Understanding Breast
Changes and Conditions
A Health Guide
U.S. Department of Health & Human Services | National Institutes of Health
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This guide Understanding Breast Changes and Conditions can help you talk with your
doctor or nurse as you learn about next steps after an abnormal mammogram result or breast
change.
View PDF, ePub, and Kindle formats: www.cancer.gov/ubc-guide
Learn more online
National Cancer Institute (NCI): NCI has comprehensive research-based information on
breast cancer prevention, screening, diagnosis, treatment, genetics, and supportive care.
●
Visit NCI’s home page for breast cancer: www.cancer.gov/breast
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View NCI’s web page that also covers breast changes and conditions:
www.cancer.gov/breast-changes
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Throughout this guide, click on links that define medical terms in the NCI
dictionary: www.cancer.gov/dictionary
Call or chat online with an information specialist at our NCI Cancer Information Service at
www.cancer.gov/contact, in English and Spanish. There, you can also request a clinical trial
search related to breast cancer, ductal carcinoma in situ (DCIS), or a breast condition.
Phone:
1-800-4-CANCER (1-800-422-6237)
Website: www.cancer.gov or www.cancer.gov/espanol
Email: [email protected]v
Centers for Disease Control and Prevention (CDC): CDC’s National Breast and Cervical
Cancer Early Detection Program (NBCCEDP) helps low-income, uninsured, and underinsured
women gain access to timely breast and cervical cancer screening, diagnostic, and treatment
services. NBCCEDP also provides patient navigation services to help women overcome
barriers and get timely access to quality care.
Visit www.cdc.gov/cancer/nbccedp to find out if you qualify for free or low-cost breast and
cervical cancer screenings.
Note to health care providers
This handout at www.cancer.gov/ubc-flyer can help your patients access an online version
of this booklet.
About this guide
www.cancer.gov
Table of Contents
Female Breast Anatomy 1
Abnormal Breast Changes 2
Breast Changes during Your Lifetime 3
Screening for Breast Cancer 4
Mammogram Findings 7
Follow-Up Tests to Diagnose Breast Conditions and Breast Cancer 10
Benign Breast Conditions 13
Precancerous Breast Conditions 16
Ductal Carcinoma in Situ (DCIS) 17
Breast Cancer 17
Talking with Your Doctor to Learn More 18
For online viewers, click on a title to be taken to that section.
The information in this booklet can help you
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talk with your doctor or nurse if you notice a breast change
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understand the importance of follow-up care if you had an abnormal mammogram result
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get the tests and treatment that your doctor or nurse recommends
We’ve also included questions within this guide to help you talk with your doctor or nurse.
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Female Breast Anatomy
To better understand breast changes, it helps to know about the breasts and
lymphatic system.
Anatomy of the female breast
The nipple and areola are on the
outside of the breast. The lobes,
lobules, and ducts are inside the
breast. The breast also has lymph
nodes that go from the breast
to the armpit and are part of the
lymphatic system. The chest wall
has skin, fat, muscles, bones, and
other tissues that form a protective
structure around vital organs.
About the female breast
The female breast has different types of breast tissue.
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Glandular tissue includes breast lobes, lobules (sacs) that make milk, and ducts that carry
milk to the nipple; most breast cancers form in the ducts.
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Fibrous connective tissue supports, protects, and holds bones, muscles, and other tissues
and organs in place.
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Fatty breast tissue is found around the glandular and fibrous connective tissue.
Dense breasts have more glandular tissue and fibrous connective tissue and less fatty breast
tissue. Learn more about dense breast tissue on page 8.
About the lymphatic system
The lymphatic system is a part of your body’s defense system. It has lymph vessels and
lymph nodes.
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Lymph vessels are thin tubes that carry a fluid called lymph and white blood cells. Lymph
vessels lead to small, bean-shaped organs called lymph nodes.
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Lymph nodes are found near your breast, under your arm, above your collarbone, in your
chest, and in other parts of your body. Lymph nodes filter substances in lymph to help fight
infection and disease. They also store disease-fighting white blood cells called lymphocytes.
