Benign Breast Diseases
Treatment of Benign Breast Diseases
There are a number of benign, (non-cancerous), conditions that may develop within the breasts. In this section you can read about some of these most common benign breast problems faced by women. If there is a question or concern, please call Dr. Kaufman for an appointment and evaluation at 516-520-1480.
Cysts are fluid-filled spaces in the breasts. They may occur as one cyst or in clusters in one or both breasts, and they may be tiny and unnoticeable or large painful and tender to the touch. Benign cysts form in the glands and occasionally in the connective tissue of the breasts. They are quite common, occurring in about half of all women, most frequently in the pre-menopausal years. They can cause uncomfortable symptoms like pain and tenderness and on rare occasion they might indicate the development of cancer. Some benign cysts shrink or stop growing on their own. For those that do not, typical treatment may involve drainage via "Fine Needle Aspiration". This procedure is performed by Dr. Kaufman under local anesthesia with a tiny needle being placed in to the cyst. The fluid is withdrawn and then sent to the lab for evaluation. Recurring cysts may be re-aspirated or removed. Most cysts are simply observed.
Fibrocystic Breast Disease
Benign cysts associated with Fibrocystic Disease are often related to hormonal changes accompanying pregnancy or the menstrual cycle. The breasts are often tender, lumpy and painful especially in or around the menstrual periods. Women diagnosed with Fibrocystic changes are sometimes helped with fine needle aspiration, or FNA, which drains fluid from any cysts in an attempt to relieve painful symptoms. Dietary changes may also be recommended, including vitamins, supplements and avoidance of caffeine, beef, dairy and salt. In addition we often recommend wearing a snug supportive sports/athletic bra. When symptoms are severe we may prescribe anti-inflammatory medication.
Fibroadenomas are lumps in the breast made of glandular and stromal (connective) tissue. Most Fibroadenomas are not dangerous. They can occur at any age, but are most common in women in their 20's or 30's. Fibroadenomas vary in size from microscopic to several inches across but rarely cause pain or tenderness. Typical treatment is to make sure the lump is not something of a serious nature. This can be accomplished using a special type of needle biopsy or via surgical removal. Surgery may not be necessary for fibroadenomas since many of them ultimately stop growing and/or shrink on their own.
Hyperplasia is an excessive growth of cells in the milk ducts or milk glands of the breast. If the cells found on a biopsy are abundant but fairly close to normal in appearance, it is considered "usual Hyperplasia". Alternatively, if the cells are abnormal, it is considered "atypical hyperplasia", which increases the risk of developing breast cancer. If Hyperplasia is identified, Dr. Kaufman will need to assess its type and extent. Close monitoring is considered essential and a recommendation will be made to have more frequent clinical breast examinations, mammograms and sonograms. An MRI of the breasts may also be obtained to help further identify and diagnose abnormal tissue. On occasion we may prescribe medications that help lower ones risk for developing Breast Cancer. Since each patient is unique the treatment and prevention strategy will vary.
A Papilloma is usually a benign tumor that can develop in the milk ducts of the breast. These finger-like protrusions grow from the tissue either as a single Papilloma or in groups. Single, or solitary, Papillomas are typically found behind the nipple area and are frequently responsible for discharge from the nipple. The nipple discharge may be bloody in nature. Multiple Papillomas may be located further from the nipple in small ducts. Papillomas may increase the risk for Breast Cancer. A mammogram, sonogram, ductogram or breast MRI may be performed to determine the presence and location of a Papilloma. Papillomas will often require surgical removal, along with the surrounding tissue and a portion of the duct in which it was found.
Phyllodes tumors are lumps in the breast made of glandular and stromal (connective) tissue. The tumor can often be felt upon breast examination and may or may not be painful. Phyllodes tumors are usually benign but occasionally may be malignant. They can appear at any age but are most commonly found in women in their 30s or 40s. Phyllodes tumors need to be surgically removed along with about one inch of the surrounding tissue in order to help prevent recurrence.
Mastitis is an inflammation of the breast tissue typically caused by an infection in women who are breastfeeding. However, breast infections can occur in any woman, young or old, pregnant or not. Smokers have a higher risk of breast infections. Often, bacteria enter the skin near the nipple and begin to multiply in the duct. As white blood cell activity in the area increases to fight the infection, it produces swelling and an increased flow of blood. The result is pain, redness, warmth and sometimes fever. Mastitis may be successfully treated with a course of antibiotics. However, there are cases that require drainage if a breast abscess occurs. On occasion, a reddened area on the breast can represent a rare form of breast cancer called inflammatory carcinoma.