Breast masses can be one of many benign formations or a sign of cancer. However, there is no need to panic immediately. If you have symptoms such as a lump that you can feel in your breast or redness, swelling, changes in the skin, it is useful to see your doctor.
What are Breast Masses
– Fibrocystic changes
– Cysts
– Fibroadenomas
– Breast infection (Mastitis)
– Traumas in the breast (fat necrosis)
– Connective tissue tumor
– Papilloma in the milk duct
-Cancer
Below you will find information on the causes, diagnosis and treatment of each.
Fibrocystic Changes
Half of all women in their lifetime have swollen and tender masses in their breasts, which we call fibrocystic changes. These are a collection of proliferated cells between the gland and fibrous tissue in the breast. Fibrocystic changes may also include fluid-filled structures called cysts. These cysts are formed by existing masses pressing on the ducts and blocking them from the outside. When fibrocystic tissues are compressed, they may move a little. Some tenderness and fullness is felt. They may also change during menstruation or menopause, depending on the increase or decrease in hormone levels. After menopause, fibrocysts decrease as estrogen and progesterone hormones decrease. Treatment of fibrocystic changes includes lifestyle changes and medication. Some studies have found that excessive consumption of caffeine causes fluid retention. It is therefore desirable to limit the consumption of caffeine-containing substances such as cola, coffee and chocolate. The use of supportive bras is recommended. If there is sensitivity, painkillers can be used. If the symptoms are severe, birth control pills or other hormone medications are prescribed.
Cysts
They are fluid-filled sacs formed by dilated ducts. Cysts are oval or round, smoothly shaped. They move slowly when pressed on. They are often detected in women in their 40s, close to menopause, due to changes in hormone levels. Cysts may form and then disappear. They can be tender and painful to the touch. They may form two weeks before menstruation and disappear spontaneously after menstruation. When the cysts disappear, the pain goes away. The presence of a cyst cannot be detected by breast examination alone. A more detailed examination is required for this. A thin needle is inserted into the suspected cyst to check for fluid. If there is fluid, it is sent to pathology for examination. There is usually no pain during this procedure, and as the fluid is removed, both the cyst itself disappears and the previous pain is reduced. It does not form for up to six weeks. Therefore, no further treatment is necessary. However, if it does not disappear or heal on its own, it is surgically removed.
Fibroadenomas
They are round, smoothly shaped, rubbery masses formed due to overgrowth of glands and connective tissue. They can grow as big as a small plum. They are usually painless and benign tumors. They may move or shift slightly when pressed on. Fibroadenomas are affected by hormonal changes. They tend to grow during pregnancy. They shrink after menopause. They can be seen in every period of women. However, they are most common in the 20s and 30s. It is very difficult to tell that the mass in the breast is a fibroadenoma just by examining it. Mammography and breast ultrasound are necessary for diagnosis. However, the definitive diagnosis is made by biopsy. It is also possible to remove the entire mass during the biopsy. Some fibroadenomas may disappear spontaneously. If it grows and bothers you, it can be surgically removed.
Breast Infections (Mastitis)
Mastitis is usually caused by bacteria entering the breast tissue during breastfeeding. If an abscess develops after mastitis, you may feel a lump in the breast or a thickened area of skin. Women after menopause can also develop mastitis. For unknown reasons, the milk ducts near the nipple swell and become red. This widens the milk ducts and causes swelling, pain and discharge from the breast. Antibiotics are sufficient for the treatment of mild mastitis. However, if mastitis is advanced and antibiotic treatment is not sufficient, surgery may be necessary. In older women, if there is no response to antibiotics, it is necessary to investigate to make sure there is no cancer.
Trauma (Fat Necrosis)
Trauma and other injuries to the breast tissue can lead to a condition called fat necrosis. It causes a round, smoothly shaped mass of loose scar tissue. If the injury is new, there is pain and there are signs of decay on the skin. If the injury is old, this mass is painless. Fat necrosis usually heals on its own. If there is no improvement, it is necessary to investigate for cancer.
Connective Tissue Tumors
They are painless masses of connective tissue in the breast. Most of the time they are benign. However, they can rarely be malignant. Benign ones can grow rapidly and reach a very large volume. It is very difficult to differentiate them from fibroadenoma on examination. Even after imaging techniques and biopsy, it may be difficult to differentiate them. However, fibroadenomas are more common and connective tissue tumors can be differentiated from fibroadenomas by their rapid growth. The treatment of connective tissue tumors is surgical removal. There is a possibility that the tumor may recur after surgery.
Papilloma in the Milk Duct
It is a small, non-cancerous growth in the milk duct. It is felt as a small mass behind the breast near the edge of the nipple. Squeezing the nipple may cause discharge or a spontaneous discharge may be observed. This discharge is usually bloody. Mammography and breast ultrasound are helpful for diagnosis. In treatment, the affected canal is surgically removed and checked for cancer.
Cancer
Malignant masses in the breast are usually painless, firm and irregularly shaped. They feel different from breast tissue. If the mass is attached to the underlying muscle tissue, it cannot be moved when pressed. The overlying skin tissue may be reddened or sunken. Other findings are as follows;
– Spontaneous clear or bloody discharge from the nipple
– Retraction or collapse of the nipple
– Changes in breast shape and size
– Flattening or collapse of the breast skin
– Point-by-point collapses on the breast skin like orange peel
Treatment will vary according to the type and stage of the cancer and the appearance of the cancer cells under a microscope. Surgery, radiotherapy, chemotherapy and hormone therapy are among the treatments. Early detection of breast cancer through regular breast examinations and mammograms will increase the chances of successful treatment.