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Abnormal Breast Changes
Check with your doctor or nurse if you notice
unusual changes in your breast(s).
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Lump or firm feeling (also called a mass),
including a lump in or near your breast, a
lump under your arm, thick or firm tissue in
or near your breast or under your arm, or a
change in the size or shape of your breast.
Breast lumps come in different shapes and
sizes. Most lumps are not breast cancer.
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Nipple changes or discharge, including fluid
from the nipple that is not breast milk. Because
nipple changes or discharge can sometimes be
signs of breast cancer, they should be checked.
However, nipple discharge can be caused by
birth control pills, medicine, and infections.
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Skin changes, including itching, redness
or darkening, scaling, swelling, dimples, or
puckers on your breast or nipple that don’t
go away.
Finding breast
changes
Being familiar with how your
breasts normally feel, such as
when you shower or put on a bra,
can make it easier to notice any
changes. However, doing routine
breast self-exams has not been
shown to decrease the chance of
dying from breast cancer.
Follow up with your doctor
or nurse if you notice a breast
change—even if you are not due
for a mammogram. Some breast
cancers, called interval breast
cancer, are diagnosed between
routine mammogram screenings.
While some breast changes can be felt or seen, others can only be found during an imaging
procedure such as a mammogram, MRI, or ultrasound.
“One day I felt a small lump in my breast.
I was worried, so I called to schedule a
mammogram. I’m glad that I did.”
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Breast Changes during Your Lifetime
Most women notice changes in the
breasts at dierent times during their
life.
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Before or during menstruation
(also called a woman’s period),
your breasts may feel painful, swollen,
or tender. You may feel one or more
lumps during this time because of
extra fluid in your breasts.
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During pregnancy your breasts may
feel lumpy. This is usually because
the glands that produce milk are
increasing in number and getting
larger.
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As you approach menopause, your
hormone levels change. This can make
your breasts feel tender, even when
you are not having your period. Your
breasts may also feel lumpier during
menopause than they did before.
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If you are taking hormones (such
as hormone replacement therapy,
birth control pills, or injections),
your breasts may become more
dense. This can make a mammogram
more difficult to interpret. Be sure
to mention that you are taking
hormones when scheduling your
mammogram appointment.
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After menopause, your hormone
levels drop. You may stop having
lumps, pain, or nipple discharge.
Talking about breast changes
with a doctor or nurse
Prepare before your visit by writing down
information about the change(s) you notice.
These are the breast changes I have noticed:
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My breast change looks or feels like this:
(Is the lump hard or soft? Does your breast
feel tender or swollen? How big is the lump?
What color is the nipple discharge?)
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This is where the breast change is:
(What part of the breast feels different? Do
both breasts feel different or only one breast?)
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This is when I first noticed the breast change:
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Since then, this is the change I’ve noticed:
(Has it stayed the same or changed?)
Share your personal medical history including,
for example,
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I’ve had these breast problems in the past:
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My last screening exam (mammogram, MRI,
or ultrasound) was on this date:
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My last menstrual period started on this date:
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I currently: have breast implants, am
pregnant, am breastfeeding
Share what you know about your family
medical history including, for example,
●
These family members had these breast
conditions:
●
These family members have tested positive for
mutations related to breast cancer risk:
●
These family members had breast cancer (at
these ages):
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Screening for Breast Cancer
Screening means checking for a disease such as breast cancer, or for changes that
may develop into disease, before there are signs or symptoms.
A screening mammogram can find signs of breast cancer and tumors that are too small to feel.
Breast cancer screening recommendations are developed by organizations such as the United
States Preventive Services Task Force (USPSTF). The USPSTF is a group of health experts
who review published research, look at the scientific quality of the evidence, and make
recommendations on health topics such as breast cancer screening.
