BREAST LUMP
- Fibroadenoma is the most common benign or non- cancerous growth of the breast, predominantly found in young women
- It usually presents as a breast lump and can sometimes be associated with pain. Although majority of the patients have a single lump, multiple lumps may also occur simultaneously
- Fibroadenomas do not interfere with pregnancy and lactation and have no additional risk for malignancy
- They can enlarge rapidly during pregnancy, breast feeding or when there is an increase of hormone influence
- A fibroadenoma is usually diagnosed through clinical examination, ultrasound or mammography, and a confirmatory needle biopsy
- All fibroadenomas do not need surgical treatment, only those that tend to grow or are associated with pain or with a suspicious biopsy need surgical removal. The surgery can usually be done as a day-care procedure. The scar is hidden around the areola so that it becomes invisible in a few months
- Few fibroadenomas may grow rapidly or recur at the operated site, these may in fact be a different type of tumor called Phyllodes tumor. These should be aggressively treated by a breast surgeon
First and foremost, there is no need to panic, as the reason for lumps could be different like cysts, fibroadenoma and others, lump is not always due to a cancer. But all breast lumps should always be thoroughly evaluated by a breast specialist. Breast cancer should be ruled out by mammography, sonography and needle biopsy
Fibroadenomas are not cancerous and do not significantly increase the risk of developing breast cancer
Fibroadenomas measuring less than 1cm may decrease in size, however larger fibroadenomas tend to increase in size. Fibroadenomas can enlarge rapidly during pregnancy, breastfeeding and while taking hormone replacement therapy
Medical treatments are not usually advised for these conditions as there is no hormonal imbalance or hormones to be corrected
Fibroadenomas can usually be removed through hidden scars around the areola. Scars in the arm pit and the inframammary fold also hide well. Use of absorbable sutures instead of removable sutures also reduces scars
As fibroadenomas are ‘pushing growths’ that do not grow into the surrounding normal tissues, their removal does not cause volume loss. The surrounding tissues that have been pushed away, falls back into the space created on removal
BREAST CYST
- A breast cyst is a localized collection of fluid in the breast
- Cysts are common in young women and are caused due to cyclical hormonal changes. They generally feel smooth under the skin and may or may not be painful
- Cysts do not increase the risk of breast cancer
Breast lump- Large cysts may present as a palpable lump in the breast. The lump is usually smooth, soft and moves easily
Breast pain- Cysts are often painful, especially prior to a period
Breast cysts are very common, may occur in up to 50% of women who attend breast clinics. They are most common between 30 to 50 years and usually disappear after menopause
Breast cysts are not cancerous and having cysts does not significantly increase the risk of developing breast cancer. The primary aim is confirming the diagnosis of a breast lump as a cyst on imaging and needle aspiration or biopsy. Once confirmed to be benign, these cysts can either be observed or treated if symptomatic. It is important that every new breast lump be appropriately investigated
Simple cysts causing no symptoms and having benign features on imaging do not require treatment. Only Cysts that are large and symptomatic are aspirated with a needle
Complex cysts have a thick wall or debris. These are aspirated and cytologically evaluated and excised if suspicious
Surgery is rarely recommended to remove cysts. Only cysts that recur after repeated aspirations or cysts that show suspicious features on imaging or biopsy are excised
Cysts can recur after aspirations or new cysts can form in the nearby breast tissues due to hormonal fluctuations. Cysts that recur within a few weeks following aspiration may require more testing
