What is a Benign Breast Tumor?

Breast tumors are common and account for about two-thirds of breast diseases. Its proportion is roughly benign breast tumors, breast malignant tumors, and other breast diseases, each accounting for about 1/3.

Benign breast tumor

Clinical manifestations of benign breast tumors

Adenofibroma and intraductal or intracapsular papilloma are more common in benign breast tumors.

Breast malignant tumors include cancer, sarcoma and carcinosarcoma. And breast cancer accounts for the majority.

Excess breast tumor: A tumor that grows on an excess breast is called an excess breast tumor. Can be benign or malignant, cancer is more common.

Male breast tumors: benign tumors include cysts, adenofibromas, lipomas, and papilloma. Malignant people have cancer and sarcoma.

Multiple benign breast tumors

Benign breast tumor

Breast Adenofibroma: It is most common in young women aged 20-25. Generally, they are solitary, and there may be multiple who appear in one or both breasts. The occurrence of breast adenofibroma is closely related to estrogen stimulation (strong ovarian function). Therefore, it rarely occurs before or after menstruation.

Clinical manifestations: Breast fibroids are mostly located in the outer upper quadrant of the breast. Often oval-shaped, the smaller ones are cherry-sized or walnut-sized, but larger ones are also possible. The tumor surface is generally smooth and hard. The tumor has a clear state and has no adhesion to the skin and surrounding tissues. Can be pushed around the breast without hindrance. Although it can be moved, let it go. No spontaneous pain or tenderness.

Intramammary duct or intracapsular papilloma: This disease is rare, mostly in women aged 40-50. Can be single or multiple shots. Tumors are usually located in the dilated nipples of the nipple, or in cysts that communicate with the nipples near the nipple. Papilloma is usually small, has pedicles and many villi, and is rich in thin-walled blood vessels, so it is easy to bleed.

Clinical manifestations: Patients generally have no pain. The main symptoms are nipple discharge and bleeding. Sometimes small round masses can be felt on the nipple, which is soft and non-adhesive to the skin and can be pushed. When the breast is squeezed, bloody secretions can be discharged from the nipple. Papilloma in the ducts or sacs of the breast can be 6-8% cancerous.

Symptoms of benign breast tumor disease

1. Painless mass: It is usually the first symptom. It is characterized by infiltrative growth of the mass. Even if the mass is small, it can cause skin adhesion when the ligamentum of the breast is involved. Larger masses may have skin edema and orange peel. , Nipple retraction or depression, lymphadenopathy and other symptoms; skin satellite nodules, and even ulcers later. Early diagnosis of this disease should be distinguished from benign breast lesions such as inflammatory masses, breast hyperplasia, and benign tumors.

2, nipple discharge: breast cancer with nipple discharge as the only symptom is rare, most of which are accompanied by breast masses, generally more bloody bloody bloody common.

3. Nipple change: When the breast fibrous tissue and duct system are infiltrated by the lesions, the nipple is shortened and the nipple is biased towards the side of the tumor to further develop the nipple, which can flatten, retract, sag, or even completely sink into the areola. Sometimes the entire breast is elevated due to contracture of the fibrous tissue in the breast. Clinically, the nipples on both sides are different, and the typical symptoms of eczema-like cancer when the nipples are still eroded.

Examination of benign breast tumor disease

A regular physical examination of the breast should include both inspection and palpation. The patient will be taken into an examination room with good natural or daylight. Before the examination, it is necessary to fully expose the chest and bilateral breasts, and use two methods of sitting and lying according to the requirements of the examining doctor. In the sitting position, both hands fell on the knees, and the upper limbs were relaxed; in the supine position, a pillow was sometimes added to properly raise the shoulders and chest, so that the breasts could be examined in a relatively flat condition, and it was not easy to miss the lesions.

The doctor will observe the development of the breast, whether it is symmetrical on both sides, whether the size is similar, whether the nipples are in the same position, whether the nipples have erosion, retraction, overflow, and whether the breast skin is abnormal. Changes such as cellulite sign and dimple sign are important manifestations of breast cancer diagnosis. Patients are often asked to hold their hands high to reveal the underside of the breast and the tail of the breast.

