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Surgical Treatment of Benign Breast Diseases

What are Benign Breast Diseases?

Benign breast diseases or benign breast conditions are non-cancerous disorders of the breast. These include abnormal growths and changes in your breast tissues such as:

  • Cysts or fluid-filled sacs in your breast tissue
  • Benign breast tumours: These are abnormal cell growths that feel like a lump in your breast; common benign breast tumours include fibroadenoma and intraductal papilloma
  • Breast pain, also called mastalgia, mastodynia, and mammalgia
  • Mastitis or breast inflammation
  • Abnormal nipple discharge which may be clear, bloody, yellow, or brown in colour and may vary in consistency from thin and watery to thick and sticky
  • Breast calcifications or small deposits of calcium in your breast tissues such as the breasts ducts and/or lobules

Benign breast diseases do not spread to other parts of your body and are not life-threatening compared to malignant breast cancer. They can affect women of the reproductive age group in their 30s and 40s as well post-menopausal women in their 50s and 60s.

What are the Causes of Benign Breast Diseases?

The common causes of benign breast diseases may include:

  • Hormone fluctuations during menstruation, pregnancy or menopause
  • Breast infection
  • Use of medications such as birth control pills/oral contraceptives
  • Hormone replacement therapy
  • Breast injury

What are the Signs and Symptoms of Benign Breast Diseases?

The common signs and symptoms of benign breast diseases may include:

  • A lump in your breasts or underarms
  • Swelling, tenderness, and/or pain in your breasts
  • Clear or green nipple discharge
  • Differences in the size or shape of your breasts
  • Pain in your breast.

How are Benign Breast Diseases Diagnosed?

If you experience any unusual symptoms or discomfort in one or both of your breasts, you should visit a specialist. To diagnose a benign breast disease, your doctor will perform the following:

  • Review your medical history
  • A thorough breast examination to check for any lumps, nipple discharge, or changes in the appearance of nipple
  • Examination of the lymph nodes in your armpit or lower neck to check for any swelling or tenderness to touch

If a breast lump, pain or thickening of breast tissue is noted, your doctor may order further diagnostic tests, such as:

  • Mammogram – an X-ray examination of your breast
  • Breast biopsy – surgical removal of a sample of breast tissue or cells and fluid from a diseased area for microscopic analysis
  • Ultrasound scan – use of high-frequency sound waves to obtain images of breast tissue to detect any anomalies
  • Magnetic resonance imaging (MRI) – use of radio wave and strong magnetic field to produce detailed images of breast tissue to detect cancerous lesions

These diagnostic tests help determine the root cause of the breast disorder and assist the physician to plan the best course of therapy.

What are the Treatment Options for Benign Breast Diseases?

The treatment for benign breast disease is based on the severity of the disease, its location, and the age of the patient. Treatment options may include conservative management and surgical intervention.

Conservative Treatments

Conservative treatments are non-surgical approaches to treat benign breast disease and may involve any of the following approaches:

  • Change in medications that may cause benign breast disease
  • Application of topical creams or ointment around the nipple or breast to treat abnormal skin changes
  • Oral medications to treat benign breast disease
  • Use of warm compresses

Surgery for Benign Breast Disease

Surgery is recommended when conservative treatments fail to provide relief for benign breast diseases. Surgical procedures may include:

  • Mammary Duct Excision- removal of some or all of the breast ducts
  • Lumpectomy – surgical removal of a lump or abnormal tissue from a breast

Pre-Surgical Preparation for Benign Breast Disease Surgery

Some of the common precautions to be followed while preparing for your surgery for benign breast disease may include:

  • If you are taking blood thinners or aspirin, you are required to stop them before your surgery to minimise the risk of bleeding.
  • Avoid eating or drinking for at least 8 to 12 hours prior to your surgery.
  • Have someone to drive you back home after your surgery.
  • Your doctor may give you other specific instructions as necessary.

Procedure: Benign Breast Disease Surgery

Prior to your benign breast surgery, your nurse or surgeon will mark the area where the cut is to be made. The general steps for a benign breast surgery include:

  • You will lie on your back (supine position).
  • Local or general anaesthesia is administered to keep you comfortable.
  • Your surgeon makes an incision around the marked area on the breast.
  • The abnormal breast tissue underlying the skin is removed, including the lymph nodes and the inner layer of muscle tissue.
  • Sometimes, surgical drains: tubes to collect excess fluid, maybe inserted temporarily.
  • The breast incision is sutured closed.
  • A surgical dressing is used to cover the incision.

Post-Operative Care following Benign Breast Disease Surgery

You may be required to stay in the hospital based upon the type of procedure you underwent and your doctor’s discretion.

  • You will be given specific instructions to be followed after discharge. These include tips on how to care for the surgical drain, bandage, and stitches.
  • To prevent breast stiffness and scar formation, you may be required to perform some simple hand exercises.
  • Your surgeon will also recommend the appropriate time for you to start wearing a bra and when you can resume your regular physical activities.
  • You may experience slight pain in the breast that has been operated after your surgery. Your doctor will prescribe pain relief medications to keep you comfortable.

Risks and Complications of Benign Breast Disease Surgery

Benign breast disease surgery is a relatively safe procedure. However, as with any breast surgery, some risks and complications may occur, such as:

  • Reaction to anaesthesia
  • Infection at the incision site
  • Formation of blood clots
  • Accumulation of fluids in breast tissue
  • Loss of sensation in the breasts or nipples
  • Poor healing of the surgical incision