What causes pain in your fibroadenomas

Fibroadenomas, breast cysts, and breast lipomas

Fibroadenomas: Most common benign breast tumors, probably caused by hormonal disorders. Fibroadenomas occur both individually and in large numbers. About a third of all women are affected, especially women under 40 years of age.

Breast cysts (Cysts): Benign growths in the glandular tissue of the breast, which are caused by the closure of the ducts excreted by the glands.

Breast lipomas(Breast fat lumps): Encapsulated benign tumors of the adipose tissue of the female breast. Since the proportion of fatty tissue in the breast increases with age, lipomas usually occur in women over 30 years of age.

Leading complaints

Fibroadenomas:

  • One or more palpable, small, movable, non-painful lumps
  • Rapidly growing in women under 40 years of age.

Breast cysts:

  • Rough, round, rubber-like, sometimes elastic knots that can be moved
  • Sensitive to touch or painful, for example before your period
  • For larger cysts: painful regardless of the cycle.

Breast lipomas:

  • Visible bumps that bulge out of the skin and are movable
  • The skin over the tumor often feels cooler than the surrounding tissue
  • Pain when the chest is squeezed or stretched when moving.

When to the doctor

Within the next two days, if

  • You discover a lump in your breast no matter how it feels.
  • the breasts do not develop symmetrically, that is, when you suddenly discover a difference in size.
  • the breasts behave differently or differently when the arms are raised.

The illness

Fibroadenomas. These harmless tumors often develop independently of one another in multiple locations on the breast. They consist largely of connective tissue that is overgrown, surrounds the glandular lobes, and often grows in small tubers. The various forms (simple and complex) differ mainly in their proportions of connective tissue. In the more complex forms, the tissue appears "restless" due to certain cell changes, as it contains cysts, enlarged gland cells or calcium.

In about 20% of cases, fibroadenomas resolve on their own during the fertile years, in the remaining cases only after the menopause. However, if they tend to grow further or if they affect the breast contour, they are surgically removed.

Breast cysts. They are also harmless, but often cause discomfort when they are bulging with secretions. A cyst cannot be clearly distinguished from breast cancer by palpation. Ultrasound-guided probing, suction and tissue examination of the cyst contents are usually sufficient to make a reliable diagnosis.

Breast lipomas. These benign soft tissue tumors are made up of adipose tissue cells enclosed in a capsule of connective tissue. Lipomas grow very slowly and are only removed when they cause discomfort.

causes

Fibroadenomas. The probable cause is hormonal and metabolic disorders. Fibroadenomas are also common in women who suffer from metabolic disorders such as diabetes mellitus or high uric acid levels (hyperuricemia). Certain immunosuppressants, Carney syndrome and the Epstein-Barr virus are suspected to be further causes.

Breast cysts. There are different causes for it:

  • Accumulation of fluid in the lobule of the gland
  • Obstruction of the excretory ducts of the glandular lobules
  • Disposition.

Breast lipomas. At the moment it is not yet known exactly how they arise; a genetic predisposition is suspected.

Diagnostic assurance

Inspection and palpation. After the anamnesis discussion, the doctor makes a preliminary diagnosis by looking (inspection) and palpation of the breasts and armpits.

Ultrasonic. This procedure is used to determine the location of the nodes and tumors, as well as their size and wall thickness. In the case of bulging, painful breast cysts, the liquid content is sucked off through a very thin needle under ultrasound control with a fine needle puncture and examined in the laboratory.

Mammography. The tissue of the breasts in younger women, which tends to be radiopaque and opaque, makes it difficult to visualize tumors, lumps or malignant tumors in mammography. For this reason, mammography only makes sense for women aged around 35 and over.

Biopsy. If the differentiation from other breast diseases such as breast cancer is not 100% possible, the tissue removed as part of a punch biopsy is examined in the laboratory.

Fibroadenomas are firm, round, limited and - in contrast to breast cancer - 100% movable tumors. If they are superficial, they can simulate breast cancer by changing the breast contour. Mammography usually provides clarity (picture on the right).
Georg Thieme Verlag, Stuttgart

treatment

Fibroadenomas. Most fibroadenomas are harmless and do not require treatment. Surgical removal is only required if the nodes are larger than 3 cm and growing rapidly. The doctor removes the fibroadenomas from their anchoring in the connective tissue.

Breast cysts. Unremarkable breast cysts do not need treatment.

Breast lipomas. Treatment is not required if the diagnosis is clear. If the tumor grows, it should be removed to be on the safe side. Often there are also cosmetic reasons for this.

forecast

Fibroadenomas. They do not increase the general risk of developing breast cancer. If there are malignant tumors in the vicinity of multiple fibroadenomas, regular self-examination and intensive medical care are necessary in order to detect possible degeneration of the fibroadenomas at an early stage.

Breast cysts. Breast cysts usually regress after menopause. However, they persist with hormone therapy.

Breast lipomas. The prognosis is good, as malignant degeneration into liposarcomas is very rare. However, lipomas often pose a cosmetic problem. Unfortunately, surgical removal is not safe, as recurrences occur.

Your pharmacy recommends

What you can do yourself

Feel your chest yourself at least once a month and see a doctor if you notice any new changes or irregularities (your familiar lumps are not at risk).

Authors

Dr. med. Astrid Waskowiak, Dr. med. Arne Schäffler in: Gesundheit heute, edited by Dr. med. Arne Schäffler. Trias, Stuttgart, 3rd edition (2014). Revision and update of the sections “Symptoms and leading complaints”, “The disease”, “Confirmation of diagnosis”, “Treatment”, “Prognosis” and “Your pharmacy recommends”: Dagmar Fernholz | last changed on at 08:57


Important note: This article has been written according to scientific standards and has been checked by medical professionals. The information communicated in this article can in no way replace professional advice in your pharmacy. The content cannot and must not be used to make independent diagnoses or to start therapy.