Other Breast Pathologies

What else might be detected in screening?

 

Breasts are like any other part of the body – they can develop cancers and also other conditions that aren’t cancer (called benign conditions), that may cause some discomfort, or anxiety. Breasts are constantly changing as woman get older, and go through pregnancy or the menopause, as well as the daily hormonal changes due to the menstrual cycle. These changes can cause some breast conditions to develop, and these may need treatment – however a lot of benign conditions are safe to leave alone.

Cysts

These are very common, caused by fluid build-up in the breast lobules (see our anatomy page), leaving them stretched and full of fluid – a little like a water balloon, if you will! They can be very tiny micro-cysts, or a few centimetres wide, and feel like hard or soft lumps. They can develop as a response to the hormonal changes in a woman, and can cause pain and discomfort. To treat them, it’s common to draw off the fluid using a small needle and syringe, and the fluid can be clear or very dark green in colour. Sometimes breast cysts can return, even after drainage: you will be offered another drainage, the treatment is usually the same each time.

Fibroadenoma

grapesThis also feels like a lump, but this seems like it moves around under touch – for this reason it used to be known as a ‘breast mouse’! They’re usually painless, and again can vary in size from about 1- 3cm, and again are thought to be caused by hormones. A simple fibroadenoma won’t turn into cancer. They’re diagnosed using the ‘triple assessment’ of mammogram, ultrasound and  needle biopsy test, and treatment is not always necessary. If treatment is recommended, which is rare, then it will usually be surgery.

Duct Ectasia

Breast ducts are the tubes that carry milk from the lobules that produced it to the nipple. The ducts directly behind the nipple can change, and widen and shorten as the breasts age – this is normal – but sometimes it can cause the nipple to be pulled inwards instead of sticking outwards (called an inverted nipple). Sometimes, secretions can collect in the ducts behind the nipple, and get infected, causing the feeling of a lump there, or cause a leaky nipple discharge. Although the cause is normal, the symptoms (nipple inversion, discharge, lump) are the same as some breast cancers – so you need to get it checked out. You’ll be offered a clinical examination and imaging, but it usually doesn’t need any treatment, although occasionally surgery is offered if the symptoms become problematic.

Breast Calcifications

You can’t feel breast calcifications, as they are tiny (less than a millimetre in size) and don’t cause any symptoms. They are usually only found by having a mammogram. They form because the breast duct gets a little blocked up, usually from normal cell ‘debris’ or other changes, and this causes the calcium in our normal breast secretions to harden and form tiny spheres. Nine times out of ten, this is caused by normal ageing changes in the breast – but in one out of ten cases, the ducts are being blocked by cancerous cells. If calcifications are seen on your mammogram, you will be offered a needle biopsy so that the tissue with the calcifications in it can be looked at under the microscope, where cancerous cells can be identified. Treatment will then follow. With calcifications, it’s important to remember that calcifications themselves are not a problem – but what is causing it might well be. So, if your calcifications are caused by the normal aging process of the breast then there is no need for treatment, and they will not turn into cancer at a later date.

Sclerosing Breast Lesions

These are otherwise known as sclerosing adenosis, radial scar or complex sclerosing lesions, and are areas of breast tissue that harden because the breast is ageing. It’s a normal, benign finding, but can cause problems because when seen on mammograms, they look very similar to what a breast cancer looks like. They aren’t able to be felt, only very rarely, when in that case they can feel like a lump. The only way to sort out what it is for sure is to take a sample by needle biopsy, and sometimes by a vacuum assisted biopsy, which samples more of the area to get a definite first-time result from these sometimes tricky-to-diagnose lesions.

Read our breast cancer information page Click Here.