Palpation of the breast is very important. In particular, the doctor will pay attention to the location, size, border, texture, mobility, and adhesion of the skin and pectoral muscles when examining the mass, so as to make a judgment on the nature of the lesion. Experienced doctors often gently lift the breasts with their hands or increase skin tension to find out whether the skin caused depression after a slight stretch. If this is the case, it often indicates the possibility of early breast cancer. In order to examine the relationship between the mass and deep tissues, patients are sometimes required to have their hands on their hips to keep the pectoral muscles in a contracted state. If the mass invades the pectoralis fascia or pectoral muscles, the affected breast will be raised and the movement will be restricted during pectoral muscle contraction. Make a percussion on the surface of the breast in the quadrant or clockwise with the belly of two fingers flat. Do not grasp the breast with your fingers to prevent the normal breast tissue from being mistaken for a mass.

The axillary and supraclavicular lymph nodes are regional lymph nodes of breast cancer, so palpation of the axillary is also part of the physical examination, and occult breast cancer is sometimes found because the axillary touches the lymph nodes. The examination generally uses a sitting position, and the patient's arm is held up by the examiner to relax the armpit naturally to facilitate the examination. In the examination of the supraclavicular lymph nodes, the doctor often touches the supraclavicular fossa with both thumbs.

In addition to breast physical examination, women of all ages can also learn breast self-examination, which is a simple and economical method for early detection of breast cancer, but requires some training. Self-examination of the breast is usually performed once a month. The pre-menopausal women should choose the 9th to 11th days after menstrual cramps. At this time, the endocrine hormone is mainly the estrogen, which has the least effect on the breast. Abnormal changes in the breast are found; postmenopausal women should choose a time that is easy to remember, such as the first day of each month; when breast lumps are found during breastfeeding, they should be checked again after stopping breastfeeding.

Classification of benign breast tumors

Benign breast tumor

Breast fibroids are the most common benign tumors in young women. Most of them are painless tumors, and they are mostly found by accident. They are smaller in the initial stage but grow faster. They grow slowly or stop growing up to 3 cm. They are round or oval. Round, clear boundary, mostly more bulge, less flat, less smooth surface, small nodules on the fine touch, some are obviously lobulated, moderately hard, mostly non-tender, can be pushed freely.

Breast fibroids have good resection results. However, breast fibroids can occur repeatedly. After a surgical resection, other parts of the breast can occur again. If there are continuous new breast fibromas, surgery is difficult to continue, and patients often refuse surgery. At this time, androgen therapy can be tried. Oral testosterone is started one week after menstruation is stopped, and it ends before the beginning of the next menstruation. Daily small doses should not exceed 100mg. During the treatment, the degree is not to disturb the menstrual cycle.

Benign breast tumors : Cystic hyperplasia of the breast:

Cystic hyperplasia of the breast refers to the epithelial hyperplasia of the milk ducts or acinars and the expansion or formation of cysts in the hyperepithelial ducts. The disease occurs in women around the age of 40, but young women and elderly women can also suffer from it. The length of time from onset to treatment varies. The shortest is only a few days and the longest is more than ten years. The mass is the main symptom and can manifest in 4 different ways:

Single mass: Mostly caused by large cysts, with clear boundaries, which can be pushed freely, often identified as cysts. Unless there are too many sac contents, greater tension, or deep masses that are mistaken for solidity. The contents of the sac are mostly clear, and if the infection is complicated, the content is cloudy. If it causes adhesion of surrounding tissues, it can retract the nipple when it is adjacent to the nipple.

Most masses: caused by multiple cysts, palpation is multiple cystic nodules, which can involve whole milk.

Segmental nodules of the breast: This nodule is mostly triangular, with the bottom edge at the edge of the breast and the tip pointing at the nipple.

Nipple discharge (bloody or serous): No obvious positive findings in breast examination, but pressing some parts of the peri-mammary gland (equivalent to one breast leaf or several glands) can cause one breast duct or several breast ducts Overflow.