USPSTF screening recommendations for most women
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Ages 40–49: The decision of when to start mammography is a personal one. Screening
mammograms in this age group may reduce the risk for breast cancer death, although less
than in older age groups. Also, the number of false-positive test results and unnecessary
biopsies is larger in this age group, especially among women in their early 40s, than in
older age groups.
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Ages 50–74: Most of the benefit of mammography
comes from screening every 2 years during ages
50 to 74.
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Age 75 or older: The decision of whether to
continue screening at age 75 and beyond is a
personal one to make after talking with your doctor
or nurse.
Talk with your doctor or nurse about when to get
screened and what screening test to have, based on
your personal medical history, family medical
history, and personal preference. Making this decision
together is called shared decision making.
Where to get screened
If you don’t have a doctor, you can find a clinic near you that offers breast cancer screening
by contacting your state or local health department or the National Breast and Cervical
Cancer Early Detection Program (NBCCEDP) at www.cdc.gov/cancer/nbccedp.
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Am I at average or high
risk for breast cancer?
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How often should I be
screened?
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What breast cancer
screening test is
recommended for me?
Questions to ask
about breast
cancer screening
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Screening mammogram
A screening mammogram is an x-ray of the breast that is used to find breast cancer. During
the procedure, your breast is pressed between two plastic plates. You will stand still for a few
seconds when the x-ray is being taken. Some discomfort is normal, but if it’s painful, tell the
mammography technician. The x-rays are sent to a radiologist, who studies them and sends
a radiology report to your doctor or nurse.
Depending on where you get your mammogram, you may get a 2-D mammogram or a
3-D mammogram.
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2-D mammography takes pictures
from two different angles, the side
and above.
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3-D mammography takes pictures
from many different angles. 3-D
mammography is also called
digital breast tomosynthesis.
Although 3-D mammography may
allow breast tissue to be seen more
clearly, it may involve a higher dose
of radiation. And it is not known
whether it is better than standard
2-D mammography at finding life-
threatening breast cancers early.
Learn more about guidelines for screening mammograms at www.cancer.gov/mammograms.
Breast cancer screening clinical trial: A cancer screening clinical trial, called TMIST
(Tomosynthesis Mammographic Imaging Screening Trial) is working to determine whether
3-D is better than 2-D at reducing the development of advanced breast cancer. The results
will help researchers develop individualized screening recommendations based on a woman’s
risk for breast cancer
Learn more about this breast cancer screening trial at www.cancer.gov/tmist.
Vaccination and breast cancer screening
You may be advised to wait 4 to 6 weeks after getting some vaccines, such as the COVID-19
vaccine, before getting your routine screening mammogram. This is because certain vaccines
may cause temporary swelling of the lymph nodes in your armpit. This swelling may be
mistaken as a sign of breast cancer.
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“My doctor talked with me about where and
how often to get a mammogram, based on
the guidelines. It helped to have her explain
this information.”
Breast MRI
A breast MRI (also called magnetic
resonance imaging) uses a powerful
magnet, radio waves, and a computer
to take detailed pictures of areas
inside the breast. MRI is used
in addition to mammograms in
some women who have a high
risk of breast cancer. MRI is not
used alone because it doesn’t find
certain breast changes, such as
microcalcifications. And although
MRI has high sensitivity (it can
detect cancers that mammograms
may miss), it does not have high
specificity, which means it may give
false-positive test results.
Your doctor can help you understand how factors in your personal medical history and family
medical history may increase or decrease your risk for breast cancer.
Learn about risk factors for breast cancer at www.cancer.gov/breast-prevention-pdq.
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Mammogram Findings
You should receive the results of your mammogram within 30 days. Be sure the mammography
facility has your current contact information. It’s helpful to get your mammogram at the same
facility each time, so your current mammogram can be compared with past mammograms.
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If your results were normal: Your
breast tissue shows no signs of a mass or
calcification.
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If your results were abnormal: An abnormal
breast change was found. Although many
breast changes found on a mammogram are
benign (not cancer), it’s important to get
the follow-up tests advised by your doctor or
nurse.
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If you don’t get your results: Call your
doctor or nurse.
