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Understanding Breast Changes: A Health Guide for Women

  • Posted: 01/01/2011

Breast Conditions and Follow-Up Care


ConditionsFeaturesWhat Your Doctor May Recommend
Adenosis
  • Small round lumps, lumpiness, or you may not feel anything at all
  • Enlarged breast lobules
  • If there is scar-like fibrous tissue, the condition is called sclerosing adenosis. It may be painful.
  • Some studies have found that women with sclerosing adenosis may have a slightly increased risk of breast cancer.
  • A core biopsy or a surgical biopsy may be needed to make a diagnosis.
Atypical lobular hyperplasia (ALH)
  • Abnormal cells in the breast lobules
  • ALH increases your risk of breast cancer.

Regular follow-up, such as:

  • Mammograms
  • Clinical breast exams.

Treatment, such as:

  • Tamoxifen (for all women) or raloxifene (for postmenopausal women)
Atypical ductal hyperplasia (ADH)
  • Abnormal cells in the breast ducts
  • ADH increases your risk of breast cancer.

Regular follow-up, such as:

  • Mammograms
  • Clinical breast exams.

Treatment, such as:

  • Tamoxifen (for all women) or raloxifene (for postmenopausal women)
Breast cancer
  • Cancer cells found in the breast, with a biopsy
  • A lump in or near your breast or under your arm
  • Thick or firm tissue in or near your breast or under your arm
  • A change in the size or shape of your breast
  • A nipple that's turned inward (inverted) into the breast
  • Skin on your breast that is itchy, red, scaly, dimpled, or puckered
  • Nipple discharge that is not breast milk

Treatment depends on the extent or stage of cancer.

Tests are done to find out if the cancer has spread to others parts of your body.

Treatment may include:

Clinical trials may be an option for you. Talk with your doctor to learn more.

Cysts
  • Lumps filled with fluid
  • Often in both breasts
  • May be painful just before your menstrual period begins
  • Some cysts may be felt. Others are too small to be felt.
  • Most common in women 35-50 years old
  • Cysts may be watched by your doctor over time, since they may go away on their own.
  • Ultrasound can show if the lump is solid or filled with fluid.
  • Fine needle aspiration may be used to remove fluid from the cyst.
Ductal carcinoma in situ (DCIS)
  • Abnormal cells in the lining of a breast duct
  • Unlike cancer cells that can spread, these abnormal cells have not spread outside the breast duct.
  • May be called noninvasive cancer or Stage 0 breast carcinoma in situ.

Treatment is needed because doctors don't know which cases of DCIS may become invasive breast cancer. Treatment choices include:

  • Lumpectomy. This is a type of breastconserving surgery or breast-sparing surgery. It is usually followed by radiation therapy.
  • Mastectomy. Surgery to remove the breast.
  • Tamoxifen. This drug may be taken to lower the chance that DCIS will come back after treatment or to prevent invasive breast cancer.
  • Clinical trials. Talk with your doctor about whether a clinical trial is a good choice for you.
Fat necrosis
  • Round, firm lumps that usually don't hurt
  • May appear after an injury to the breast, surgery, or radiation therapy
  • Formed by damaged fatty tissue
  • Skin around the lump may look red, bruised, or dimpled
  • A benign (not cancer) breast condition
  • A biopsy may be needed to diagnose and remove fat necrosis, since it often looks like cancer.
  • Fat necrosis does not usually need treatment.
Fibroadenoma
  • Hard, round lumps that move around easily and usually don't hurt
  • Often found by the woman
  • Appear on a mammogram as smooth, round lumps with clearly defined edges
  • The most common benign breast tumors
  • Common in women under 30 years old
  • Most fibroadenomas do not increase your risk of breast cancer. However, complex fibroadenomas do slightly increase your risk.
  • A biopsy may be needed to diagnose fibroadenoma.
  • A minimally invasive technique such as ultrasound-guided cryoablation or an excisional biopsy may be used to remove the lumps.
  • These growths may be watched by your doctor over time, since they may go away on their own.
Intraductal papilloma
  • A wart-like growth inside the milk duct, usually close to the nipple
  • May cause pain and a lump
  • May cause clear, sticky, or bloody discharge
  • Most common in women 35-55 years old
  • Unlike single papillomas, multiple papillomas increase your risk of breast cancer.
  • A biopsy may be needed to diagnose the growth and remove it.
Lobular carcinoma in situ (LCIS)
  • A condition in which abnormal cells are found in the breast lobules
  • LCIS increases your risk of breast cancer.

Regular follow-up, such as:

  • Mammograms
  • Clinical breast exams

Treatment choices:

  • Tamoxifen (for all women) or raloxifene (for postmenopausal women) may be taken.
  • A small number of women with LCIS and high risk factors for breast cancer may choose to have surgery.
  • Clinical trials may be an option for you. Talk with your doctor to learn more.
Macrocalcifications
  • Calcium deposits in the breast that look like small white dots on a mammogram
  • Often caused by aging
  • Cannot be felt
  • Usually benign (not cancer)
  • Common in women over 50 years old
  • Another mammogram may be needed to have a closer look at the area.
  • Treatment is usually not needed.
Microcalcification
  • Calcium deposits in the breast that look like tiny white specks on a mammogram
  • Not usually a sign of cancer. However, if found in an area of rapidly dividing cells or grouped together in a certain way, they may be a sign of DCIS or invasive breast cancer.
  • Another mammogram or a biopsy may be needed to make a diagnosis.
More information on these breast conditions can be found on www.cancer.gov or by calling 1-800-4-CANCER (1-800-422-6237).


Glossary Terms

biological therapy (BY-oh-LAH-jih-kul THAYR-uh-pee)
Treatment to boost or restore the ability of the immune system to fight cancer, infections, and other diseases. Also used to lessen certain side effects that may be caused by some cancer treatments. Agents used in biological therapy include monoclonal antibodies, growth factors, and vaccines. These agents may also have a direct antitumor effect. Also called biological response modifier therapy, biotherapy, BRM therapy, and immunotherapy.
chemotherapy (KEE-moh-THAYR-uh-pee)
Treatment with drugs that kill cancer cells.
hormonal therapy (hor-MOH-nul THAYR-uh-pee)
Treatment that adds, blocks, or removes hormones. For certain conditions (such as diabetes or menopause), hormones are given to adjust low hormone levels. To slow or stop the growth of certain cancers (such as prostate and breast cancer), synthetic hormones or other drugs may be given to block the body’s natural hormones. Sometimes surgery is needed to remove the gland that makes a certain hormone. Also called endocrine therapy, hormone therapy, and hormone treatment.
radiation therapy (RAY-dee-AY-shun THAYR-uh-pee)
The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called irradiation and radiotherapy.
surgery (SER-juh-ree)
A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.