Breast Disorders

Breast diseases can be classified either with disorders of the integuement, or disorders of the reproductive system.

Underlying breast health and implications to disease

Cancer

Factors that appear to be implicated in decreasing the risk of, early diagnosis of, or reccurence of breast cancer are regular breast examinations by health care professionals, regular mammograms, self examination of breasts, healthy diet, and exercise to decrease excess body fat.

Healthy diet appears to reduce the risk of breast cancer, and includes limiting dietary fat, eating a balanced diet that includes plenty of nutrients and dietary fibre such as are found in fruits and vegetables, and restricting intake of alcohol to a minimum of two drinks per day or less.

If any lumps, unusual swelling of the breast or other problems exist, it is recommended that professional medical assistance be obtained. Only your doctor can determine if a problem truly exists. Early detection of problems is important.

Disease and abnormalities

A majority of breast diseases are noncancerous.

Pre-malignant and malignant diseases

• Carcinoma in situ, a pre-malignant condition which can progress to a malignant cancer

Malignant diseases include:

• Breast cancer

See also:

• Epidemiology and etiology of breast cancer
• List of breast carcinogenic substances
• Paget's disease of the nipple, also known as Paget's disease of the breast

Among women worldwide, breast cancer is the most common cause of cancer death. Breast self-examination (BSE) is an easy but unreliable method for finding possible breast cancer.

Infections and inflammations

These may be caused among others by trauma, secretory stasis/milk engorgement, hormonal stimulation, infections or autoimmune reactions. Repeated occurrence unrelated to lactation requires endocrinological examination.

Mastitis

• bacterial mastitis
• mastitis from milk engorgement or secretory stasis
• mastitis of mumps
• chronic intramammary abscess
• chronic subareolar abscess
• tuberculosis of the breast
• syphilis of the breast
• retromammary abscess
• actinomycosis of the breast
• Mondor's disease
• duct ectasia syndrome
• breast engorgement

Benign conditions

Benign conditions include:

Congenital disorders

• inverted nipple
• supernumerary nipples/supernumerary breasts (polymazia / polymastia) /duplicated nipples

Aberrations of normal development and involution

• cyclical nodularity
• breast cysts
• fibroadenoma – benign tumor
• gynecomastia (males)
• nipple discharge, galactorrhea
• mammary fistula

Fibrocystic disease / Fibrocystic changes

• cysts
• epithelial hyperplasia
• epithelial metaplasia
• papillomas
• adenosis

Pregnancy-related

• galactocoele

Fibrocystic Breast Condition

Also called: fibrocystic breast disease, Chronic cystic mastitis, Diffuse cystic mastopathy, Mammary dysplasia

Mastitis

• bacterial mastitis
• mastitis from milk engorgement or secretory stasis
• mastitis of mumps
• chronic intramammary abscess
• chronic subareolar abscess
• tuberculosis of the breast
• syphilis of the breast
• retromammary abscess
• actinomycosis of the breast
• Mondor’s disease
• duct ectasia syndrome
• breast engorgement

Terminology

Depending on appearance, symptoms, aetiological assumptions and histological findings a variety of terms has been used to describe mastitis and various related aspects.

• galactopoiesis: milk production
• secretory disease: aberrant secretory activity in the lobular and lactiferous duct system, believed to be the most frequent factor causing galactophoritis. The secretions may be milk like or apocrine luminal fluid.
• retention syndrome (aka retention mastitis): accumulation of secretions in the ducts with mainly intraductal inflammation.
• galactostasis: accumulation of milky secretions in the ducts
• galactophoritis: inflammation of the lobular and lactiferous duct system, mainly resulting from secretory disease and retention syndrome.
• plasma cell mastitis: plasma cells from the intraductal inflammation infiltrate surrounding tissue.
• duct ectasia: literally widening of lactiferous ducts – relatively common finding in breast exams, increase with age. Strongly correlated with cyclic and noncyclic breast pain. Correlation with mastitis is of anecdotal quality.
• duct ectasia syndrome: in older literature this was used as synonym for nonpuerperal mastitis with recurring breast abscess, nipple discharge and possibly associated fibrocystic condition with blue dome cysts. Recent research shows that duct ectasia is only weakly correlated with mastitis symptoms (inflammation, breast abscess). The use of the terms Duct Ectasia and Duct Ectasia Syndrome is inconsistent throughout the literature.
• squamous metaplasia of lactiferous ducts: cuboid cells in the epithelial lining of the lactiferous ducts transform (squamous metaplasia) to squamous epithelial cells. Present in many cases of subareolar abscesses.
• subareolar abscess: abscess bellow or in close vicinity of the areola. Mostly galactophoritis resulting from secretory disease, duct blockage and duct permeability changes
• retroareolar abscess: deeper (closer to chest) than a subareolar abscess.
• periductal inflammation (aka periductal mastitis): inflammation infiltrated tissue surrounding lactiferous ducts. Almost synonym for subareolar abscess. May be just a different name for plasma cell mastitis.
• fistula: fine channel draining an abscess cavity
• Zuska's disease: subareolar abscess associated with squamous metaplasia of lactiferous ducts. Some authors also associate this with nipple discharge.