If you notice a breast change
before you are due for your next
mammogram, call your doctor or
nurse. Sometimes breast cancer is
diagnosed before you are due for your
next mammogram. Breast cancer that
develops between mammograms is
known as an interval breast cancer.
These breast cancers tend to be larger,
grow and spread more quickly, and
have a worse prognosis than breast
cancers that are found during a
screening mammogram.
“I was nervous when I had an abnormal
mammogram nding. I was relieved to
learn that most abnormal results are
not breast cancer.”
Did you notice a
breast change after a
recent mammogram?
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Normal
mammogram
Benign cyst
(not cancer)
Breast
calcifications
Breast
cancer
What can a mammogram show?
Mammograms can show a mass (lump), calcifications, dense breast tissue, and other
changes in breast tissue. The radiologist will study the mammogram for changes that do
not look normal and for differences between your breasts. When possible, your most recent
mammogram will be compared with past mammograms to check for changes.
Mass (also called a lump): The size, shape, and edges of a lump give the radiologist
important information. A lump that is not cancer often looks smooth and round and has
clear, defined edges. Lumps that look like this are often cysts and are not cancer. However,
if the lump on the mammogram has a jagged outline, an irregular shape, or other unusual
features, it is of more concern and more tests may be needed.
Calcifications are deposits of calcium in the breast. They are too small to be felt but can be
seen on a mammogram. There are two types:
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Macrocalcifications look like small white dots on a mammogram. They are often caused by
aging, an old injury, or inflammation and are usually benign (not cancer).
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Microcalcifications look like white specks on a mammogram. If found in an area of rapidly
dividing cells or grouped together in a certain way, they may be a sign of DCIS or breast
cancer. Calcium in your diet does not cause breast calcifications.
Breast density is a description of the relative amounts of dense and fatty tissue on a
mammogram. Dense breasts, which have relatively less fat and relatively more glandular
tissue and connective tissue than fatty breast tissue, can make a mammogram more
difficult to interpret. That’s because both dense breast tissue and some abnormal breast
changes, such as calcifications and tumors, appear as white areas in the mammogram. As a
result, mammography is less sensitive in women with dense breasts—that is, it is more likely
to miss cancer. Women with dense breasts also have an increased risk of developing, but not
dying from, breast cancer.
Learn how having dense breast tissue may affect mammography and get answers to questions about
dense breasts at www.cancer.gov/DenseBreasts.
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Understanding your
mammogram report
It’s important to understand your mammogram
results. Don’t hesitate to call your doctor if you
have questions about what your mammogram
letter means. Be sure you understand the
findings and the recommended next steps you
need to take.
Mammogram reports use the Breast Imaging
Reporting and Data System (BI-RADS) to
report findings, shown in the table below.
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What is my BI-RADS category?
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What do I need to do?
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Do I need follow-up testing?
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When should I get my next
mammogram?
Breast Imaging Reporting and Data System (BI-RADS)
Category Finding (assessment) Recommended next steps
0 Need additional imaging evaluation
Additional imaging needed before a category
can be assigned
1 Negative Continue regular screening mammograms
2 Benign (not cancer) Continue regular screening mammograms
3 Probably benign Receive a 6-month follow-up mammogram
4 Suspicious abnormality May require biopsy
5 Highly suggestive of malignancy (cancer) Requires biopsy
6 Known biopsy-proven malignancy (cancer)
Biopsy confirms presence of cancer before
treatment begins
Questions to ask
about your
mammogram results
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Follow-Up Tests to Diagnose Breast
Conditions and Breast Cancer
The procedures and tests listed below may be recommended by your doctor or nurse to
diagnose a breast change that was found on a mammogram or that you or your doctor or
nurse felt. Keep in mind that fewer than 1 in 10 women who are called back for more testing
after a screening mammogram are found to have breast cancer.
Breast imaging procedures
Breast imaging procedures take detailed pictures of areas inside the breast. The results of the
breast imaging tests listed below, and the expertise of the radiologist interpreting your tests,
are important for an accurate diagnosis.
