Causes and Symptoms (Magill’s Medical Guide, Sixth Edition)
Because of fear of breast cancer and discomfort, noncancerous breast disorders often cause women a great deal of anxiety and distress. The most common breast concern of women is the presence of fibrocystic breasts, which can feel nodular and tender. Other, less common breast conditions include mastitis, fat necrosis, nipple discharge, and a variety of benign breast tumors.
Common symptoms of fibrocystic breast condition include a dense and lumpy texture, which is usually more evident in the upper and outer quadrants of the breast. Intermittent or persistent dull pain, tenderness, and itching of the nipples often occur premenstrually, lessening after menstruation begins. This condition is so common, occurring in an estimated 60 percent of women between thirty and fifty years old, that it is considered a variation of normal. The lumpy tissue often causes significant discomfort, and its presence can terrify women checking for cancer during breast self-examination and make the diagnosis of cancer more difficult.
The cause of fibrocystic breasts is unknown, although the associated discomfort fluctuates with the menstrual cycle and rarely occurs after menopause, so ovarian hormones are likely involved. A family history of fibrocystic breasts increases risk, and excessive dietary fat and caffeine intake may exacerbate the condition.
After breast lumps and pain, nipple discharge is the third most common breast...
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Treatment and Therapy (Magill’s Medical Guide, Sixth Edition)
The diagnosis of fibrocystic breast condition is made by physical examination. Fibrocystic lumps are usually rounded, smooth, and malleable, although they can mimic hard and stationary cancerous lumps. The density of fibrocystic tissue makes physical examinations and mammography less effective, and ultrasound scans and needle biopsies are often necessary to rule out cancer. Although synthetic androgen (male) hormone therapy can be prescribed in severe cases and oral contraceptives can lessen symptoms, reducing dietary fat and caffeine intake are good first steps. Homeopathic treatments such as soy, vitamin E, vitamin B6, and evening primrose oil are controversial.
For mastitis, application of a hot, moist compress to the infected area can relieve symptoms, and the infection usually responds well to antibiotics. Lactating women should continue to breast-feed or pump while undergoing treatment. For women who are not breast-feeding, mastitis should be differentiated from a rare form of breast cancer through mammography or biopsy.
Galactoceles are generally left untreated unless they cause discomfort. They can be drained by fine needle aspiration if necessary. Fibroadenomas usually stop growing without treatment, but they need to be surgically removed if they continue to grow. Intraductal papillomas are treated by removing the affected duct. Duct ectasia can be treated with heat compresses, by antibiotics, or, in...
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Perspective and Prospects (Magill’s Medical Guide, Sixth Edition)
Like most disorders that primarily affect women and are associated with sex differentiation, noncancerous breast disorders were rarely discussed and were not well understood before the mid-twentieth century. In the nineteenth century, breast disorders were surrounded by myth and social stigma, and mastitis often went untreated for weeks, causing tremendous discomfort. The invention of mammography in the mid-1960’s, as well as that decade’s increased sexual openness, made it easier to talk about breast disorders as well as to diagnose them accurately. Fibrocystic breast condition, originally called fibrocystic disease, is now accepted as normal for many women, and testing procedures are beginning to adapt to this norm. Over time, mammography, the collection of data from two generations of women, and the generally increased awareness of women’s health issues have improved the diagnosis and treatment of these disorders.
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For Further Information: (Magill’s Medical Guide, Sixth Edition)
Chinyama, Catherine N. Benign Breast Disease: Radiology, Pathology, Risk Assessment. New York: Springer, 2004.
Dixon, J. Michael, ed. ABC of Breast Diseases. 3d ed. Hoboken, N.J.: BMJ Books-Wiley, 2006.
Love, Susan, and Karen Lindsey. Dr. Susan Love’s Breast Book. Rev. 4th ed. Cambridge, Mass.: Da Capo Press, 2005.
McGinn, Kerry Anne. Informed Woman’s Guide to Breast Health: Breast Changes That Are Not Cancer. 3d ed. Palo Alto, Calif.: Bull, 2001.
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