Benign Breast Lesions: Understanding Risks, Diagnosis, and Management - Dr Chetana Bakshi

Breast cancer is the most common cancer in females in India, accounting for 28% of all female cancers according to recent data. While this statistic is alarming, it is also important to note that nearly 75% of palpable breast lesions are benign.

Benign breast lesions, although generally non-cancerous, are a known risk factor for breast cancer. However, the risk varies depending on the histology of the benign lesion, as highlighted in a 2005 study published in The New England Journal of Medicine.

Benign breast disease is particularly common in women of reproductive age and is often associated with hormonal imbalances or hormone replacement therapy. The most common benign breast conditions include fibroadenoma (seen in 25% of women), fibroadenosis, mammary duct ectasia, traumatic fat necrosis, intraductal papilloma, and breast abscess.

Diagnosing benign breast disease begins with vigilance. If a lesion is palpable, it is crucial to consult a doctor immediately. After clinical examination and initial investigations, a mammogram is often the first step to differentiate between benign and malignant lesions.

In cases where doubt persists, further tests like MRI or a biopsy may be recommended. If the lesion is large, recently developed, or appears suspicious on mammography, a biopsy is typically required to confirm the diagnosis. For lesions diagnosed as benign through biopsy, regular surveillance is usually sufficient.

Certain benign breast lesions, such as complex cystic fibroadenoma, do increase the risk of breast cancer. The relative risk of breast cancer in individuals with benign breast disease is estimated to be 1.5 to 1.6 times higher than in the general population.

However, this risk varies based on biopsy results. For example, non-proliferative lesions carry a lower risk compared to proliferative lesions with atypical cells. Age at diagnosis also plays a role, with younger women facing a higher risk compared to older women.

Treatment and follow-up for benign breast lesions depend on their size, type, and associated symptoms. Small cysts often require no intervention and can be observed over time, while larger lumps, suspicious lesions, or those accompanied by symptoms like bloody nipple discharge may warrant surgical removal.

Infections, such as abscesses, are treated with antibiotics. For proliferative lesions or those showing atypical hyperplasia, surgical excision is usually recommended.

In conclusion, only 20-25% of breast lumps are cancerous. While benign breast lesions modestly increase the risk of breast cancer (about 1.5 times), the actual risk depends on the lesion's histological characteristics, with atypical hyperplasia posing the highest risk.

Regular clinical checks, mammograms, and, when necessary, biopsies are essential for early detection and management. If you detect any lump in your breast, it is imperative to consult a healthcare professional promptly.