Diagnostic mammogram: A type of mammography in which more x-ray pictures of the
breast are taken from different angles to allow an area of the breast to be examined more
closely.
Ductography (also called a galactography): A procedure that takes pictures of the breast
ducts so that doctors can learn more about certain kinds of abnormal nipple discharge or a
breast mass. Pictures are taken using a contrast material that is given through an injection to
help breast ducts show up clearly.
Magnetic resonance imaging (MRI) of the breast: A procedure in which radio waves and
a powerful magnet linked to a computer are used to create detailed pictures of areas inside
the breast. An MRI can help your doctor learn more about a breast mass or enlarged lymph
nodes that were found during a clinical breast exam but were not seen on a mammogram or
ultrasound.
Ultrasound of the breast: A procedure that that uses high-energy sound waves to look at
tissues and organs inside the body. The sound waves make echoes that form images (called a
sonogram) of the tissues and organs on a computer screen. These images can show if a breast
lump is solid or is filled with fluid.
Questions to ask before an
imaging test
Questions to ask
after an imaging test
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Why is this test needed? What will it tell us?
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What type of imaging test will I have?
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What happens during the procedure?
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How long will the procedure take?
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How long will the appointment take?
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What are the results of my test?
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What do these findings mean?
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What next steps should I take?
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Breast biopsies and surgical procedures
A biopsy is a procedure to remove cells or tissue to be checked under a microscope, by a
pathologist, for signs of disease. When an imaging procedure shows an abnormal breast
change, a biopsy may be needed to make a definitive diagnosis. Some types of biopsies may
also be used as treatment.
Your doctor will talk with you about the type of biopsy, why it’s needed, and what to expect
during and after the procedure.
Needle biopsy: A procedure that removes cells, small tissue samples, or fluid so that it can be
examined under a microscope.
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A fine-needle aspiration biopsy uses a thin needle to drain fluid or to remove cells.
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A core needle biopsy (also called a core biopsy) uses a wide needle to remove small tissue
sample(s) that are about the size of a grain of rice.
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A vacuum-assisted core biopsy (also called a vacuum-assisted biopsy) is used to remove a
small sample of breast tissue with a probe that is connected to a vacuum device. The tiny
cut made in the breast is much smaller than with surgical biopsy.
Surgical biopsy: A procedure that removes breast tissue so that it can be examined under a
microscope.
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An incisional biopsy procedure removes a sample of breast tissue.
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An excisional biopsy procedure removes the entire lump or suspicious area.
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A wide local excision is used to cut out a tumor or other abnormal lesion and some normal
tissue around it.
Sometimes an imaging procedure is used to help a surgeon find and remove an abnormal
area during a biopsy. A stereotactic biopsy uses mammography; there are also ultrasound-
guided biopsies and MRI-guided biopsies.
Questions to ask before
a biopsy
Questions to ask after
the results of a biopsy
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Why is a biopsy needed?
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What type of biopsy will I have?
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What happens during the biopsy?
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How long will the procedure take?
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How should I care for the area where I
had the biopsy?
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When will I know the results?
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What are my biopsy results?
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What do these findings mean?
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What next steps should I take?
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Should I see a breast surgeon or
other specialist?
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Commonly asked questions about breast procedures
Here are answers to commonly asked questions about tests and procedures:
Where are breast biopsy and other surgical procedures done?
Breast biopsies and surgical procedures are usually done in a doctor’s office, clinic, or hospital
on an outpatient basis. This means you will go home the same day as the procedure.
What are dierent types of anesthesia?
Anesthesia is the loss of feeling or awareness caused by drugs or other substances. It will be used
so you won’t feel pain during a breast procedure. Local anesthesia causes the loss of feeling in
a small area, so you’ll be awake but won’t feel pain during the procedure. Regional anesthesia
is used to cause a temporary loss of feeling in a region or part of the body. General anesthesia
causes you to be asleep during the procedure.
What happens during a wire localization procedure?
