The development of a new lump in the breast or armpit is the most common initial symptom of breast cancer, according to the Centers for Disease Control and Prevention. But for millions of women, lumps in the breast that come and go are common.
These lumps and other accompanying symptoms could be signs of benign breast disease, a group of noncancerous conditions that can sometimes elevate the risk of cancer but are rarely associated with its presence.
[SEE: Signs You Might Have Breast Cancer.]
What Is Benign Breast Disease?
Also called fibrocystic breast disease, this condition isn’t actually a disease state, says Dr. Rachel A. Greenup, section chief of breast surgery and co-director of the Center for Breast Cancer at Smilow Cancer Hospital and Yale Cancer Center in New Haven, Connecticut.
“Benign breast disease really refers to very normal, benign or noncancerous conditions where the breasts can be lumpy and tender in a cyclical fashion, typically associated with a woman’s menstrual cycle,” she explains.
Across the menstrual cycle, a woman’s hormone levels fluctuate, and this can change the breasts’ shape, size and how they feel to the touch. Why exactly it happens isn’t completely understood, Greenup says, but the cycle is driven by glands in the breast that are responsive to estrogen and progesterone levels.
Benign breast disease generally does not increase the risk of developing breast cancer; available data estimates that approximately 1 million women get this diagnosis each year, and up to 50% of women will experience fibrocystic changes that cause noncancerous breast lumps to form during their lifetime. Men can also develop benign breast disease.
And it may be even more widespread than the figures suggest.
“We don’t have great baseline data because it’s probably more common than is reported and tends to be identified in women who are seeing primary care doctors and having the most severe symptoms,” Greenup says.
[SEE: Tips for a Mammogram.]
Symptoms of Benign Breast Disease
Specific symptoms vary depending on the exact diagnosis, but common signs include:
— Pain and tenderness, particularly during exercise and shortly before menstruation
— Swelling or enlargement of the breast tissue, particularly at specific points in the menstrual cycle
— Spontaneous discharge from the nipple that can range from clear to brown
Common Types of Benign Breast Disease
Benign breast disease is common, and there are several different types that can develop.
“As a breast radiologist, I see a lot of benign breast disease on imaging,” says Dr. Mia Kazanjian, a board-certified breast and body radiologist in private practice based in Connecticut. Most of the time, it does not turn into cancer; however, some types of benign breast disease can increase the risk of developing cancer in the future, she notes.
Here is more information about the most common types of benign breast disease, their symptoms, how they’re diagnosed and common treatment approaches.
Fibrocystic disease of the breast
This common condition impacts women during their reproductive years and is often tied to fluctuations in hormones throughout the menstrual cycle. In women with this condition, the breast tissue is usually very dense with some fluid-filled glands or cysts, explains Dr. Maher Gobran, a breast surgeon and surgical oncologist with Providence St. Joseph Hospital in Orange, California.
Symptoms that usually worsen just before menstruation and improve afterward include:
— Breast pain
— Lumpiness
— Breast engorgement or swelling
— Pain or discomfort when exercising
To diagnose this condition, your doctor will take a medical history and conduct a clinical exam and breast imaging. You likely won’t need a breast biopsy unless a lump develops that seems suspicious, Gobran says, and management usually involves symptom relief through lifestyle adjustments such as:
— Limiting caffeine and alcohol intake
— Wearing supportive wireless bras
— Using over-the-counter pain medications such as acetaminophen or ibuprofen when pain is more severe
Still, it can be concerning, Gobran adds. “While fibrocystic breast changes can cause significant anxiety, they do not increase the risk of breast cancer.”
Nevertheless, this condition can sometimes make breast cancer detection more challenging because dense breast tissue can make it more difficult to spot tumors on a mammogram.
[READ: 10 Questions to Ask at Your OB-GYN Appointment.]
Fibroadenoma
Another common benign breast condition is called fibroadenoma. This typically occurs in women in their teens into their early 30s and usually presents as a firm, smooth, rubbery, well-defined lump, Gobran explains. These fibroadenomas are usually painless and are moveable under the skin. They can range in size from tiny to several centimeters in diameter.
These lumps can change in size when hormone levels fluctuate especially during pregnancy, but they don’t usually turn into breast cancer. They’re diagnosed using a physical exam, ultrasound and occasionally biopsy.
Fibroadenomas don’t need to be treated, but they should be monitored through regular exams and imaging. If the lump grows quickly or causes discomfort, your doctor may recommend removing it. Surgical excision is straightforward, typically conducted on an outpatient basis, and usually has minimal complications, Gobran notes.
Breast cysts
Breast cysts are fluid-filled glands that form within breast tissue, most often in women between the ages of 35 and 50. They tend to appear right before a menstrual period as smooth, rounded and tender lumps and can change in size as hormone levels fluctuate. Breast cysts are usually visualized by ultrasound.
Breast cysts do not increase the risk of breast cancer and typically do not require treatment. Many resolve on their own naturally.
However, if you have a large or painful cyst, your doctor may recommend aspirating it to drain the fluid and provide immediate relief, Gobran says. This process may have to be repeated, as these cysts can sometimes reaccumulate a few times before resolving completely. Your doctor will also likely want to monitor your breast with exams and imaging to spot any concerning changes.
Papilloma
These benign tumors form within the milk ducts of the breast and most commonly occur between the ages of 35 and 55. They tend to show up near the nipple, but can also arise in peripheral ducts.
The hallmark symptom of a papilloma is spontaneous, often bloody, nipple discharge from a single duct. You might also feel a small lump behind or near the nipple, although many can’t be felt at all.