The breast pain in this disease is mostly insignificant. It is dull or tingling, and it can be accompanied by pain when the ducts begin to dilate.

Adopting traditional Chinese medicine to clear the liver and regulating qi, dissolving phlegm and clearing collaterals, promoting blood circulation and removing blood stasis, and western medicine hormone therapy, if the effect is not good, it can be excised and pathologically examined. The principle of resection is resection of the lesion area. If the lesion is extensive, total breast resection can be used as appropriate; if pathological examination is found after surgery, cancer surgery is added.

Benign breast tumors Large ductal papilloma of the breast:

A large ductal papilloma of the breast refers to a papilloma that occurs in a section of the duct from the opening of the duct to about 1 cm below the ampulla. Dominated by single shots, more frequent are rare. Gynecological experts said that clinical breast examination can be manifested as nipple discharge, pain, and touching the tumor. Nipple discharge smear cytology shows red blood cells and epithelial cells, and sometimes tumor cells, but it is often not possible to determine benign or Malignant.

Nipple discharge is the only clinical manifestation of large ductal papilloma of the breast. The treatment principles are as follows: A single catheter drainage can be locally excised, and if a certain area is pressed to cause an overflow, a feasible area is removed. With ductal discharge, the elderly can perform total mastectomy, and the younger should perform partial resection. The specimens were excised for pathological examination. Finally, based on the pathological examination, it was decided whether to add other treatments.

The following clinical manifestations of papilloma appear, and the treatment is as follows: If there is bleeding, large catheterization is feasible. If there are small nodules next to the areola, the nodules can be removed. There are obvious cystic masses in the middle of the breast, especially when the tumor is large, all patients with a clinical diagnosis unknown, middle-aged women and above, should be treated with total mastectomy, if the tumor is smaller, local resection is sufficient.

Large ductal papilloma is very rare, so it should not be considered a precancerous lesion. There are very few recurrences after local resection of large duct papilloma, so care should be taken in the choice of total mastectomy.

Benign breast tumor lipoma

Lipoma is the most common benign tumor on the body surface and can occur in any structure with adipose tissue, but it is most common on the body surface and breasts. Occurred in more obese female patients, the age of onset is more common in 30-50 years old.

Mainly manifested as a single, round or leaf-like soft mass, with clear boundaries, slow growth, and rarely malignant changes.

The main treatment is surgical resection. But the operation should be thorough, if there is residual, it will definitely cause recurrence. The resected tissue should be sent for pathological examination to avoid missed diagnosis with other tumors.

Benign breast tumor breast leiomyoma

Leiomyomas most commonly occur in the uterus, and leiomyomas in the breast are extremely rare.

Breast leiomyomas can be divided by source:

Superficial leiomyomas originate from breast skin, especially leiomyomas in the dermis of the areola area. Appears as a small tumor with a slight bulge in the areola area, with firm quality, clear borders, slow growth, and no discomfort.

Angioleiomyoma is derived from smooth muscle on the blood vessel wall of the breast itself. Often lumps and lumps in the deep part of the breast, larger than superficial leiomyoma, slow growth, clear boundaries, no discomfort.

Surgery is the only treatment.

Benign breast tumor

Very rare. It is almost impossible to have a correct diagnosis clinically. It is mainly manifested by a wrapped lump in the breast, which is not active, grows slowly, and has no discomfort. More common in young women after middle age. Surgical resection is the only treatment.

Benign breast tumors other soft tissue tumors

Soft fibroids: Also known as skin tags or fibroepithelial papilloma or fibrolipoma. Mostly occur in the nipple, the tumor surface is basically consistent with the surrounding skin, there is a pedicle connected to the skin, and the texture is soft. Those with large skin tags that are unsightly should be removed from the pedicle, including some normal tissues.

Neurofibromas: Often a part of systemic fibromatosis, a group of soft or pale brown pigmented overhanging masses grow from the nipple and areola area without discomfort. Body surface often consists of scattered masses and pigmented spots. Removal is generally not required, and it can be removed individually if it is huge, ulcerated, or hinders aesthetics.

Other relatively rare benign tumors include hemangiomas, schwannomas, and granulosa cell tumors.