In Geneva, in the absence of specific risk factors, the breast cancer screening program recommends a mammogram every two years for women aged 50 to 74. This screening remains a key tool for identifying suspicious lesions at an early stage.
The glossary below lists the most common breast conditions, which are often benign, to help you better understand their nature and progression.
Breast conditions related to breastfeeding
Certain conditions are specifically associated with pregnancy and breastfeeding. Although often alarming, in most cases they are easily treated.
Breast abscess
A breast abscess is an accumulation of pus linked to a bacterial infection of the mammary gland. It manifests as a painful lump, redness, a feeling of heat, and sometimes fever. Sometimes pus may drain from the nipple or through the skin. This complication most often occurs after mastitis, affecting approximately 5 to 10% of breastfeeding women.
Abscesses in breastfeeding women (puerperal abscesses) are usually unilateral and located deep within the mammary gland. The main risk factors include engorgement, poor milk drainage, or nipple lesions (such as cracks).
- Diagnosis: breast ultrasound
- Treatment: ultrasound-guided puncture + antibiotics
- Breastfeeding: often continued, unless the infection is severe
Good milk drainage, regular breastfeeding, or moderate use of a breast pump help prevent engorgement and promote healing.
Blocked milk duct
A blocked duct occurs when a milk duct becomes blocked, causing a painful lump or localized hardening, sometimes accompanied by redness and/or heat. This is a common problem in breastfeeding women, especially in the first few weeks. The most common causes are poorly emptied breasts, incorrect latching, abrupt weaning, or pressure on the breast.
Recommendations for unblocking a duct:
- Apply heat and massage before feeding. This method can be effective before a feed, as it helps to soften the breast and promote milk ejection.
- Completely empty the breast (feed or pump).
- Adjust the breastfeeding position.
This problem usually resolves quickly when treated early.
“Rusty duct” syndrome
During pregnancy or the first few days after giving birth, breast milk may appear pinkish or brownish in color. This harmless phenomenon, caused by increased vascularization and microlesions in the milk ducts, is called rusty duct syndrome. This phenomenon is usually bilateral and occurs in the first few days after delivery, disappearing spontaneously within 7 to 10 days postpartum. If this is not the case, it is advisable to consult a specialist. Breastfeeding can be continued without risk to the infant.
In rare cases, an intraductal fissure due to poor latching by the infant or mechanical irritation of the nipple can also cause slight localized bleeding.
Outside of pregnancy and breastfeeding, any bloody nipple discharge should be evaluated by a doctor.
Breast engorgement
Breast engorgement is an excessive accumulation of milk in the breasts, causing swelling, tension, and pain. This condition, which is common in the early stages of breastfeeding, can be relieved by:
- Frequent and regular breastfeeding
- Gently massaging the breast
- Applying warm compresses before feeding
In case of fever or signs of infection, medical consultation is necessary to prevent complications such as mastitis.
Other benign breast conditions
Many benign breast lesions can occur independently of breastfeeding. Some are hormone-dependent, while others are related to changes in glandular or connective tissue.
Fibrocystic changes and fibrocystic nodules
Fibrocystic changes are one of the most common causes of breast pain in women of childbearing age. They are a normal development of the breasts linked to hormonal fluctuations. They manifest as:
- A grainy or bumpy texture
- Breast pain or sensitivity that varies with the menstrual cycle
- Diffuse or localized nodularity
These changes are often bilateral and symmetrical, with a predominance in the upper outer part of the breasts. On palpation, denser or irregular areas may be felt.
Fibrocystic nodules are small, round, mobile, and often painful masses, especially in the second half of the cycle. They may contain microcysts, fibrous tissue, or correspond to areas of increased density. These nodules are frequently benign.
Breast cysts
Breast cysts are fluid-filled pockets located in the mammary glands, especially between the ages of 30 and 50. They are often benign and related to hormonal changes.
Although breast cysts are not generally associated with an increased risk of breast cancer, it is important to consult a doctor for an accurate diagnosis. As a general rule, an ultrasound or mammogram will be recommended. If necessary, a biopsy may be performed to rule out any doubts.