“While intraductal papillomas themselves are benign, they can sometimes harbor atypical cells and slightly increase the risk of developing breast cancer, particularly when multiple papillomas are present or if atypia is found,” Gobran says.
Diagnosis is usually made through a mammogram or ultrasound followed by a biopsy. Your doctor will want to monitor the area and may recommend surgical removal.
Atypical hyperplasia and lobular carcinoma in situ
Breast cells that grow abnormally and show some cancer-like features develop in atypical hyperplasia of the breast. There are two subtypes of this condition — atypical ductal hyperplasia, or ADH and atypical lobular hyperplasia, or ALH. The difference depends on whether the abnormal cells originate in the breast ducts or lobules. The lobules are the breast’s milk-producing sacs.
“Although not cancer, atypical hyperplasia is considered a high-risk breast lesion, as it significantly increases the lifetime risk of developing breast cancer — about four to fiv times higher than that of the general population,” Gobran notes.
Diagnosis is usually made during a breast biopsy performed after a suspicious finding on a routine mammogram.
A similar condition called lobular carcinoma in situ, or LCIS, is another precancerous growth that can develop in the lobules. ALH typically has fewer abnormal cells and is considered a milder condition than LCIS, but both are linked to an increased risk of breast cancer in the future.
Because of this risk, some of these lesions are surgically removed to ensure there is no associated breast cancer, explains Dr. Melissa Pilewskie, clinical associate professor and director of the Breast Care Center at Michigan Medicine in Ann Arbor.
“In addition, medical treatment with anti-estrogen medications, such as tamoxifen or an aromatase inhibitor, may be recommended to help reduce future cancer risk following a diagnosis of a high-risk lesion,” she notes.
Individuals who develop an atypical hyperplasia should have more frequent breast exams than other women.
Breast infections or abscesses
Noncancerous infections can also develop in the breast and will present with pain, swelling, warmth or redness. Infections or abscesses frequently require antibiotics and possibly draining, Pilewskie notes.
[READ: Saline vs. Silicone Breast Implants.]
Does Benign Breast Disease Lead to Cancer?
Benign breast disease is rarely associated with cancer, but some types can elevate risk.
For example, one long-range study conducted in Spain found that women with a history of benign breast disease were about twice as likely to be diagnosed with breast cancer over a 20-year period. Another study of African American women with benign breast disease found that nearly 7% later developed breast cancer. A third study found that only 3.2% of patients with breast symptoms subsequently received a diagnosis of breast cancer.
While certain types of benign breast disease, including atypical hyperplasia, can increase the risk for breast cancer, ongoing surveillance and lifestyle and medication interventions will help prevent complications.
[READ: Surprising Breast Cancer Risk Factors]
When to Visit a Doctor
Anytime you notice a new lump or change in your breast, you should contact your health care provider for advice and support. While lumps come and go in many women, it could be a sign of something more serious, and it’s important to get it checked out to understand what you’re dealing with.
“It can be really hard to tell the difference between a benign lump and a cancerous lump,” Greenup says, “and we would never want a patient to feel responsible for making that decision.”
Therefore, “the general guidance is that if women have changes that don’t return to baseline after a menstrual cycle, or a new lump that’s different or changing or growing, they should always defer to getting evaluated by a medical professional,” she adds. This means both a physical exam and imaging with mammogram and/or ultrasound technology.
The key, Kazanjian notes, is to get evaluated if you experience symptoms such as pain, a palpable lump, changes in skin texture or nipple discharge. “I think that it’s very important to determine the cause of symptoms given that breast cancer is so common — 1 in 8 women — and given the rise in breast cancer in women under 50,” she notes.
Unfortunately, however, “every year we see young women who present with breast pain or a lump and are dismissed as not being old enough to have breast cancer and they in fact do end up having breast cancer,” Greenup points out. So if you develop a mass or pain and any concerning change to your breast, seek care, regardless of your age.
The American Cancer Society recommends the following screening guidelines for women who are at average risk of developing breast cancer:
— Women between the ages of 40 and 44 should have the option to start screening with an annual mammogram.
— Women between the ages of 45 and 54 should have an annual mammogram.
— Women ages 55 and older can continue annual mammographic screening or switch to every other year.
Average risk means you don’t have a personal or strong family history of breast cancer and you do not have a genetic mutation that increases risk. You should continue screening for as long as you are in good health and expected to live at least 10 more years.
For women who are at high risk of developing breast cancer, the ACS recommends getting a breast MRI and a mammogram every year, typically starting at age 30. Talk with your doctor about your risk factors and determine an appropriate screening timeline.
How to Prevent and Manage Benign Breast Disease
While there’s no surefire way to prevent the development of benign breast disease, there are a few ways to reduce your risk, such as:
— Reducing or avoiding caffeine, alcohol and excess sodium to reduce water retention and swelling.
— Exercising regularly and eating a healthy diet to help manage your weight.
— Evening primrose oil supplements are reported by some patients as valuable. “It’s not really played out in the scientific world to be effective but we do encourage people to try it,” Greenup says.
— Ensuring you’re wearing the right size bra. “Many women gain and lose weight over their lifetime and their breast size changes, but they continue purchasing and wearing bras that may not be well-fitted,” Greenup says. Professional bra fitting services, offered at most department stores, can help you find the right size.
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Benign Breast Disease: More Common Than You Think originally appeared on usnews.com
Update 06/13/25: This story was published at an earlier date and has been updated with new information.