Wire localization (also called needle localization and needle/wire localization) is a procedure
used to mark a small area of abnormal tissue to be removed. An imaging device is used to guide
a thin wire with a hook at the end through a hollow needle to place the wire in or around the
abnormal area. Once the wire is in the right place, the needle is removed, and the wire is left in
place so the doctor will know where the abnormal tissue is. The wire is removed when a biopsy
is done.
What is a breast biopsy clip?
A breast biopsy clip (also called a breast biopsy marker) is a tiny metal object that is placed into
the breast during a biopsy to mark the area where the biopsy was done. The clip or marker is
left inside the breast to identify the area on future imaging exams or to help locate the site
in the event that breast cancer is diagnosed, and surgery is required. The clip does not cause
pain or harm and can stay in the breast. However, if the abnormal area is removed, the clip or
marker will often be removed as part of the surgery.
“I needed to have a second mammogram,
followed by an MRI and then a biopsy.
My doctor explained why I needed each
procedure and the results of each one.”
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Benign Breast Conditions
Your doctor will use the findings from follow-up tests listed in the previous section to diagnose
most breast conditions. You and your doctor will receive a radiology report after an imaging
test such as a mammogram, MRI, or ultrasound or a pathology report after a biopsy. Most of
the benign (not cancer) breast conditions listed below are not related to and do not increase
your risk of breast cancer.
Adenosis: A breast condition in which there are
enlarged breast lobules that may cause small round
lumps or lumpiness. Or you may not feel anything at
all. It does not increase your risk of breast cancer. If
the enlarged lobules have scar-like fibrous tissue, the
condition is called sclerosing adenosis, which is
explained on page 15.
Breast duct ectasia (also called mammary
duct ectasia): A breast condition in which one
or more breast ducts widens and thickens. This
can cause the duct to become blocked with fluid.
It may sometimes cause whitish, greenish, or
blackish nipple discharge, tender or darker nipples,
or inverted nipples. If the blocked duct becomes
infected, you may feel a lump under the nipple.
Breast duct ectasia is a benign breast condition that
is most common in women who are approaching or
have gone through menopause. It does not increase
your risk of breast cancer.
Cysts in the breast: Closed, saclike pockets of tissue that can form in the breast. Most
breast cysts are filled with fluid and called simple cysts. They may be painful just before your
menstrual period begins. You may be able to feel a cyst, although some are too small to be felt.
Most cysts are benign and do not increase your risk of breast cancer. Cysts are most common
in premenopausal women and in women taking menopausal hormone therapy.
Fat necrosis of the breast: A condition that causes round, firm, usually painless lumps. Fat
necrosis may appear after an injury to the breast, surgery, or radiation therapy. Skin around
the lump may look red, bruised, or dimpled. Fat necrosis is a benign condition that does not
increase your risk of breast cancer.
Questions to ask
about a breast
condition
●
What is the name (and
spelling) of the breast
condition that I have?
●
Does this condition increase
my risk of breast cancer?
●
Can you help me understand
this risk and if it’s something
to be concerned about?
●
What are the next steps?
●
Does this condition go away
on its own? Does it need
monitoring or treatment?
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Fibroadenoma: Benign breast tumors that often feel like hard, round lumps in the breast and
move easily. Fibroadenomas don’t usually hurt and may sometimes be too small to be felt.
Fibroadenomas are the most common benign breast tumors in women under 30 years old,
although they can be found at any age. These tumors may get larger when estrogen levels
increase (during pregnancy or with hormone replacement therapy) and smaller during
menopause. Most fibroadenomas are simple fibroadenomas and don’t increase your risk of
breast cancer. However, complex fibroadenomas are larger and may slightly increase your
risk of breast cancer.
Fibrocystic breast changes (also called fibrocystic breasts): A common breast condition
in which you may have breast swelling or discomfort, sensitive nipples, nipple discharge and
itching. You may also have a mass (also called lumps) or cysts. Symptoms often start before
or during your menstrual period. As many as half of all women notice fibrocystic breast
changes. It’s most common among women under the age of 45 and among women taking
hormone replacement therapy. Fibrocystic breast changes do not increase your risk of breast
cancer.
