Finding benign breast conditions

Signs and symptoms of breast changes

Changes in the breasts may be caused either by benign conditions or cancer. The most common symptoms are likely to be caused by benign conditions. Still, it is important to let your doctor know about any changes you notice. Many symptoms of benign conditions are the same as those seen in breast cancer. It is hard to tell the difference between benign and cancerous conditions based on symptoms alone. Your doctor can do other tests to tell the difference between the two.

Some benign breast conditions may not cause any symptoms and may be found during a mammogram or a breast biopsy.

Lumps

A benign breast condition often causes a lump. It may or may not feel tender. A woman may find it while showering or during other daily activities, or when checking her breasts or under her arms during a breast self-exam. In some cases her doctor or nurse may find it during a breast exam.

The younger a woman is, the more likely it is that a single breast lump will be benign:

• In women under 30, the most common cause is a benign solid tumor called a fibroadenoma.
• In women in their 30s and 40s, benign conditions (such as fibroadenoma, fibrocystic changes, or atypical hyperplasia) are the most likely causes.
• Cysts (non-cancerous, fluid-filled sacs) and non-invasive cancers (such as ductal carcinoma in situ, or DCIS) are more common in older women.

Most of these breast changes are described in more detail in the section, "Types of non-cancerous breast conditions."

In any of these age groups there is a chance that a single lump may be breast cancer, although it is more likely in older women than in younger ones. No matter what age the woman is, lumps and other changes must be checked to be sure they are not breast cancer.

Having many lumps in both breasts is most often caused by fibrocystic changes.

Breast lumps, like other symptoms, have to be considered along with other symptoms a woman may be having. For example, a new, tender lump that comes up at the same time as skin redness and a fever may be a sign of a breast infection. Still, any new lump or other change should be checked by a doctor or nurse.

Skin thickening and/or redness

Redness or thickening of an area of skin on the breast can also have different causes. For example, inflammation of the breast, known as mastitis, is common in women who are breast-feeding and is usually caused by an infection. But it's important to have a doctor or nurse check any new redness or thickening because at least one type of breast cancer (inflammatory breast cancer) can look a lot like an infection. Sometimes even doctors have trouble telling the difference. Since this kind of breast cancer grows quickly, you need to get back to the doctor right away with any breast infection that doesn't get better within a few days of being treated. (For more information, see our document, Inflammatory Breast Cancer.)

Pain

Some women have breast pain or discomfort that is related to their menstrual cycle. This type of cyclic pain is most common in the week or so before a menstrual period. It often goes away once menstruation begins. Many women with fibrocystic changes have cyclic breast pain. This is thought to be caused by changes in hormone levels.

Some benign breast conditions, such as breast inflammation (mastitis) may cause a more sudden pain in one spot. In these cases the pain is not related to the menstrual cycle. Rarely, breast cancer lumps can be painful, too.

Nipple discharge

A discharge (other than milk) from the nipple may be alarming, but in most cases it is caused by a benign condition. As with breast lumps, the younger a woman is, the more likely it is that the condition is benign. (See the section, "Nipple discharge exam (nipple smear).")

In benign conditions, a non-milky discharge is usually clear, yellow, or green. If the discharge contains blood that you can see or that is found in lab tests, the cause is still not likely to be cancer, but it is cause for concern and more testing.

If the discharge is coming from more than one breast duct or from both breasts it is usually because of a benign condition such as fibrocystic changes or duct ectasia (described later).

If the discharge (bloody or non-bloody) is from a single duct, it can be caused by a benign condition like intraductal papilloma or duct ectasia. But it can also be caused by a cancer, so you should see a doctor right away.

A milky discharge from both breasts (other than while pregnant or breast-feeding) sometimes can happen in response to the menstrual cycle. It can also be caused by an imbalance of hormones made by the pituitary or thyroid gland, or even caused by certain drugs.

Again, while benign conditions are much more common than breast cancer, it is important to let your health care team know about any changes in your breast so they can be checked out right away.