When Pam Ladds, now 68, of Newport, Vermont, was 32 years old, she found a lump in her breast. She had recently moved to the United States from her native United Kingdom, and was working as a family therapist. Also a registered nurse, Ladds knew to take any breast lump seriously, but she wasn’t too concerned about this particular lump. “It was moveable, so I was much less concerned than if I found a lump that didn’t move,” she recalls. (Cancerous lumps tend not to move around much in the breast.) Nevertheless, she knew she needed to get it checked out to be sure.
She went to see her doctor who said she’d need a mammogram to have a closer look. But the lump, which “clearly was there, didn’t show up on the mammogram.” Before long, her doctor had landed on a diagnosis: Ladds had a fibroadenoma, a noncancerous lump that’s a common form of benign breast disease. Ladds refers to it as a “breast mouse,” a common nickname given to fibroadenomas because of their mobility within the breast.
[See: What Not to Say to a Breast Cancer Patient.]
Dr. Nicole Williams, assistant professor of medical oncology at the Ohio State University Wexner Medical Center, says fibroadenomas are “probably the most common in women in their 20s and 30s but they can be found in women of any age. They tend to shrink after a woman goes through menopause.” They may feel firm, smooth, rubbery or hard, and these growths often have a defined shape. They don’t usually hurt and they tend to move around in the breast. In Ladds’ case, the breast mouse eventually disappeared on its own, and she’s not had any further problems but continues to conduct regular self-exams in case another lump should surface.
Fibroadenomas are just one example of a group of non-cancerous breast conditions that many women will experience during their lifetimes. Brigham and Women’s Hospital reports that “60 percent of premenopausal women will experience a benign breast condition at some point in their lives.”
In addition to fibroadenomas, Williams says the most common benign breast conditions include fibrosis, simple or complex cysts, ductal or lobular hyperplasia and lobular carcinoma in situ.
Fibrosis
Fibrosis of the breast means there’s a large amount of fibrous tissue in the breast that can feel rubbery, firm or hard. It can lead to swelling or tenderness in the breast, and may be influenced by hormonal changes that occur during the menstrual cycle. Fibrosis does not usually require treatment, as the condition tends to resolve itself over time. But many doctors will want to keep an eye on the condition. If fibrosis or fibrous lumps cause you pain, the American Cancer Society suggests using over-the-counter pain relievers, wearing a supportive bra or applying a warm compress.
Simple or Complex Cysts
Cysts, which are small, fluid-filled sacs, can be found in lots of places in the body. In the breast, they may cause some pain or tenderness. The ACS reports they are most often found in women in their 40s, but can occur at any age. A simple cyst is filled with fluid, while a complex cyst has both fluid and solid matter in it. Cysts often show up as a swelling or squishy, tender lump or lumps in the breast that may worsen during a woman’s menstrual period. Cysts are typically diagnosed using ultrasound imaging. Often, they will go away on their own, but if the cyst is very large or uncomfortable, your doctor may drain it with a needle.
[See: 7 Innovations in Cancer Therapy.]
Ductal or Lobular Hyperplasia
Also known as epithelial hyperplasia or proliferative breast disease, ductal and lobular hyperplasia are benign breast conditions that refer to an overgrowth of epithelial, or skin, cells in the breast. “That can be in either the ducts of the breast, in which case it’s called ductal hyperplasia, or in the lobules of the breast,” which is lobular hyperplasia, Williams says. (The lobules are glands where milk is produced in the breast and the ducts are essentially tiny tubes that deliver this milk to the nipple.)
Hyperplasia is categorized as either usual or atypical. Usual refers to a simple overgrowth of epithelial cells in the lobule or duct, while atypical hyperplasia, also called hyperplasia with atypia, refers to an overgrowth of cells that look abnormal or distorted under a microscope. Hyperplasia seldom shows itself as a lump. Rather it tends to be found in a routine mammogram and is diagnosed using a needle biopsy. In some cases, “we may go in and do an excisional biopsy and take a little bit more of the surrounding tissue,” Williams says.
Lobular Carcinoma in Situ
As Breastcancer.org reports, “despite the fact that its name includes the term ‘carcinoma,'” which means cancer, “LCIS is not a true breast cancer. Rather, LCIS is an indication that a person is at higher-than-average risk for getting breast cancer at some point in the future.” LCIS refers to abnormal cell growth in the lobules of the breast. It may also be called lobular neoplasia and is more common in premenopausal women between the ages of 40 and 50. LCIS typically doesn’t cause symptoms and may not show up on a mammogram. Breastcancer.org reports it’s typically found as the result of a biopsy that’s being conducted because of some other area of concern in the breast.
Do These Conditions Elevate My Breast Cancer Risk?
For the most part, benign breast conditions aren’t cause for much concern, Williams says, but they should be checked out just to be sure they aren’t cancerous or masking a cancer elsewhere in the breast. In most cases, you’ll be offered a mammogram, and depending on the results of that, you may have an ultrasound or a biopsy.
Although by definition these conditions are benign, meaning not cancerous, some of them can elevate your risk of developing breast cancer later. “It depends on the type of benign breast condition,” Williams says. “Fibrosis or simple cysts carry no increased risk of developing breast cancer down the line. And if you have mild hyperplasia without atypia, there’s no increased risk of developing breast cancer,” she says.
However, LCIS and hyperplasia with atypia can increase your risk of developing breast cancer. The ACS reports that atypical hyperplasia can elevate a woman’s risk for developing breast cancer 4 or 5 times that of the general population. Williams says that patients with LCIS have “anywhere from 7 to 12 times higher risk of developing invasive cancer in either breast.” That does not mean that if you have one of these conditions you’ll definitely develop breast cancer — far from it — but there is some increased risk associated with them.
[See: Breast Pain? Stop Worrying About Cancer.]
To combat that risk, Williams says increasing the frequency of screening, prescribing certain medications or adding lifestyle interventions may be helpful in reducing overall risk depending on the individual’s situation. “We talk about whether they should have more frequent screening, if we should add MRI of the breast [another form of diagnostic imaging] into the screening and if they may benefit from medicines to lower their breast cancer risks such as tamoxifen or an aromatase inhibitor,” two common hormonal therapies that can reduce some people’s risk of developing certain types of breast cancer. And in virtually all cases, patients will be encouraged to make healthy lifestyle changes, such as improving diet or increasing exercise, both of which have been shown to decrease the risk of developing breast cancer.
If you have any pain, tenderness or swelling in your breasts or find a lump, it’s best to get it checked out. But keep in mind, it’s most likely not breast cancer. Brigham and Women’s Hospital reports that roughly 80 percent of breast lumps are not cancerous.
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What Is Benign Breast Disease? originally appeared on usnews.com
