Gynecologic Problems
FAQ026, March 2017



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Benign Breast Problems and Conditions

What is a benign breast condition?

A benign breast condition is one that is not cancer. These problems often go away on their own or are easily treated. Because a few benign breast conditions can increase your risk of getting cancer in the future, you may need to have
follow-up tests or exams with your obstetrician–gynecologist (ob-gyn) or other health care professional.

What are the different types of benign breast problems?

Benign breast problems include pain, lumps or masses, infections, nipple discharge, and skin changes.

What causes benign breast pain?

There are two types of breast pain: 1) cyclic and 2) noncyclic.

  • Cyclic breast pain occurs in response to changes in hormone levels. Your breasts may feel swollen, more sensitive, or painful before your menstrual period. You may have similar symptoms if you use combined hormonal contraception such as birth control pills or hormone therapy for menopause.
  • Noncyclic breast pain is not related to the menstrual cycle. It usually occurs in one breast in one specific area. Many things can cause this type of pain, including injury, infection, medications, and large breast size. In rare cases, noncyclic breast pain can be caused by breast cancer.

How is benign breast pain treated?

For cyclic pain, wearing a well-fitted bra and taking pain-relieving medications can help. If you are on combined hormonal birth control, using your method continuously may improve symptoms. If you have noncyclic breast pain, see your ob-gyn or other health care professional.

What are benign breast lumps or masses?

There are different types of benign breast lumps. In general, benign breast masses are divided into three types:

  1. Nonproliferative—This type of mass has normal cells. A common example is a cyst. Cysts are usually small. They usually go away by themselves or can be drained with a needle. Another example is a simple fibroadenoma. Simple fibroadenomas usually shrink or go away on their own. They may need to be surgically removed if they are large or keep growing.
  2. Proliferative without atypia—In this type of breast mass, the cells are increasing in number but are otherwise normal. Having this type of lump slightly increases the risk of future breast cancer over the long term. They usually are surgically removed, but sometimes they can just be watched to make sure they are not growing.
  3. Atypical hyperplasia—Hyperplasia is a condition in which cells are increasing in number. Atypia means that the cells do not look normal under a microscope. Atypical hyperplasia greatly increases the risk of developing breast cancer in the future. Surgery to remove the cells and the area around them is recommended, along with close follow-up.

What is mastitis?

Mastitis is an infection of the breast tissue. It most commonly happens when a milk duct becomes clogged with milk during breastfeeding and does not drain properly. Your breast will be red, swollen, warm, and painful in one specific area. Mastitis can cause flu-like symptoms, such as fever, aches, and fatigue.

How is mastitis treated?

You may be prescribed an antibiotic to treat the infection. Applying warm compresses can help relieve the pain. It is safe to breastfeed your baby when you have mastitis and are taking an antibiotic.

What are the signs and symptoms of nipple discharge?

Benign discharge tends to occur in both breasts and only when the breast or nipple is squeezed. It is usually milky white or greenish in color. Discharge that is bloody or clear is more concerning.

What causes nipple discharge?

Discharge from the nipple is a common benign breast symptom. During pregnancy, nipple discharge is normal as the breasts get ready to produce milk. In women who are not pregnant, it can be caused by hormonal changes. Some medications can cause nipple discharge. Nipple discharge should be checked by an ob-gyn or other health care professional.

What skin changes can affect the breasts?

Breast skin can be affected by common skin problems, such as psoriasis and eczema. Yeast infection of the skin folds under the breast is a common condition. Women with large breasts are more likely to have this problem. Some skin changes of the breast raise concern for cancer. These include redness, warmth, dimpling of the skin, and ulcers (small, red, painful blisters). Nipple changes such as crusting, scaling, or a nipple that has changed shape also raise concern. Tell your ob-gyn or other health care professional about any skin changes that you notice.

How are benign breast conditions evaluated?

If you have breast symptoms, let your health care professional know. You most likely will have a breast exam. In some cases, you may need to have an imaging test of your breast. Breast imaging can be done with mammography, an ultrasound exam, or magnetic resonance imaging (MRI). Imaging may be followed by a biopsy.

What kind of follow-up will I need if I have a benign breast condition?

Most benign breast conditions do not increase your risk of cancer, but some, such as certain types of breast lumps, do. If you have a condition that increases the risk of cancer, more frequent clinical breast exams and imaging tests over the next 1–2 years may be recommended. The recommended course of follow-up is based on your age, health risks, and test results.

What is breast self-awareness?

Being aware of how your breasts normally look and feel is called breast self-awareness. Knowing what is normal for you will help you detect any changes that may signal a problem. If you notice any of the following, contact your health care professional:

  • A new lump
  • Skin changes
    • —Thickening
    • —Dimpling
    • —Unexplained reddening
    • —Nipple scaling or redness
    • —Ulcers
  • Pain (especially if it is in one place or is getting worse)

Glossary

Antibiotic: A drug that treats certain types of infections.

Atypical Hyperplasia: A condition in which cells in the breast ducts or lobes are increasing in number and do not look normal under a microscope.

Benign: Not cancer.

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

Cells: The smallest units of a structure in the body; the building blocks for all parts of the body.

Cyst: A sac or pouch filled with fluid.

Fibroadenoma: A type of solid, benign breast mass.

Hormone: A substance made in the body by cells or organs that controls the function of cells or organs. An example is estrogen, which controls the function of female reproductive organs.

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

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

Mammography: An imaging technique in which X-rays of the breast are used to detect breast cancer. The image that is created is called a mammogram.

Mastitis: Infection of the breast tissue.

Menopause: The time in a woman’s life when menstruation stops; defined as the absence of menstrual periods for 1 year.

Nonproliferative: A term used to describe a benign breast mass containing normal cells.

Obstetrician–Gynecologist (Ob-Gyn): A physician with special skills, training, and education in women’s health.

Proliferative Without Atypia: A term that describes a benign breast mass in which the cells are increasing in number but are otherwise normal.

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 March 2017 by the American College of Obstetricians and Gynecologists

American Congress of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188 | Mailing Address: PO Box 70620, Washington, DC 20024-9998