Some women experience breast pain without an apparent cause – it is seldom associated with breast cancer. There are several breast conditions a woman may experience that are not cancer.

Microcalcifications, Fibrocystic Breasts, Cysts, and Other Breast Conditions

There are several breast conditions a woman may experience that are not cancer. Many will produce a noticeable lump, many will be detected in your annual mammogram, but others will only be noticed through other symptoms, such as pain or discharge. Many of these conditions require no treatment.

Although your condition may be benign, it’s important to let your doctor know if you notice any changes to your breasts.

This section includes information on the following conditions:

Microcalcifications

Microcalcifications are tiny deposits of calcium clustered together in the milk ducts.

Symptoms

Microcalcifications have no symptoms that a woman will notice herself (like a lump).

Diagnosis

Microcalcifications will show up on a mammogram as tiny white flecks in the tissue. Many times these are not cancer; however, in some instances they are associated with very early cancer ( ductal carcimona in situ). Consequently, they need to be investigated thoroughly.

In order to evaluate microcalcifications more carefully, additional magnification views are taken during a mammogram. Sometimes a biopsy may be necessary to definitively determine if the microcalcifications are cancerous or not.

Treatment

If the microcalcifications are not cancerous, which they most often are not, there is nothing you need to do. If a biopsy is recommended and the microcalcifications are found to be ductal carcinoma in situ, you will be referred to a surgeon by your referring physician.

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Fibrocystic Breasts

Fibrocystic changes occur in about half of all women, mostly during child bearing years. The cause appears to be normal hormonal fluctuations because the symptoms of fibrocystic breasts usually increase right before menstruation and subside after menstruation. Additionally, these monthly changes usually stop after menopause.

Fibrocystic breast changes used to be referred to as a disease. Since the condition is so prevalent, it is no longer considered a disease.

Symptoms

The following symptoms of fibrocystic breasts usually peak right before menstruation. They can range from mild to severe.

Diagnosis

Mammogram results for women with fibrocystic breasts may be more difficult to read due to the breast tissue being more dense (more fibrous, cystic, and glandular relative to fatty). However, a definitive diagnosis can be made with a combination of mammography, ultrasound and sometimes a minimally invasive needle biopsy.

Treatment

If you have fibrocystic breasts, there is no further treatment necessary. If you have severe or persistent pain though, talk to your doctor.

Some of the following self help measures may alleviate symptoms:

Additional Information

Women with this condition may find it more difficult to perform a breast self examination. It’s important to monitor the monthly changes in your breast tissue so you will notice if there are any new changes.

Fibroadenomas

A fibroadenoma is a benign (non-cancerous) growth in the breast that is made up of breast cells and fibrous tissue. This condition is more common in younger women and can develop quickly, sometimes within a few months. It will not become cancerous and does not increase your risk of developing breast cancer.

Symptoms

Larger fibroadenomas tend to be round and distinct from surrounding breast tissue and may feel like a marble in the breast.

Diagnosis

Fibroadenomas usually appear as dark gray masses on a mammogram. A definitive diagnosis can be made with a combination of breast ultrasound and a minimally invasive needle biopsy.

Treatment

Surgery is not usually required, but many doctors will recommend it if the fibroadenomas continue to grow or change the shape of the breast.

Having surgery could cause the loss of some normal breast tissue and cause scarring and changes in the shape of the breast. This could also make future exams and mammograms more difficult to interpret.

If a woman chooses not to have surgery, it is important that she have regular clinical breast exams to ensure that the mass isn’t growing.

Additional Information

Sometimes a new fibroadenoma will grow after one is surgically removed.

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Simple Cysts

A cyst is a little pocket of fluid in the breast. It occurs when a milk duct becomes blocked, preventing the normal breast fluid to flow through the ducts. The trapped fluid forms a pocket that starts off small, but can grow larger as more fluid builds up. It’s possible to have multiple cysts.

Symptoms

You may or may not be able to feel cysts in your breasts, depending on their size.

Following are some symptoms you may experience with cysts:

Diagnosis

A cyst will appear on a mammogram as a round or oval gray structure. Ultrasound can provide an accurate diagnosis of cysts.

Treatment

Cysts do not become cancerous and do not need to be surgically removed. If the cyst is painful, it can be drained (aspirated) using ultrasound to guide a tiny needle.

Additional Information

In a small percentage of women, cysts will re-form after being drained.

Cysts may be caused by fibrocystic breasts. Refer to this section for more information.

Lipoma

A lipoma is a pocket of fat that’s encased by a fibrous band. They are not cancerous and do not increase your risk of getting cancer. Lipomas are quite common and harmless. They more commonly occur in post-menopausal women.

Symptoms

Lipomas may or may not be felt. If you can feel one, it will be usually be soft and moveable.

Diagnosis

A lipoma will show on a mammogram as a translucent gray mass. A clear diagnosis can be made with ultrasound and sometimes a minimally invasive needle biopsy.

Treatment

Lipomas do not need to be removed surgically.

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Intraductal Papilloma

An intraductal papilloma is a tiny, wart-like growth in a milk duct, often in the large milk ducts near the nipple. These growths are seldom cancerous and generally affect women between the ages of 35 and 55.

Symptoms

Intraductal papillomas don’t always produce symptoms. The most common symptom experienced is a spontaneous bloody or sticky nipple discharge. You may also feel a small lump behind and near the edge of your nipple.

Diagnosis

The diagnosis can be made with a ductogram followed by mammography, ultrasound and a minimally invasive needle biopsy.

Treatment

The intraductal papilloma may or may not need to be removed. Surgical removal will be recommended if the papilloma is large or associated with atypical cells.

Breast Pain

Some women may experience breast pain without an apparent cause. Breast pain is seldom associated with breast cancer.

Possible Causes

Following are possible causes of breast pain:

Diagnosis

A mammogram, and possibly a breast ultrasound, may be requested by your health care provider to assist in the evaluation of breast pain.

Treatment

There is no specific medical treatment for alleviating breast pain. Following are some measures you can take to reduce pain:

It is always important to discuss breast changes or pain with your physician, have yearly mammograms beginning at age 40, and continue regular breast self examination.

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Nipple Discharge

Tiny droplets of fluid may appear on the nipple surface or clothing. There is normally fluid in the milk ducts even if a woman is not pregnant or nursing. Discharge of fluid can be caused by squeezing (such as during a mammogram), sexual stimulation, a warm shower or other pressure to the breast.

Identifying Abnormal Discharge

Nipple discharge does not always indicate a problem. Further evaluation is necessary when the discharge:

*Green, gray or milky discharge does not usually need further breast diagnostic studies. These secretions may be caused by hormonal stimulation, fibrocystic changes, some medications and rarely, a pituitary gland dysfunction.

Possible Causes

Fibrocystic breasts and Intraductal Papilloma are both common causes of nipple discharge. Breast cancer is an uncommon cause.

Diagnosis & Treatment

A nipple discharge exam called a Ductogram may help identify the cause of the discharge.

With this exam, a tiny catheter is placed in the nipple opening where the discharge is seen. Contrast material is injected and then a mammogram is performed. The contrast material makes it easier to see abnormalities on the mammogram.

If an abnormality is seen, an ultrasound may be performed to further evaluate it.

It’s also possible that a minimally invasive needle biopsy will be done. A biopsy can usually remove and diagnose the problem. The discharge is usually gone after that. Most women have minimal discomfort with this procedure