German Breast Cancer Center

Breast cancer is a multifactorial disease. We are aware of numerous risk factors for its development, both genetic and environmental. Factors like age, ethnicity, gender, and heredity are non-modifiable risk factors, meaning they are factors a person cannot change or influence. However, there are also modifiable factors, which we can potentially mitigate through appropriate behavioural adjustments, such as managing our body weight, quitting smoking, and increasing physical activity. It is crucial to note that the presence of risk factors does not necessarily mean a woman will develop breast cancer. However, awareness that one belongs to a higher risk group leads to increased diligence in undergoing preventative checks, which are demonstrably the most powerful defence when facing the disease.

• Brest cysts, which are the most common finding in premenopausal women, are hormonally driven. Essentially, they are localized fluid collections within the breast. Breast cysts have a smooth texture, are movable, and can sometimes be painful. They often affect both breasts and can be found at any location. Due to their hormonal cause, cysts typically regress (disappear) during menopause unless the woman is taking oestrogen. Most cases of cysts are clinically insignificant and do not require further intervention. However, based on indications and imaging findings, your doctor may recommend further investigation (e.g., evacuative paracentesis for fluid culture or cytology, or cyst wall biopsy).

• Fibroadenoma is the most common benign, solid breast tumour. It is hormone-dependent and primarily occurs in young women, although it can appear at any age. Fibroadenomas are highly mobile under the skin, firm-elastic, and well-defined. In 10-15% of cases, there are multiple fibroadenomas. Once a tumour is confirmed as a fibroadenoma (e.g., through characteristic imaging findings or a prior biopsy confirming the diagnosis), its removal is not necessary unless desired by the patient. While fibroadenomas do not turn malignant, they require monitoring at a frequency determined by your doctor. In cases where the fibroadenoma becomes painful, causes aesthetic concerns, or when there is doubt about its diagnosis, surgical removal may be recommended through a simple procedure that does not harm the breast.

• Mastalgia is characterized by pain in one or both breasts, and it typically does not signify a serious health risk. Often, it is linked to hormonal fluctuations during a woman’s menstrual cycle (cyclical mastalgia) or, if not cyclic, may be associated with musculoskeletal or other issues. However, if the pain is intense and persistent, seeking medical advice is recommended.

• This term encompasses a variety of histopathological changes in the breast gland and is not indicative of a disease. It describes areas in the breast that appear denser in clinical and imaging examinations. Breasts affected by fibrocystic changes can swell and become painful, varying with hormone levels, and often feel like detectable lumps. Monitoring these changes can be challenging due to their nature, but they generally are not a cause for concern.

• Mastitis, an inflammation of the breast, often occurs in breastfeeding women due to blocked milk ducts, which leads to milk accumulation and bacterial growth. It can also develop outside of breastfeeding, caused by bacterial entry through the nipple’s pores or minor abrasions. Mastitis rarely relates to breast cancer and is more frequent in smokers and diabetic women. It is usually managed with broad-spectrum antibiotics, and the drainage of breast milk is necessary in breastfeeding-related cases. A breast abscess, a complication of mastitis, is a pus collection within the breast gland which requires prompt drainage. Post-inflammation imaging tests are advised to rule out the rare chance of inflammatory breast cancer.

• Approximately 2% of women have inverted nipples, meaning the nipple retracts inward, potentially affecting one or both breasts. This condition can stem from developmental anomalies during embryonic growth or genetic factors. It poses cosmetic concerns and potential breastfeeding difficulties. Surgical correction is available for congenital inverted nipples, preserving the milk ducts. If an inverted nipple develops later in life, it may signal breast disease, including cancer, and should be promptly evaluated by a medical professional.

• Nipple discharge can occur in one or both breasts, originating from one or several pores, and may be spontaneous or induced. If you notice discharge outside of pregnancy and breastfeeding periods, a medical consultation is recommended. The discharge might be due to a benign tumour within a breast duct, medication side effects, thyroid or pituitary gland disorders, or less commonly, breast cancer.

• This type of tumour, which arises outside the milk ducts, is known for its rapid growth and propensity for recurrence. Suspected phyllodes tumours should be surgically removed to prevent malignant transformation. Due to its rapid size increase, reconstructive surgery might be necessary for complete removal and to maintain cosmetic appearance.

• Gynecomastia is defined as excessive growth of the male breast gland, resulting in enlargement not caused by obesity-related fat accumulation. It is the most prevalent male breast condition and often has hormonal origins. In adolescents (ages 12-15), it typically results from an imbalance of oestradiol and testosterone and usually resolves with maturity. Adult onset, especially if unilateral, warrants medical evaluation. The doctor will investigate potential causes, including specific medications or supplements, and rule out neoplastic conditions. Idiopathic gynecomastia, without an identifiable cause, can be surgically addressed for cosmetic reasons, often through a safe and aesthetically pleasing subcutaneous mastectomy.