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Dr Senarath Edirimanne

Benign (Non cancerous) breast conditions

These conditions are often detected as a result of investigations of breast symptoms or as unexpected findings in a mammogram or breast ultrasound scan. Some of them require surgery and the others medical management or observation.

Fibroadenoma and Phyllodes tumours:

These are growths that start in supportive tissue in between the glands of the breast. Fibroadenoma are common and non cancerous. Phylloides tumous are uncommon and some of them can have cancerous behaviour. Some of these growths need surgical removal if they are large, keep on growing, suspicious for phyllodes tumours or symptomatic.

Cysts:

These are very common in women of childbearing age. Simple cysts (based on ultrasound appearance) are innocent and mostly do not need any further action. Complex cysts (based on ultrasound appearance) are mostly innocent but often needs a needle biopsy to rule out the rare chance of cancer.

Nipple discharge/ papillary lesions:

Most of the nipple discharges are not due to cancer but they need investigations to rule it out. This is particularly important if the discharge is spontaneous, ongoing, coming out of one spot, blood stained or clear straw colour. If the investigations are normal but the suspicious discharge continues, some patients need the surgical removal of the relevant duct system known as microdochectomy. Papillary lesions are growths in the main ducts of the breasts and sometimes cause nipple discharge. Usually they need removal to rule out papillary cancer even though most of them are innocent papilloma.

Breast pain/Mastalgia:

Breast pain is common. It could be related to menstrual cycle (cyclical mastalgia) or not. Some breast pain can originate from other surrounding structures such as chest wall, back and joints. After other causes are rule out most can be managed by supportive measures and some find evening primrose oil helpful. Rarely some need hormonal treatment.

Breast infection/ abscess:

These are common during breast feeding period. They are managed with antibiotics and often multiple aspirations while the patient continues to breastfeed. Infections and abscesses are uncommon outside breast feeding period and needs to be investigated to rule out an underlying cancer.

Gynaecomastia:

This is the abnormal enlargement of male breast tissue. Even though male breast cancer is uncommon any breast lump in a male needs to be checked to rule out cancer. Some forms of gynaecomastia are normal and temporary such as that happens during teenage years. Others may have underlying causes such as medical conditions, prescription or recreational drugs and settle after correction of those causes. Some patients may benefit from medical or surgical treatment.