uee3ing the nipple .ersistent $n one side only (unilateral A fluid other than breast mil!

2omen should report persistent nipple discharge to their doctors for analysis. To examine nipple discharge, a small amount of the fluid is placed on glass slides under a microscope to determine if cancer cells are present. Lo ular Carcinoma in !itu "LC#!$ Though technically a Stage ; cancer, lobular carcinoma in situ (*C+S, also called lobular neoplasia is not usually classified as a cancer. +nstead, *C+S is considered a pre-cancerous condition. +t signals a significantly increased ris! of cancer anywhere in the breast. *C+S begins in the lobules (the mil!-producing glands of the breast but does not penetrate the lobular walls. 0any times, physicians encounter *C+S serendipitously (by chance on breast biopsy while investigating an area of concern. 2hile the microscopic features of *C+S are abnormal and are similar to malignancy, *C+S does not behave as a cancer (and therefore is not treated as a cancer . 'owever, a mastectomy (breast removal may be occasionally performed if *C+S patients have a strong family history of breast cancer. 0ore li!ely, *C+S patients are closely monitored with physician performed clinical breast examinations and mammograms. Some *C+S patients are eligible to ta!e the drug tamoxifen to help prevent breast cancer. +n ABBC, the ,ood and "rug Administration approved the drug tamoxifen to prevent breast cancer in high ris! patients. Tamoxifen is an 4anti-estrogen4 and wor!s by binding to estrogen receptors. 1esearch has shown that tamoxifen can reduce breast cancer ris! in some women. Clic! here to learn more about tamoxifen. %i roc&stic Breast Condition ,ibrocystic 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 pac!ets of fluid , fibrosis (formation of scar-li!e connective tissue , lumpiness, areas of thic!ening, tenderness, or breast pain. Though sometimes painful, fibrocystic breast condition is not cancer. 'owever, fibrocystic breasts can sometimes ma!e 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. ,ibrocystic changes are the most common cause of breast lumps in women between D; and =; years old. Symptoms of fibrocystic changes in the breast include% cysts (pac!ets of fluid fibrosis (formation of scar-li!e connective tissue lumpiness areas of thic!ening tenderness pain

2omen 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 body6s levels of the hormones estrogen and progesterone. "uring each menstrual cycle, breast tissue sometimes swells because hormonal stimulation causes the breast6s mil! glands and ducts to enlarge, and in turn, the breasts retain water. "uring menstruation, breasts may feel swollen, painful, tender, or lumpy. &reast 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. ,ibrocystic breast condition is often first noticed by the woman and further investigated with clinical breast exam, mammogram, or in some instances, biopsy. ,ibrocystic changes are typically discovered in both breasts in the upper outer 5uadrant and the underside of the breast where a ridge may sometimes be felt. $ften, physicians may recommend that the symptoms of fibrocystic breasts be treated with self-care. "epending on the individual situation, several measures may be recommended to relieve the symptoms of fibrocystic breasts. The following chart summari3es treatment options for fibrocystic breasts% Treatment o' %i roc&stic Breasts Ma& #nclude: 2earing extra support bras Avoiding caffeine (controversial recommendation Ta!ing oral contraceptives (controversial recommendation Ta!ing over-the-counter medications such as aspirin, acetaminophen or 0otrin 0aintaining a low fat diet rich in fruits, vegetables, and grains Applying heat to the breasts 1educing salt inta!e Ta!ing diuretics Ta!ing vitamin /, vitamin &>, niacin, or other vitamins

Taking prescription drugs such as bromocriptine or danazol Surgically removing breast lumps

$ccasionally, doctors may surgically remove non-cancerous breast lumps. ,or women with painful cysts, draining the fluid by fine needle aspiration biopsy may help relieve symptoms of fibrocystic breasts. Clic! here to learn more about fibrocystic breasts. C&sts

&reast cysts are accumulations of fluid in the breast. 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. 2hile the cause of cysts is un!nown, experts do !now that cysts respond to the body#s hormone levels. ,or instance, cysts may appear a wee! or two before a woman#s menstrual period and disappear afterwards. Cysts are most common in pre-menopausal women, especially when they are approaching menopause. 'owever, cysts can occur in women after menopause as well, especially if they are ta!ing hormone replacement therapy ('1T . /xisting cysts may also persist or enlarge in women on '1T. Some research has suggested that caffeine can cause breast cysts, although this is controversial among members of the medical community. )evertheless, some women find that reducing caffeine consumption decreases breast discomfort. 0ost women only develop one or two cysts at a time, but in some cases, multiple cysts may appear throughout the breast. Cysts are usually confirmed with mammography and ultrasound (sonogram . +n particular, ultrasound is excellent at 5uic!ly identifying whether a breast abnormality is in fact a cyst or a solid mass. After the abnormality is found to be a cyst with ultrasound, it is usually left alone unless% The diagnosis is uncertain. 0ost 4simple cysts4 are well-defined, have distinct borders, and ultrasound signals are able to easily pass through them. 'owever, some cysts contain low levels of internal echoes which ma!es it difficult for physicians to definitively diagnose them as cysts without draining their fluid. These types of cysts are called 4complex cysts.4 2hile complex cysts can appear similar to solid masses on ultrasound, they are non-cancerous. The cyst is causing discomfort. +n some instances, cysts can be painful. "raining the cysts with a thin needle (fine needle aspiration collapses them and reduces discomfort. Some radiologists in8ect air into the area after drainage to help minimi3e the chances that the cyst will return.

