Tumours


Benign breast tumours
In the breast benign tumours may occur. Usually, these tumours don’t require treatment. However, these lesions may cause symptoms such as pain or a feeling of heaviness in the breast. Some types of benign lesions can become cancerous, and must therefore be removed.

Below is an overview of the different benign tumours of the breast.
Click on one of the links for more information.

Mastopathy

This is a collective name for several benign diseases of the breast. The breast can feel irregular and multiple nodules, skeins and discs can be felt. Furthermore, the breast may feel tense and secretion from the nipple may occur. Mastopathy can occur simultaneously in both breasts. The main symptoms are a regular, cycle dependent pain. After menopause, the symptoms disappear. Treatment is particularly symptomatic, aiming at pain relief. Surgery is not the solution.

Fibroadenoma

A lump of connective tissue that is caused by local proliferation of this tissue. The surrounding tissue is pushed away, but the fibro-adenoma does not grow into it. There is no relationship with cancer. The deviation is innocent and surgery is not needed. In cause of symptoms of pain or marked increase, surgery may be considered.

Intraductal papilloma

This is a benign tumour of the milk ducts. It may cause blockage of the milk duct, thereby causing local swelling. It can also cause (bloody) nipple discharge. The papilloma can be selectively removed via an operation. The excised tissue is subsequently examined under the microscope.

Ductal hyperplasia

This is an excessive growth of the milk ducts. This is a benign disorder, but it increases the likelihood of an occult malignant lesion.

Sclerosing adenosis

This is an increase of glandular structure particles in the final branches of the mammary glands, the so-called lobules. The new glands are comprised of normal, noncancerous cells. This goes along with an increase in the fibrous tissue surrounding it, called sclerosis.

Usually this diagnosis is established when biopsy is done of breast calcifications seen on a chest X-ray. This condition is harmless and surgery is not required.

Phyllodes tumor

This is a rare tumour (1% of all breast tumours). It is seen mainly in women and rarely in men. There is a malignant variant and a benignant variant. The malignant variant is seen in 2 out of 1 million women each year. Usually it is a soft, mobile, benign mass that pushes the surrounding tissue away, but does not grow into it. These tumours are often large (> 5cm).

Generally, these tumours do not spread not to lymph nodes. There are several types. The malignant types can spread to other organs (such as lung) via the blood. More often a less malignant type is seen. It is of great importance to remove the tumour with a wide margin of normal tissue. The phyllodes tumor has a high rate of local recurrence. With surgery the tumour is locally removed. In a few cases mastectomy is required.

Mastitis

This literally means inflammation of the breast. It is an inflammation of the milk ducts, sometimes in combination with an inflammation of the intervening tissue. The breast is swollen, red and painful. These symptoms are often accompanied by fever.

Fat necrosis

This condition can develop after an injury or surgery of the breast. The fat tissue in the breast atrophies and forms a lump.

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Malignant breast tumours
Most malignancies of the breast originate in the milk ducts. These tumours are usually visible on mammogram. The less common malignant tumours occur in the mammary gland itself. These tumours are usually difficult observable on mammogram or ultrasound and are often less palpable.

Below is an overview of the various malignant tumours of the breast.
Click on one of the links for more information.

Ductal carcinoma in situ

Very early stage of cancer that develops in the milk ducts (hence the name ductal). It is non-invasive, which means that it is not spread outside the milk ducts and that is has not spread to the lymph nodes. To prevent development into an invasive cancer it must be treated by, often breast-conserving, surgery followed by radiation.

Lobular carcinoma in situ

Lobular carcinoma in situ (LCIS) is a non-invasive cancer that arises in a mammary gland. LCIS will not spread to the lymph nodes.

Ductal carcinoma

This invasive cancer arises in the milk ducts and grows through the boundaries of the ducts and into the surrounding tissue. It is the most common type of breast cancer. It is often palpable as a hard lump and has the tendency to disseminate to the lymph nodes of the axillary or the sternum. This type of breast cancer has the worst prognosis.

Lobular carcinoma

Cancer originating in a breast gland and growing through the boundaries of it. It usually causes a general swelling of breast instead of a nodule. It covers 5-10% of all breast cancer. Because it is more widespread through the breast, it is often discovered at progressed stage. This type of cancer does metastasize.

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