Treatment will depend on the discomfort caused. In most cases, breast cysts do not require medical treatment and resolve spontaneously. However, in cases of pain or discomfort, treatment may be considered, and the cyst may be aspirated, which usually causes it to disappear. Surgery is not usually necessary.
Adenofibroma (fibroadenoma)
Adenofibroma is a benign tumor that is common in women under the age of 35. It appears as a smooth, mobile, painless lump. Adenofibroma usually occurs in isolation and affects only one breast. When there are more than five tumors, it is referred to as breast polyadenomatosis. It can regress spontaneously, especially during menopause when there is no longer any hormonal stimulation. Surgical excision may be considered if it becomes large or bothersome.
Breast adenosis
Adenosis is a benign condition characterized by proliferation of the breast lobules. Often asymptomatic, it is discovered incidentally during a screening mammogram or histological examination.
The simple form does not require any intervention. However, sclerosing adenosis, where the lobules are surrounded by scar tissue, is associated with a slightly increased risk of breast cancer. Closer monitoring is therefore recommended, with regular follow-up imaging.
Breast lipoma
A lipoma is a benign tumor consisting of fatty tissue. Although lipomas are more common elsewhere on the body, they can occasionally appear in the breast.
They appear as soft, mobile, painless masses that grow slowly. Usually located on the surface and rarely problematic, they can be removed if their size causes aesthetic or functional discomfort.
Breast hamartoma
Hamartoma, also known as adenofibrolipoma, is a rare, well-defined, benign breast tumor. It combines glandular, fibrous, and fatty tissue.
Often discovered incidentally during a mammogram, it can reach several centimeters in diameter. Although benign, it can cause discomfort if it becomes large.
Treatment: usually consists of simple monitoring, with surgery only considered in cases of discomfort or growth. Complications are rare, with less than 2% of cases of hamartoma developing into cancerous tumors.
Intraductal papilloma
Intraductal papilloma is a small benign tumor, similar to a wart, that develops in the milk ducts of the breast (the lactation ducts that carry milk to the nipple). It mainly affects women between the ages of 30 and 50 and accounts for less than 10% of benign breast masses.
The most common symptom is clear or bloody nipple discharge, often unilateral. Sometimes, a small granular mass can be felt on palpation near the nipple.
Diagnosis: ultrasound, galactography, or biopsy.
Treatment: surgical removal is recommended due to a low but existing risk of malignant transformation, followed by annual monitoring for five years.
Phyllodes tumor
Phyllodes tumor is a rare tumor of the breast connective tissue, accounting for less than 1% of breast tumors. It most often appears in women between the ages of 40 and 50, but can occur at any age.
It is characterized by rapid, sometimes impressive growth and a firm, bumpy mass. The majority are benign, but 10% have malignant potential.
Treatment: surgery with wide margins to prevent recurrence. Radiotherapy may be considered in some cases.
Fat necrosis
Fat necrosis, or cytosteatonecrosis, results from trauma to the breast (impact, surgery, radiotherapy) or appears spontaneously. It most often affects women who are overweight or have large breasts.
It manifests as a firm, painless mass, sometimes accompanied by slight redness. It can mimic cancer on imaging, but a biopsy confirms its benign nature.
It heals spontaneously in most cases. Drainage or surgery is rarely necessary.
Prevention and screening: an essential role
Even though most breast conditions are benign, it is crucial not to ignore warning signs. Seeking prompt medical attention will ensure a reliable diagnosis and appropriate treatment if necessary.
When to consult a doctor:
- Appearance of a lump or nodule in the breast
- Unusual nipple discharge
- Persistent pain
- Redness or changes in the skin of the breast
- Changes in the shape or texture of a breast
Screening in Geneva:
- Mammogram every two years for women aged 50 to 74 with no particular risk factors
- Personalized monitoring for high-risk women
Most breast lumps are non-cancerous. Early diagnosis and appropriate follow-up remain the best guarantees of effective and reassuring treatment.
