Benign tumors are local swellings in the breast. When such swellings are clinically and radiologically indistinguishable from a malignant tumor, they need to be surgically removed. Although a great variety of benign tumors exist, listed below are the most frequently encountered types:
These swellings develop as a result of fluid accumulation in small or large cysts (sacs). This condition occurs in about one third of women before the menopause. The typical complaint is of a swelling, sometimes painful, in the second half of the menstrual cycle. Sometimes the accumulations form microcysts, on other occasions you can clearly palpate the fluid filled cysts.
When the cysts are small, they decrease in volume after the return of menstruation. Large cysts (up to several centimeters in diameter) may persist. When clinically indicated, they may easily be drained under ultrasound guidance. If the wall of the cyst does not contain highly proliferating cells, this condition is not associated with any increased risk of breast cancer.
Duct ectasia of the breast
Here, milk secretion stops and causes inflammatory cells surrounding the ducts. There is an accumulation of concentrated material inside the ducts. This concentrated material can sometimes be seen beneath the nipple. After a while connective tissue forms, causing the ducts to contract, resulting in inflammation and pain.
This is a common tumor. Fibroadenomas are firm, clearly defined swellings that are very mobile on manual examination. Surgery to remove them is relatively straight forwards. Fibroadenomas contain epithelial cells and connective tissue. They rarely grow fast.
These are benign tumors that grow in the breast gland ducts. They form around a central stalk with blood vessels. Epithelial cells proliferate around them. The solitary papillomas usually arise in one of the major ducts below the nipple complex. They may appear as multiple small papillomas in the depths of the breast tissue in smaller channels. Multiple papillomas have a slightly increased risk of malignant change.
Sometimes this can cause confusion. During mammographic screening, a radiologist may see a star-shaped lesion. It may resemble a malignant tumor with puckering. In reality, the star shaped strands are due to the connective tissue that surrounds the radial scar.
These are small calcifications in the breast usually found incidentally on routine mammography. A radiologist is often able to determine whether or not these are benign. Microcalcifications occur as a result of stationary milk in the ducts that has calcified. If there is any doubt, any areas of calcification should be biopsied.
These are usually small, but can be large areas, where fat has died as a result of interruption of the local blood flow. Fat necrosis usually occurs after local trauma to the breast, for example, after a traffic accident.