Gynecologic Problems
FAQ026, November 2012



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Benign Breast Problems and Conditions

What is breast tissue made of?

Your breasts are made up of glands, fat, and fibrous tissue. Each breast has 15–20 sections called lobes. Each lobe has many smaller lobules. The lobules end in dozens of tiny glands that can produce milk.

What kinds of changes occur in breast tissue throughout life?

Your breasts respond to changes in levels of the hormones estrogen and progesterone during your menstrual cycle, pregnancy, breastfeeding, and menopause. Hormones cause a change in the amount of fluid in the breasts. This may make the breasts feel more sensitive or painful. You may notice changes in your breasts if you use hormonal contraception such as birth control pills or hormone therapy.

What are benign breast problems?

Benign breast problems are breast problems that are not cancerous. There are four common benign breast problems:

1. Fibrocystic breast changes

2. Cysts

3. Fibroadenomas

4. Mastitis

What are fibrocystic breast changes?

Some women have breasts that are swollen, lumpy, and tender. These are called fibrocystic breast changes. The condition is most common in the childbearing years but also can happen after menopause in women who are taking hormone therapy.

Is there treatment for fibrocystic breast changes?

There is no treatment, but there are things you can do to help relieve the symptoms:

  • Apply heat or ice to the breast.
  • Take an over-the-counter nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen.
  • Wear a well-fitting bra.

What are breast cysts?

Breast cysts are small sacs filled with fluid. They can be almost any size. Some cysts feel like a soft grape or water-filled balloon, but some can feel firm. You may have pain or tenderness in the area of the cyst. The cyst may get bigger just before your menstrual period. Cysts are common in women between the ages of 25 years and 50 years and they usually go away after menopause, although women who take hormone therapy may continue to have cysts.

How are breast cysts treated?

Breast cysts are treated if they are large and painful. If your cysts are causing discomfort, your health care provider may drain the fluid with a procedure called fine-needle aspiration. The cyst also may be surgically removed. Birth control pills may be used to help prevent cysts from coming back.

What are fibroadenomas?

Fibroadenomas are solid lumps that occur most often in young women. Fibroadenomas may appear in both breasts. The lumps have a well-defined smooth shape. Usually they do not cause any pain.

How are fibroadenomas treated?

In many cases, treatment is not needed for fibroadenomas. Some women, however, decide to have surgery to remove the lumps. This is called a lumpectomy.

What is mastitis?

Mastitis is an infection in the breast tissue. It most commonly happens when a woman is breastfeeding and a duct becomes clogged with milk and does not drain properly. Infection sometimes can occur unrelated to pregnancy and breastfeeding. Mastitis can cause flu-like symptoms, such as fever, aches, and fatigue. Your breasts also may be swollen, painful, have red streaks, and feel hot to the touch.

How is mastitis treated?

There are different treatments for mastitis, depending on the type of infection. These treatments include emptying your breasts of milk; taking antibiotics; or applying a warm, wet cloth to your breast for 15–20 minutes, a few times a day. If you are taking antibiotics, you usually can continue to breastfeed your baby or use a breast pump to prevent your breasts from getting engorged with milk.

What should I do if I find a lump in my breast?

If you find a lump or suspicious area in your breast, contact your health care provider. Your health care provider will probably do a physical exam of your breasts. This is called a clinical breast exam. Based on the results of this exam, more tests may be recommended.

What is mammography?

Mammography can be used as a screening test for breast cancer (screening mammography) or to help diagnose a suspicious area or problem (diagnostic mammography). An annual screening mammogram is recommended for women aged 40–75 years. Women older than 75 years should talk to their health care providers about the need to continue having this test.

What happens if a suspicious lump or area is found during a routine screening mammogram?

If a suspicious area or lump is found on a screening mammogram, you will be called back for a follow-up test to find the exact cause of the problem. Follow-up testing may be a diagnostic mammogram, an ultrasound exam, or a magnetic resonance imaging (MRI) exam.

What happens if the results of the follow-up tests to my routine screening tests are abnormal?

If the results of the follow-up tests are abnormal, you may have a biopsy. There are several types of biopsies. The type of biopsy you have depends on several factors, including the size and location of the lump or area:

  • Fine-needle aspiration is the removal of a small sample of tissue from the lump through a thin, hollow needle into a syringe.
  • A core biopsy is the removal of a sample of tissue with the use of a needle with a special tip.
  • A surgical biopsy or lumpectomy is a procedure in which a surgeon removes part or all of the lump.

Glossary

Antibiotics: Drugs that treat infections.

Benign: Not cancer.

Biopsy: A minor surgical procedure to remove a small piece of tissue that is then examined under a microscope in a lab.

Estrogen: A female hormone produced in the ovaries.

Fine-needle Aspiration: A procedure in which a needle and syringe are used to withdraw a small amount of tissue. The tissue sample then is examined under a microscope to look for cancer cells.

Hormone Therapy: Treatment in which estrogen, and often progestin, is taken to help relieve some of the symptoms caused by the low levels of hormones produced by the body.

Hormones: Substances produced by the body to control the functions of various organs.

Lumpectomy: Complete surgical removal of a breast lump.

Magnetic Resonance Imaging (MRI): A method of viewing internal organs and structures by using a strong magnetic field and sound waves.

Mammography: A procedure in which X-rays of the breast are used to detect breast cancer.

Menopause: The time in a woman’s life when the ovaries have stopped functioning; defined as the absence of menstrual periods for 1 year.

Progesterone: A female hormone that is produced in the ovaries and prepares the lining of the uterus for pregnancy.

Screening Test: A test that looks for possible signs of disease in people who do not have symptoms.

Ultrasound Exam: A test in which sound waves are used to examine internal structures.

If you have further questions, contact your obstetrician–gynecologist.

FAQ026: Designed as an aid to patients, this document sets forth current information and opinions related to women’s health. The information does not dictate an exclusive course of treatment or procedure to be followed and should not be construed as excluding other acceptable methods of practice. Variations, taking into account the needs of the individual patient, resources, and limitations unique to the institution or type of practice, may be appropriate.

Copyright November 2012 by the American College of Obstetricians and Gynecologists.