Understanding Breast Conditions and Treatments

The following alphabetical list of breast conditions includes follow-up steps and treatments that may be recommended by your health care provider. Some of these breast conditions are associated with an increased risk of breast cancer, although most are benign.

Adenosis: A benign condition of glandular tissue in the breast that may result in small round lumps, lumpiness, or lumps that are too small to be felt. If there is scar-like fibrous tissue, the condition is called sclerosing adenosis.

Atypical ductal hyperplasia (ADH): A condition in which there are more cells than normal in the breast ducts and the cells look abnormal under a microscope. Women with ADH have an increased risk of breast cancer.

• If ADH is found after a core needle biopsy, then a surgical biopsy is often recommended as the next step.
• If ADH is found and diagnosed after a surgical biopsy that takes out the entire area of ADH, follow-up care includes more frequent mammograms. Sometimes, your doctor may advise more frequent clinical breast exams and breast self-exams.
• Drugs such as tamoxifen (for all women) or raloxifene or an aromatase inhibitor (for postmenopausal women) may also be prescribed.

Atypical lobular hyperplasia (ALH): A condition in which there are more cells than normal in the breast lobules and the cells may look abnormal. Women with ALH have an increased risk of breast cancer.

• If ALH is found after a core needle biopsy, as is often the case, your doctor will talk with you about whether a surgical biopsy or more frequent mammograms are recommended.
• If ALH is found during a surgical biopsy that takes out the entire area of ALH, follow-up care generally includes only more frequent mammograms.
• Drugs such as tamoxifen (for all women) or raloxifene or an aromatase inhibitor (for postmenopausal women) may also be prescribed.

Cysts: Fluid-filled lumps that are often found in both breasts. They may be painful just before your menstrual period begins. Some cysts may be felt, while others are too small to be felt. Cysts are most common in premenopausal women and in women taking menopausal hormone therapy. Cysts are diagnosed with ultrasound and/or fine needle aspiration and usually don’t require additional treatment.

Ductal carcinoma in situ (DCIS): A condition in which abnormal cells are found in the lining of a breast duct. DCIS may also be referred to as intraductal carcinoma. In some cases, DCIS will become invasive breast cancer. Treatment is based on how much and what part of the breast is affected and how abnormal the cells look (grade). Most women with DCIS are cured with proper treatment. Treatment may include:

• Lumpectomy. This is a type of breast-conserving surgery (also called breast-sparing surgery). This may be followed by radiation therapy.
• Mastectomy. This is surgery to remove the breast or as much of the breast tissue as possible.
• Tamoxifen. This drug may also be taken to lower the chance that DCIS will come back after treatment or to prevent invasive breast cancer.

Duct ectasia (also called mammary duct ectasia): A breast condition in which the ducts in the breast thicken and become blocked with fluid, causing nipple discharge, tender or red nipples, and inverted nipples. If the blocked duct becomes infected, you may feel a lump under the nipple. Most often this condition goes away on its own and doesn’t need treatment. Your health care provider may suggest you take pain medicine; apply a warm, wet cloth to your breast; use breast pads for nipple discharge; and/or take antibiotics. 

Fat necrosis: A breast condition that may cause round, firm, usually painless lumps. It may appear after an injury to the breast, surgery, or radiation therapy. Skin around the lump may look red, bruised, or dimpled. A biopsy may be used to both diagnose and remove fat necrosis.

Fibroadenoma: A benign tumor that feels like a hard, round lump in the breast. These lumps move easily and usually don’t hurt. Fibroadenomas are the most common benign breast tumor in women under 30 years old. Complex fibroadenomas may slightly increase your risk of breast cancer. These lumps may go away, or your doctor may advise that they be removed.

Fibrocystic breast changes (also called fibrosis or fibrocystic breast disease): A common breast condition that causes painful, lumpy breasts. Symptoms often start before or during your menstrual period. Other changes may include sensitive nipples and itching. Fibrosis is most common among women under the age of 45 and among women taking hormone replacement therapy. As many as half of all women may have fibrocystic breast changes at some point in their lives. Although these changes are not usually treated, your health care provider may recommend that you take pain medicine, apply heat or ice compresses, and/or wear a tighter fitting bra.

Granular cell tumors: These rare tumors are almost always benign. Symptoms may include a firm lump in the breast. Surgery may be needed to remove these tumors.

Intraductal papilloma: A wart-like growth that is usually close to the nipple. It may cause pain, a lump, and clear, sticky, or bloody discharge. Single papillomas don’t increase a woman’s risk of breast cancer. However, women with multiple papillomas have an increased risk of breast cancer. A biopsy is often used to both diagnose and remove these growths.

Lobular carcinoma in situ (LCIS): A condition in which abnormal cells are found in the breast lobules. There are more abnormal cells in the lobules with LCIS than with ALH. Women with LCIS have an increased risk of developing cancer in either breast.

• If LCIS is found after a core needle biopsy, an excisional biopsy will be done.
• If LCIS is diagnosed and removed during an excisional biopsy, follow-up includes more frequent mammograms. Your doctor may also advise more frequent clinical breast exams and breast self-exams.
• Drugs such as tamoxifen (for all women) or raloxifene or an aromatase inhibitor (for postmenopausal women) may also be prescribed by your doctor.

Mastitis: A breast condition in which the breast looks red and feels lumpy, warm, and tender. It is most common among women who are breastfeeding and is caused when a milk duct becomes blocked and infected. Mastitis is commonly treated with antibiotics and can be prevented with a change in breastfeeding techniques that your doctor, nurse, or a breastfeeding consultant can help with.

Phyllodes tumor (also called CSP and cystosarcoma phyllodes): A rare type of breast tumor that is usually benign but may be cancer. In rare cases, it may spread to other parts of the body. These tumors are usually removed surgically.

Sclerosing Adenosis: A type of adenosis in which scar-like fibrous tissue is found in the glands of the breast. It may cause pain and slightly increase a woman’s risk of breast cancer. Although treatment is not usually needed, your doctor may advise taking pain medicine, making dietary changes, or wearing a bra with extra support.