Types of Breast Masses (Benign and Malignant)

It’s important to know about the different type of breast masses.  Not all breast lumps are cancerous!  Here is a brief overview of the most common, and not-so common breast masses.

Let’s first take a look at a normal breast:

You can see that the breast is made up of many different types of tissue including fat, ligaments, ducts, and mammary tissue which is where milk is produced.  This area is the functional portion of the breast.  This tissue is made up of “Terminal ductal lobular units” or “TDLUs”.  This is where nearly all breast masses (abnormal breast tissue) develop.  The mass could be either benign (not cancer), or malignant (cancer).

There are many different types of benign breast masses.  Here are some of the most common

Benign Breast Masses

Cysts  

 A cyst is simply a fluid filled sac.  It can be simple, complex (with debris or septations), or sebaceous (filled with oil).  These are very common and typically nothing to worry about!  Sometimes they are removed if they are causing any discomfort.  Some women have many cysts within their breasts, and this can be termed “Fibrocystic breasts”.

Fibroadenoma 

Fibroadenomas are the most common solid breast mass in women over 35 years old.  They too are usually not removed unless they cause discomfort. 

Ductal or Intracystic Papilloma 

 A papilloma is a proliferation (accumulation) of cells.  It can form within a mammary duct or within a cyst.  Commonly, women who develop a papilloma will have bloody nipple discharge.

Lipoma 

 A lipoma is simply a mass made of fat, also known as adipose tissue.

Hamartoma 

A hamartoma is a proliferation of a mixture of fibrous, glandular and fatty tissues.

Fluid collections: Seroma, Hematoma, Abcess

A fluid collection can form within the breast after having any type of breast injury or surgery.

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There are also different types of malignant breast masses.  Here are some of the most common:

Malignant Breast Masses

Invasive Ductal Carcinoma (IDC) 

Invasive ductal carcinoma is the most common type of breast cancer.   This type of cancer develops within the mammary ducts, but has spread beyond them into surrounding tissues.

Invasive Lobular (ILC) 

Invasive lobular carcinoma forms within the lobules of the breast.   It is the second most common type of breast cancer.  ILC is often difficult to detect on either mammogram or ultrasound. 

Ductal Carcinoma In Situ (DCIS)

DCIS is the non-invasive form of Invasive Ductal Carcinoma.  In other words, this is ductal breast cancer before it has spread.   It is the most common type of non-invasive breast cancer.

   An interesting study was published in November of 2011 which involved Latina women and white women who were recently diagnosed with DCIS.  According to Kaplan et al. (2011), past evidence has suggested that Latinas are less likely to use breast conserving surgery to treat DCIS when compared to white women.  This study aimed to determine why this discrepancy existed.  Women diagnosed with DCIS and living in California were surveyed about how they treated their cancer. Did they completely remove their breast with a mastectomy, or did they try to conserve their breast?  The results of the survey showed that there were no differences in receipt of mastectomy or breast conserving surgery between ethnic groups.  What could this result mean for Latinas?  Feel free to write your thoughts below!

Read the full study here

http://proxy-tu.researchport.umd.edu/login?ins=tu&url=http://search.ebscohost.com.proxy-tu.researchport.umd.edu/login.aspx?direct=true&db=aph&AN=58043739&site=ehost-live

Lobular Carcinoma In Situ (LCIS)

 LCIS is an abnormal area that has formed within the milk producing glands within the breast.  The cancer has not yet spread beyond the glandular tissue.  This is not a true cancer. 

Inflammatory Breast Cancer (IBC) 

Inflammatory breast cancer is very rare and very aggressive.   Signs of IBC included reddening and swelling of the breast.

 Paget’s Disease of the Nipple 

With Paget’s disease, breast cancer develops in or around the nipple.  The nipple becomes scaly, red, and itchy.

Phyllodes Tumors

Phyllodes tumors are also very rare.  Some types are benign and some are malignant.  They tend to grow very rapidly, but rarely spread outside the breast.

Male Breast Cancer
Men can develop breast cancer as well, although it is very rare.

 Metastatic Carcinoma

Cancers within the breast can either originate within the breast (all of the types above), or originate in other parts of the body and spread, or metastasize, to the breast.  Metastatic breast cancers are extremely rare; however, most often come from bones, lungs, intestines, or ovaries.

Other less common types:

Tubular Carcinoma

Medullary Carcinoma

Colloid (mucinous) Carcinoma 

Papillary Carcinoma

Cribiform Carcinoma

Read more about these rare invasive breast cancers, and all of the different types of breast cancers here:

English http://www.breastcancer.org/symptoms/types/

Spanish http://www.breastcancer.org/es/sintomas/tipos/

The following pie chart shows the incidences of each subtype of breast cancer.

References
Breastcancer.org. (2011). Types of breast cancer. Retrieved from http://www.breastcancer.org/symptoms/types/

Iversen, C. B. (2009).  Breast ultrasound registry review [PowerPoint slides]. Baltimore, MD: Johns Hopkins Hospital Schools of Medical Imaging.

Kaplan, C., Nápoles, A., Hwang, E., Bloom, J., Stewart, S., Nickleach, D., & Karliner, L. (2011). Selection of treatment among Latina and non-Latina white women with ductal carcinoma in situ. Journal Of Women's Health (2002), 20(2), 215-223.