Benign Breast Diseases
In this title, which also includes the group of breast diseases formerly described as fibrocystic breast disease, I will mostly talk about the most common benign breast diseases.
Breast Cysts
Breast cysts occur in almost 40% of women. They are most common between the ages of 35 and 50 and are less common during menopause. They develop in the milk glands where the milk ducts terminate and are fluid-filled structures.
- Simple breast cysts contain only fluid and have thin walls. They do not carry cancer potential and are the most common group, mostly causing pain in the breast and a palpable mass.
- Complicated breast cysts are mostly structures containing dense fluid due to their fluid structure. Although it is accepted that they do not carry cancer risk, they can be followed up more closely or biopsy can be taken in case of suspicion on imaging.
- Complex breast cysts, on the other hand, have a thicker wall structure or structures that create different compartments in the fluid-containing part. The risk of cancer may be increased not because of the cystic structure but because of the wall structure and the mass structures in its content, and follow-up is performed with imaging or biopsies.
Despite a general rumor, breast cysts do not decrease after pregnancy and breastfeeding periods; in fact, they usually increase in size during pregnancy. Their number and size may also increase in women receiving hormone replacement therapy after menopause.
Fibroadenomas
Fibroadenomas are benign tumors formed by the connective tissue that makes up the breast and the cells that form the milk glands. They tend to occur in more than one or both breasts in one out of every 5 women. In adults, they are divided into 3 groups: simple, complex and giant fibroadenomas.
- Simple fibroadenomas do not carry cancer potential, biopsy is usually taken from fibroadenomas reported to be over 1 cm on imaging and if it is reported as a simple fibroadenoma in the foreground, it is decided whether it should be removed surgically according to its growth status.
- Complex fibroadenomas are structures that contain not only fibroepithelial changes but also cell proliferation findings as a result of biopsy. They are at risk of cancer not by themselves but because of the associated diseases that cause cell changes and proliferation. Fibroadenomas described as such on biopsy are surgically removed.
- Giant fibroadenomas, fibroadenomas over 10 cm, should be removed regardless of the biopsy result, as they can cause confusion in imaging and pathology examinations.
Lipomas
They are sebaceous glands, and although they do not normally pose any cancer risk, they are removed when they can cause confusion on imaging.