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Untitled Document
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| Breast
and Ovarian Cancer |
What Breast Conditions Can
Mimic Cancer? |
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By
Kari Danziger,
MS, CGC
Reviewed
by Miriam Komaromy,
MD
Last
updated September 12, 2000
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Although
the discovery of a breast lump can be scary, statistics
show that a woman shouldn't panic … four out of
five breast lumps turn out not to be cancer.
Cysts and fibroadenomas are common
causes of of noncancerous breast lumps, and microcalcifications
can appear as spots on mammograms that are not necessarily associated with breast cancer or precancerous conditions.
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Breast
cysts
develop in approximately seven percent of all women, most
commonly in women who are approaching menopause
. These fluid-filled sacs deep in the breast are usually
not cancerous.
They feel like firm lumps and often appear as a mass on
a mammogram. To determine whether a mass is a cyst or
a tumor,
a doctor will often perform an ultrasound scan to evaluate
whether the lump is cystic (i.e., hollow and fluid-filled)
or solid. Sometimes doctors will need to use additional
imaging tests or perform a biopsy
to make a diagnosis.
If the mass is cystic, the next question is whether it
is a simple cyst (one compartment) or a complex cyst (more
than one compartment within the cyst). Simple cysts are
very unlikely to be cancer. Fine needle aspiration (FNA)
may be used to remove the fluid from a simple cyst, but
this is not always necessary; the doctor may simply monitor
it. Complex cysts are somewhat more likely to be cancerous,
so doctors will often order further tests, including biopsies,
to make sure they are not cancerous.
Overall, women with breast cysts have two to three times
as great a risk of subsequently developing breat cancer
compared with women who do not have breast cysts. Women
under age 45 who have cysts have a higher breast cancer
risk than do older women with cysts. |
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| Fibroadenomas |
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Fibroadenomas
are benign
masses often found in young women. They come in a range
of sizes and feel like smooth, hard, round lumps that
can be moved around in the breast tissue; they may or
may not be apparent on a mammogram.
Although it's not necessary to remove fibroadenomas,
doctors sometimes remove them to rule out the possibility
of a malignant tumor. Although
fibroadenomas do not themselves turn into breast cancer,
some studies suggest that women who have fibroadenomas
are at about two times the risk for subsequently developing
breast cancer compared with women who do not have fibroadenomas.
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| Microcalcifications |
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Microcalcifications
are tiny mineral deposits that may occur singly or in
clusters within the breast tissue and sometimes appear
as white specks on mammogram film. Usually, they are
caused by benign breast conditions, although less often
they can be signs of cancer or precancerous conditions.
Often X-ray specialists (radiologists) can tell whether
microcalcifications are suggestive of cancer or not
based on the number and pattern of the microcalcifications.
The appearance of the microcalcifications is used to
decide whether further tests, such as a biopsy, should
be performed, or whether the woman should be monitored
with follow up mammograms and physical exam instead.
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References
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Dixon,
J.M. et al. (1999). Risk of Breast Cancer in Women With
Breast Cysts. The Lancet. 353(9166): 1742.
Dupont, W.D. et al. (1994). Long-term risk of breast
cancer in women with fibroadenoma. N Engl J Med.
331(1):10-5.
Moskowitz M. (1983). Predictive value of certain mammographic
signs in screening for breast cancer. Cancer,
51, 1007.
Sickles EA. (1986). Mammographic features of 300 consecutive
nonpalpable breast cancer. Am J Roentgenol, 146,
661.
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