Granular cell tumor (also called Abrikosso tumor): A rare type of soft tissue tumor that
may cause a firm lump. Granular cell tumors usually begin in Schwann cells (cells that hold
nerve cells in place) and can occur anywhere in the body, including the breasts. Very rarely,
granular cell tumors may be malignant (cancer) and spread to nearby tissue.
Hematoma of the breast: A pool of clotted or partially clotted blood under the skin of the
breast that may cause a lump, fever, and breast inflammation. Hematomas are usually caused
by a broken blood vessel after an injury or surgery to the breast. They can also occur without
injury in people taking aspirin or blood thinners. Hematomas do not increase your risk of
breast cancer.
Intraductal breast papilloma (also called intraductal papilloma): A breast condition that
causes wartlike growths in the breast duct.
●
Single intraductal papillomas are usually close to the nipple and may cause a lump, pain,
and clear or bloody discharge. They do not increase your risk of breast cancer.
●
Multiple intraductal papillomas may not be felt or cause nipple discharge. They are smaller
and often found farther away from the nipple than single intraductal breast papillomas.
Multiple intraductal papillomas may increase your risk of breast cancer.
Lipoma of the breast: A benign tumor made of fat cells. It’s usually a painless, single, soft
lump. Lipoma does not increase your risk of breast cancer.
Mastitis: A painful breast condition that is most common in women who are breastfeeding.
It’s caused when a breast duct (also called a milk duct) becomes blocked or infected. Your
breast may look red or darker and feel lumpy, warm, and tender. You may also have nipple
discharge and a fever or flu-like symptoms. Mastitis is usually diagnosed by your doctor, based
on your signs and symptoms.
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Phyllodes tumor (also called cystosarcoma phyllodes of the breast or CSP): A rare type
of breast tumor that is usually painless. It starts in the connective tissue of the breast and
may grow quickly. These tumors grow in a leaf-life pattern and are named after the Greek
word “phyllodes,” which means leaf-like. Although most phyllodes tumors are benign (not
cancer), they may sometimes be malignant (cancer). Your risk of developing a phyllodes
tumor is higher if you have Li-Fraumeni syndrome, a rare, inherited disorder.
Radial scars (also called complex sclerosing lesions): A type of benign tissue that looks
like a scar when viewed under a microscope. Often, multiple lesions are seen in both breasts.
Radial scars cannot usually be felt and rarely cause symptoms. Radial scars may slightly
increase your risk of breast cancer.
Sclerosing adenosis of the breast: A condition that doesn’t usually cause symptoms,
although you may notice a small lump or breast pain. Scar-like fibrous tissue is found in the
breast lobules. Sclerosing adenosis may slightly increase your risk of breast cancer. Learn
more about complex sclerosing lesions, commonly called radial scars, above.
“I talked with my doctor to learn what
treatment she recommended for the benign
breast condition that I had.”
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www.cancer.gov
“My doctor made the time to help me
understand my increased risk of breast
cancer and the pathology report after my
biopsy.”
Precancerous Breast Conditions
A precancerous condition is one that is not cancer but may become cancer. If you are
diagnosed with one of these conditions, you have a higher risk of breast cancer. The risk of
developing breast cancer is lower for ADH and ALH than for PLCIS and LCIS.
Atypical ductal hyperplasia (ADH): A breast condition in which there are more cells than
usual in the breast ducts and the cells look atypical (abnormal) under a microscope. ADH
may increase your risk of breast cancer.
Atypical lobular hyperplasia (ALH): A breast condition in which there are more cells than
usual in the breast lobules and these cells look atypical (abnormal) under a microscope. ALH
may increase your risk of breast cancer.
Lobular carcinoma in situ (LCIS): A breast condition in which abnormal cells are found in
the breast lobules. There are more abnormal cells in the breast lobules with LCIS than with
ALH. LCIS increases your risk of developing cancer in either breast.