2hen cysts are drained, the fluid is usually discarded unless it is bloody or loo!s suspicious. +n these cases, it is sent to a pathology laboratory for analysis under a microscope. )ormal cystic fluid can be a number of colors including yellow, brown, green, blac!, amber, or mil!yBenign Breast Conditions (alactoceles -alactoceles are mil!-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. -alactoceles are treated the same way as cysts% usually by leaving them alone. +f the diagnosis is uncertain or the galactocele is causing discomfort, it can be drained with a thin needle (fine needle aspiration . %i roadenomas ,ibroadenomas are common benign breast tumors often too small to feel by hand, though occasionally, they may grow to be several inches in diameter. ,ibroadenomas are made up of both glandular and stromal (connective breast tissue and usually occur in women between :;-D; 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 li!e a marble within the breast. Some women have only one fibroadenoma while others may have multiple tumors. ,ibroadenoma are usually diagnosed by fine needle aspiration or core needle biopsy. ,ibroadenomas often stop growing or even shrin! on their own without any treatment. +n these cases, doctors may recommend not having the tumors removed. ,ibroadenoma surgery may involve removing a margin of surrounding breast tissue. The ris! of surgery is that scarring could occur that could distort the shape and texture of the breast and ma!e future physical examination and mammography more difficult to interpret. $n 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. )h&llodes Tumors

.hyllodes 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. .hyllodes tumors are usually benign but on very rare occasions, they may be malignant (cancerous and could metastasi3e (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. #ntraductal )apillomas +ntraductal papillomas are non-cancerous wart-li!e growths with a branching or stal! that has grown inside the breast. A papilloma often involves the large mil! ducts near the nipple, causing bloody nipple discharge. $ccasionally, multiple papillomas may be found further from the nipple. .apillomas 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 . $f 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 . (ranular Cell Tumors -ranular cell tumors are usually found in the mouth or s!in but may rarely be detected in the breast. 0ost granular cell tumors of the breast are identified as movable, firm lumps, measuring between one-half and one inch in diameter. "octors typically diagnose grandular cell tumors by a fine needle or needle core biopsy and then surgically remove the tumors along with a surrounding margin of breast tissue. -ranular cell tumors do not indicate higher ris! for developing breast cancer. Duct *ctasia "uct ectasia, widening and hardening of the duct, is characteri3ed by a thic! green or blac! nipple discharge, typically affecting women in their forties and fifties. The nipple and surrounding tissue may be red and tender. "uct ectasia is a benign condition but can sometimes be mista!en as cancer if a hard lump develops around the abnormal duct. $palescent (clear nipple discharge is often due to duct ectasia or cyst. $ften, duct ectasia does not need treatment, or improves with the application of heat or antibiotic drugs. $ccasionally, the affected duct is surgically removed by an incision at the border of the areola (the pigmented region around the nipple . %at Necrosis ,at necrosis, a benign condition where fatty breast tissue swells or becomes tender, can occur spontaneously or as the result of an in8ury to the breast. 2hen the body attempts to repair damaged breast tissue, the affected area may sometimes be replaced with firm scar tissue. ,at necrosis may be mista!en as cancer on a mammogram@ however symptoms of fat necrosis usually subside within a month. &iopsy can confirm fat necrosis. According to the American Cancer Society, some areas of fat necrosis can have a different response to in8ury. +nstead of forming scar tissue, the fat cells die and release their contents, forming a sac-li!e collection of greasy

fluid called an oil cyst. $il cysts can be diagnosed by fine needle aspiration, which also serves as a treatment. 2hile 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. Breast #n'lammation: Mastitis 0astitis, another non-cancerous condition, most commonly affects women while they are breast-feeding. Crac!ing of the s!in around the nipple allows bacteria from the s!in surface to enter the breast duct where it grows and attracts inflammatory cells. +nflammatory cells release substances to fight the infection, but also cause breast tissue swelling and increased blood flow. &reasts infected with mastitis often swell, become red in color, and feel warm to the touch. 0ost of the time, mastitis is treated with antibiotics. 'owever, if a collection of pus (an abscess from inflammatory cells and fluid results, the pus may have to be drained. Clic! here for information about mastitis as a result of breast-feeding. Clic! here for information about malignant (cancerous breast inflammation, called inflammatory breast cancer. Conclusion This article describes a variety of benign breast conditions and typical treatments. 2omen should discuss all breast concerns with their physicians. Treatments will vary depending on specific cases, family history, and other factors. The American Cancer Society recommends the following guidelines for the detection of breast cancer in women who are asymptomatic (show no symptoms of breast cancer % 2omen :; years of age and older should perform breast self-examination (&S/ every month. 2omen :;-DB should have a physical examination of the breast (C&/ or clinical breast exam at least every three years, performed by health care professional such as a physician, physician assistant, nurse or nurse practitioner. C&/ may often be received in the same appointment as a .ap smear. 2omen :;-DB should also perform monthly &S/. 2omen ?; and older should have a physical examination of the breast (C&/ or clinical breast exam every year, performed by a health care professional, such as a physician, physician assistant, nurse or nurse practitioner. C&/ can often be performed in the same visit as a mammogram. 0onthly &S/ should also be performed. 2omen ?; years of age and older should have a screening mammogram every year in addition to annual C&/ and monthly &S/.

2omen at high ris! of breast cancer such as those with a strong family history of breast cancer, should as! their physician whether annual mammography should begin before age ?;. ,or example, some physicians recommend women begin screening mammography at an age ten years earlier than the age her mother was diagnosed with breast cancer. Additional +esources and +e'erences The Breast Book: The Essential Guide to Breast Care and Breast Health for Women of All Ages (ABB> by 0iriam Stoppard, 0" and 1ache Simmons. This boo! covers a variety of topics and breast health concerns, including benign and malignant conditions. ,or more information on both benign and malignant nipple discharge, please visit http%77www.imaginis.com7breasthealth7nipple.asp. http%77www.cancer.org7. The American Cancer Society provides detailed information on benign breast conditions.