Not all lumps are cancer
Don't assume the worst, but do see your doctor

[October 23, 2019]  Benign (non-cancerous) breast conditions are very common, and most women have them. In fact, most breast changes are benign. Unlike breast cancers, benign breast conditions are not life-threatening. But some are linked with a higher risk of getting breast cancer later on.

Some breast changes may not cause symptoms and may be found during a mammogram. But sometimes they can cause symptoms that are like those from breast cancer, so it can be hard to tell the difference based on symptoms alone. If your symptoms or mammogram results suggest that you may have a problem with your breast, your doctor will take more steps to find out what it is.

Fibrosis and Simple Cysts in the Breast

Many breast lumps turn out to be caused by fibrosis and/or cysts, which are non-cancerous (benign) changes in breast tissue that many women get at some time in their lives. These changes are sometimes called fibrocystic changes, and used to be called fibrocystic disease.

Fibrosis and cysts are most common in women of child-bearing age, but they can affect women of any age. They may be found in different parts of the breast and in both breasts at the same time.

Fibrosis

Fibrosis refers to a large amount of fibrous tissue, the same tissue that ligaments and scar tissue are made of. Areas of fibrosis feel rubbery, firm, or hard to the touch.

Cysts

Cysts are fluid-filled, round or oval sacs within the breasts. They are often felt as a round, movable lump, which might also be tender to the touch. They are most often found in women in their 40s, but they can occur in women of any age. Monthly hormone changes often cause cysts to get bigger and become painful and sometimes more noticeable just before the menstrual period.

Cysts begin when fluid starts to build up inside the breast glands. Microcysts (tiny, microscopic cysts) are too small to feel and are found only when tissue is looked at under a microscope. If fluid continues to build up, macrocysts (large cysts) can form. These can be felt easily and can be as large as 1 or 2 inches across.

Diagnosis

Most often, fibrocystic changes are diagnosed based on symptoms, such as breast lumps, swelling, and/or tenderness or pain. These symptoms tend to be worse just before your menstrual period, and may change during different stages of your menstrual cycle. Your breasts may feel lumpy, and at times you may notice a clear or slightly cloudy nipple discharge.

Sometimes, one of the lumps might feel firmer or have other features that lead to a concern about cancer. When this happens, an ultrasound may be done to see if the lump is solid or is just filled with fluid (called a simple cyst). Simple cysts are not usually a cause for concern. But if the ultrasound shows the lump is solid or if the cyst has both fluid and solid components (a complex cyst), a biopsy may be needed to make sure that it’s not cancer.

How do fibrosis and simple cysts affect your risk for breast cancer?

Neither fibrosis nor simple cysts increase your risk of later developing breast cancer. Complex cysts are more of a concern, as there is a small chance they might contain cancer or put you at risk of cancer later on, depending on what is found at the time of biopsy.

Treatment

Cyst fluid doesn't need to be removed unless it's causing discomfort. But it can be drained by putting a thin, hollow needle into the cyst, which might be done to confirm the diagnosis. Removing the fluid may reduce pressure and pain for some time. If removed, the fluid might come back later, but cysts may also go away over time. For cysts that continue to come back and cause symptoms, surgery to remove them might be an option.

Most women with fibrocystic changes and without bothersome symptoms do not need treatment, but they might be watched closely. If you have mild discomfort from fibrosis, you may get relief from well-fitted, supportive bras, applying heat, or using over-the-counter pain relievers.

Some women report that their breast symptoms improve if they avoid caffeine and other stimulants found in coffee, tea, chocolate, and many soft drinks. Studies have not found a clear link between these stimulants and breast symptoms, but many women feel that avoiding these foods and drinks for a couple of months is worth trying.

Because breast swelling toward the end of the menstrual cycle is painful for some women, some doctors recommend over-the-counter pain relievers such as acetaminophen or ibuprofen, or other medicines. It’s been suggested that some types of vitamin or herbal supplements might relieve symptoms, but so far none have been proven to be helpful, and some may have side effects if taken in large doses. Some doctors prescribe hormones, such as oral contraceptives (birth control pills), tamoxifen, or androgens. But these are usually given only to women with severe symptoms because they also can have serious side effects.

[The American Cancer Society medical and editorial content team]

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.