Benign breast disease represents a spectrum of disorders that come to clinical attention as imaging abnormalities or as palpable lesions found on physical examination. Following establishment of a benign diagnosis, treatment in general is aimed at symptomatic relief and patient education.
Some benign breast diseases, such as atypical hyperplasia, confer an increase in the patient's future risk of developing breast cancer, and should lead to counseling about screening recommendations and risk reduction strategies. These lesions are considered risk markers, rather than premalignant, because those cancers that subsequently develop are not necessarily in the area of the atypia, and may occur in the contralateral breast.
This topic will review the pathologic classification and treatment of benign breast disorders. Evaluation of women presenting with symptoms related to the breast and diagnosis of breast disorders are discussed separately. (See "Breast masses and other common breast problems" and "Breast pain" and "Nipple discharge".)
CLASSIFICATION OF BENIGN BREAST LESIONS
Benign epithelial breast lesions can be classified histologically into three categories: nonproliferative, proliferative without atypia, and atypical hyperplasia. The categorization is based upon the degree of cellular proliferation and atypia [1-10]. (See "Breast development and morphology".)
NONPROLIFERATIVE BREAST LESIONS
Nonproliferative epithelial lesions are generally not associated with an increased risk of breast cancer . It should be noted that terms such as fibrocystic changes, fibrocystic disease, chronic cystic mastitis, and mammary dysplasia refer to nonproliferative lesions and are not useful clinically, as they encompass a heterogeneous group of diagnoses [5,11]. The most common nonproliferative breast lesions are breast cysts. Other nonproliferative lesions include papillary apocrine change, epithelial-related calcifications and mild hyperplasia of the usual type .