Arizona Blood & Cancer Specialists Logo

Operable Benign
Breast Conditions

With some benign breast conditions, surgery may be required.

Because of improvements in breast imaging, widespread education and awareness about women’s health and cancer, breast abnormalities are being found at earlier stages than ever before.

Depending on the abnormality, surgery may be recommended. A biopsy is a common type of surgery that is ordered to obtain additional studies so that a determination can be made as to a diagnosis. During a biopsy, tissue is removed and sent for examination by a pathologist. This is usually done in a surgeon's office or by a radiologist in an outpatient or hospital setting.

The goal of the biopsy is to obtain a definitive diagnosis. It does not remove the lesion or area of concern that has been identified with a physical exam and breast imaging.

Excisional biopsies or other types of surgical procedures to remove abnormalities may be recommended for other potentially operable conditions that include:

Breast Abscess:

Mastitis is an infection that affects breast tissue. This can happen during breastfeeding when a milk duct becomes clogged and doesn’t drain properly. This is a painful condition that can cause the breast to be red, swollen, and painful, especially in a specific area. In addition, this kind of infection can cause flu-like symptoms including fever, body aches, and fatigue.

A sebaceous cyst develops in the sebaceous gland which secretes sebum, an oil that lubricates a person’s hair and skin. When this type of breast cyst is infected it will appear red and swollen and can be quite painful.

There are rare cancers-that can present similar to a breast abscess so it’s important to be closely followed by a breast specialist or breast surgeon with any type of breast abscess.

Fibroadenoma:

The most common type of benign breast tumor is a simple fibroadenoma. They are usually diagnosed in younger, premenopausal women, however, women at any age can develop a fibroadenoma.

African American women have a higher incidence of developing fibroadenomas more frequently and at a younger age.

Younger girls and teenagers can develop juvenile fibroadenomas. They tend to be large and grow rapidly.

Complex fibroadenomas may have areas of calcification, cysts, or other changes within it.

Not every fibroadenoma requires surgery. Breast surgeons consider things such as the size, the amount of pain it is causing, if it’s growing, or if the pathology is uncertain to make a determination whether it should be removed surgically.

For fibroadenomas that are not removed, regular follow up with breast ultrasound studies can be used to monitor whether it is increasing in size.

The risk of developing breast cancer in most women diagnosed with this type of benign breast tumor is not increased.

Skin Conditions

Dermatologic conditions such an ingrown hair, eczema, or skin rashes can affect the breast, nipple, or axilla. Because certain cancers can affect the breast skin, follow up with a breast specialist is recommended so that a breast exam can be done, and additional tests such as mammograms, ultrasound, or skin biopsy can be done to determine a diagnosis.

Supernumerary Nipple

Some people may also have an extra nipple, which is called a supernumerary nipple. Typically, they don’t pose a health risk and are not a cause for concern. They can however be a sign of a congenital breast defect and may indicate an underlying condition, including tumor growth or cancer, although this is rare. The genetic condition that causes an extra nipple can make it possible for breast cancer to develop in the third nipple, just like it would in a regular breast.

When necessary, noninvasive outpatient surgery can be performed to remove the nipples.

Nipple Discharge

Discharge from the nipple that is not breast milk can occur. Both women and men can have nipple discharge. The discharge can range from a clear fluid to one that is bloody or has a yellow, green, dark brownish appearance, or even black. There are several possible causes for a nipple discharge that can occur from one or both nipples.

Any time a nipple discharge is noticed that is not breast milk, follow up with a healthcare professional is important. They can order proper testing to determine the reason for the discharge, and to rule out breast cancer as a cause.

Lactating Adenoma

This is the most common cause for a breast mass in a woman who is pregnant or breastfeeding. Made mostly of glandular tissue, it can be triggered by the hormonal changes experienced during pregnancy and breastfeeding.

Gynecomastia

This is a condition in men that results in the enlargement of both breasts (not just on one side). It is usually not associated with cancer. Gynecomastia can be caused by medical conditions including a hormonal imbalance, testicular or adrenal gland tumors, hyperthyroidism, hypoandrogenism, hypogonadism, kidney failure, and liver disease. It can also be caused by the use of certain medications, poor nutrition, heavy alcohol, marijuana or other drug use, weight gain, or obesity.

Radial Scar

A radial scar is not actually a scar. It is an overgrowth of cells in the breast that looks like a scar when it is viewed with a microscope. Often times, radial scars are discovered when a breast biopsy is performed for another reason. If they are large enough, they can be seen on a mammogram and can look like breast cancer. Larger radial scars can contain cancer cells. A biopsy is done to differentiate radial scars from cancer.

Currently, radial scars are thought to cause a slight to moderate increased risk for cancer.

Intraductal Papilloma

This condition is most commonly diagnosed in women over the age of 40, however, men can also develop intraductal papillomas. In men though, it is very rare. Gland and fibrous tissue along with and blood vessels in the breast can form a benign, wart-like tumor that grows within the milk ducts of the breast. They are a common cause of nipple discharge that is either clear fluid or bloody discharge, especially when the discharge is only from one of the breasts. Sometimes a small lump can be felt just behind or next to the nipple and can be painful.

Typically, intraductal papillomas do not increase the risk of developing breast cancer. It is possible however for atypical cells (abnormal cells) to be present which can slightly increase the risk for developing future breast cancer. Having multiple intraductal papillomas may also slightly increase a person’s risk.

Atypia

With atypical hyperplasia, cells are increasing in number and don’t look normal when examined under a microscope. Atypical ductal hyperplasia (ADH) and atypical lobular hyperplasia (ALH), are considered high-risk conditions as these lesions greatly increase the risk of developing breast cancer in the future. Surgery is often recommended to remove the cells and the area around them. A close follow-up is also recommended.

Flat epithelial atypia (FEA) is also another type of atypical hyperplasia, however, the risk of developing into invasive breast cancer is lower.

Discordant Biopsy

On breast imaging, sometimes benign lesions can look like malignant lesions. When the radiologist has a suspicion that a breast malignancy is present, a core needle biopsy is done to confirm the radiologic findings. When there is a discrepancy between what is seen on imaging and the pathologic results from the biopsy, a surgical biopsy may be recommended as a repeat biopsy because the findings from an initial core needle biopsy were inconclusive. “False-negative” results can happen with a core needle biopsy because a smaller amount of tissue is removed compared to a surgical biopsy.