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Overview of benign breast disease

Author
Michael S Sabel, MD
Section Editor
Anees B Chagpar, MD, MSc, MA, MPH, MBA, FACS, FRCS(C)
Deputy Editor
Wenliang Chen, MD, PhD

INTRODUCTION

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 "Clinical manifestations and diagnosis of a palpable breast mass" 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 [1]. 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 [5]. Apocrine metaplasia (also referred to as a "benign epithelial alteration") is also a nonproliferative change that is secondary to some form of irritation, typically associated with a breast cyst.

                                   

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Literature review current through: Jul 2017. | This topic last updated: Jul 05, 2017.
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