Pleomorphic lobular carcinoma in situ (PLCIS): A breast condition in which abnormal
cells are found in the breast lobules. These cells are often larger and more abnormal than in
LCIS. PLCIS is more likely to become invasive breast cancer than LCIS. PLCIS occurs most
often in postmenopausal women.
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1-800-4-CANCER (1-800-422-6237)
Ductal Carcinoma in Situ (DCIS)
Ductal carcinoma in situ (DCIS) is a noninvasive breast
condition in which abnormal cells are found inside the
breast duct but have not spread outside it. DCIS is also
called intraductal breast carcinoma or stage 0 breast
carcinoma in situ.
Although the cells are abnormal, they are not considered
cancer because they do not have the ability to break
through the duct wall or spread in the body, which is
the definition of cancer. DCIS may sometimes become
invasive breast cancer and spread to other tissues.
Doctors diagnose some cases of DCIS as being at lower risk of becoming invasive than others.
However, since doctors don’t currently know for sure which cases of DCIS will become
invasive cancer and which ones won’t, DCIS is almost always treated. Because research is
ongoing and you have choices about treatment, it may be helpful to get a second opinion
and discuss your treatment options with more than one doctor.
Learn about treatment options in the DCIS section of www.cancer.gov/BreastTreatment.
DCIS and clinical trials: You and your doctor can find DCIS prevention and treatment
clinical trials near you by entering “DCIS” as a keyword in www.cancer.gov/trials. One
nationwide clinical trial, called COMET, is comparing active monitoring with surgery in
women with low-risk DCIS.
Learn more about this clinical trial: Comparing an Operation to Monitoring, with or without
Endocrine Therapy (COMET) at www.cometstudy.org.
Breast Cancer
Breast cancer (also called invasive breast cancer) is a disease in which cancer cells form in the
tissues of the breast. Breast cancer is not just one disease. There are different breast cancer
subtypes.
In breast cancer, cells grow and divide without control
and invade nearby breast tissue. Cancer cells may also
form a mass called a tumor and metastasize (spread) to
the lymph nodes or other parts of the body.
Invasive ductal carcinoma is the most common type of
breast cancer.
Learn more about breast cancer, including treatment options,
at www.cancer.gov/types/breast.
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www.cancer.gov
Talking with Your Doctor to Learn More
It can be stressful to receive an abnormal mammogram result or notice a breast change and
need follow-up testing. Here are tips to help you talk with your doctor or nurse, consider a
second opinion, and get answers to any breast health questions you may still have.
Meeting with your doctor or nurse
When you meet with your doctor or nurse, it’s important to get information that helps you
to understand your diagnosis and to make medical decisions. You may want to ask a friend or
family member to go with you to take notes and ask questions.
It’s important to ask your doctor or nurse to
●
explain and write down medical terms, such as the name of a procedure, treatment, or
breast condition
●
go over treatment options, if needed, for the breast condition that you have
●
give you information to read or websites to visit, if you are interested in learning more
●
refer you to a breast specialist for follow-up medical care and treatment if needed; you
can also call your insurance company for the names of specialists who participate with
your plan
Considering a second opinion
You may want to get a second opinion on the recommended treatment. Even highly
experienced doctors sometimes have different opinions. If you choose to get a second
opinion, you will need to get information on the diagnosis and treatment from the first
doctor to give to the second doctor.
A second opinion is especially helpful when
●
the first opinion on the treatment comes from a doctor who doesn’t specialize in or
frequently treat the breast condition that you were diagnosed with
●
there are complicated medical decisions that need to be made
●
there are different treatment options to choose from
Considering a clinical trial
Clinical trials are being carried out to learn more about how to prevent, detect, and treat
breast conditions and breast cancer. You can call 1-800-4-CANCER to get help finding clinical
trials that are most relevant to you or a loved one.
You and your doctor can also find clinical trials by searching www.cancer.gov/trials.
