For Women Facing a Breast Biopsy

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Benign breast conditions: Not all lumps are cancer

If you find changes or something unusual in one of your breasts, it’s important to see a doctor or nurse as soon as possible. But keep in mind that most breast changes are not cancer. Just because your doctor wants you to have a biopsy does not mean you have breast cancer. (A biopsy (by-op-see) is when a piece of tissue is taken out and looked at under a microscope.) In fact, most biopsy results are not cancer. But the only way to know for sure is to take out and test tissue from the suspicious area of the breast. (See “Appendix A” for more information on breast cancer.)

Non-cancerous breast conditions are very common, and they are never life threatening. The 2 main types are fibrosis and/or cysts and other non-cancerous or benign (be-nine) breast tumors.

Fibrosis and cysts

Fibrosis and/or cysts are benign changes in the breast tissue that happen in many women at some time in their lives. (These used to be called fibrocystic breast disease and may still be called fibrocystic changes.) These changes often are affected by hormones and may get worse just before your menstrual period starts.

Fibrosis is firmness in the connective tissues, and cysts are fluid-filled sacs. These changes can cause areas of lumpiness, thickening, or tenderness; nipple discharge; or pain in the breast. If they are painful, cysts can be treated by taking out the fluid with a needle and syringe, but they may fill up again later.

A cyst cannot be diagnosed by physical exam alone, nor can it be diagnosed by a mammogram (breast x-ray) alone. To be sure that a lump is really a cyst, the doctor can do either a breast ultrasound or take fluid out of the cyst with a thin, hollow needle.

A cyst is filled with fluid. If a cyst has any solid parts, it’s no longer a simple cyst, and more tests may be needed. Some of these lumps can be watched with mammograms, but others may need a biopsy. The size, shape, and edges (margins) of the lump help the doctor figure out if it might be cancer.

Lumps and areas of thickening caused by fibrosis and cysts are almost always harmless. In severe cases, doctors can prescribe medicines that may help reduce or relieve symptoms, but surgery is rarely needed.

Benign breast tumors

Benign breast tumors are non-cancerous areas where breast cells have grown abnormally and rapidly, often forming a lump. Unlike cysts, which are filled with fluid, tumors are solid.

Benign breast tumors may hurt, but they are not dangerous and do not spread from the breast to other organs. Still, some benign breast conditions, such as papillomas and atypical hyperplasia, are important to know about because women with them have a higher risk of developing breast cancer.

A biopsy is the only way to find out if a lump is benign or cancer. In a biopsy, part or all of the lump or suspicious area is taken out and looked at under a microscope. (See the section called “Types of biopsy procedures” for more on this.)

If a benign tumor is large, it may change the breast’s size and shape. If it’s growing into the tissue of the milk ducts, it may cause an abnormal discharge from the nipple. Depending on the type, size, and number of benign tumors, doctors may recommend surgery to remove them.

For more information on this, please see our document called Non-Cancerous Breast Conditions.

The normal breast

Other benign breast conditions

Mastitis

Mastitis is a breast infection that most often occurs in women who are breast-feeding. The breast may become red, warm, or painful. Abscesses (pus-filled pockets) can form, and they may need to be drained with a needle. Mastitis is treated with antibiotics. If the mastitis doesn’t get better with antibiotics, it’s important that you let the doctor know. Some breast cancers can look a lot like infections.

Fat necrosis

Fat necrosis sometimes happens when an injury to the breast heals and leaves scar tissue that can feel like a lump. A biopsy can confirm that the lump is not cancer. Sometimes when the breast is injured, an oil cyst (fluid-filled area) forms instead of scar tissue during healing. Oil cysts can be diagnosed and treated by using a needle to take out the fluid.

Duct ectasia

Duct ectasia is common and most often affects women in their 40s and 50s. Symptoms are usually a green, black, thick, or sticky discharge from the nipple, and tenderness or redness of the nipple and area around the nipple. Duct ectasia can also cause a hard lump, which is usually biopsied to be sure it’s not cancer. Redness that does not go away may need to be biopsied to be sure it’s not cancer.


Last Medical Review: 07/21/2014
Last Revised: 07/21/2014