Patient's question:
Hello, I am only 26 years old this year. But my breasts often swell and hurt. The hospital check-up results showed multiple cystic breasts. What should I do in this situation? How should it be treated? Will it turn into cancer? I am really scared. Thank you, please as soon as possible.Doctor's answer:
Common breast cysts include simple cysts and lactational cysts. Simple cysts are the most common type of breast cyst. They are primarily caused by endocrine disorders leading to the proliferation of ductal epithelium, an increase in intraductal cells, resulting in duct extension, tortuosity, and folding. In the folded areas, the duct wall undergoes necrosis due to ischemia, forming a cyst.The X-ray appearance of a simple cyst is a round or oval dense shadow with smooth edges and uniform density. Due to the cyst compressing the surrounding adipose tissue, a "halo" of lucency is often observed around the cyst wall. The density of the cyst is similar to or slightly denser than the breast glandular tissue. Solitary cysts are typically round, while multiple cysts are often oval, more commonly occurring on both sides.
Lactational cysts, also known as (milk retention cysts), are less common than simple cysts. They are primarily formed due to the obstruction of a duct during lactation, leading to milk stasis and cyst formation. The X-ray appearance of lactational cysts is a round or oval lucency, with a diameter of approximately 1–2 cm, occasionally exceeding 3 cm. The density of the cyst is similar to that of fat. Lactational cysts can occur in any part of the breast, but are most commonly found in the deeper regions.
The breast is composed of the nipple, areolae, surrounding breast tissue, and the skin covering them. Each breast contains 15–20 lobules, each with a lactiferous duct leading to the nipple. The size of these lobules varies with age or hormones. For example, during puberty, a flat chest gradually develops into a mature breast. Before and after menstruation, the breasts may become noticeably swollen and then shrink. During pregnancy and lactation, they may also swell. The changes in the breast are closely related to the estrogen and progesterone secreted by the ovaries.
Fibroadenomas are another type of benign tumor, more common in women aged 30–50, especially those nearing menopause. The breast is a hormone-sensitive organ, and hormones are secreted in particularly high amounts during menstruation, pregnancy, and lactation. Under excessive stimulation, the breast produces more secretions and is prone to developing cysts. A single cyst is called a "water sac," while a series of cysts are referred to as "fibroadenomas." When small, cysts may not cause any symptoms. However, if they grow large and coincide with a surge in hormones, they may cause pain and even form palpable hard lumps. Women often become very frightened by such sudden lumps, fearing they may be breast cancer.
There are many treatment options for fibroadenomas. If the cyst is solitary, doctors often use needle aspiration to remove the fluid. Additionally, patients with more pronounced symptoms may take diuretics, pain relievers, hormone medications, or oral contraceptives to alleviate discomfort caused by the cyst.
Does fibroadenoma increase the risk of breast cancer? Currently, there is no definitive evidence to establish a direct link between the two. However, Dr. Qiming Chen, a breast surgeon at Ande Hospital, believes, "Fibroadenomas are fibroadenomas, while breast cancer is the abnormal proliferation of cells from the outset. The two conditions are fundamentally different. What we should be concerned about is not identifying the focus of breast cancer."
Statistical data shows that women with fibroadenomas have a 2–4 times higher risk of developing breast cancer compared to the general population. Therefore, women who have had fibroadenomas must strengthen self-examinations and undergo annual follow-up checks at the hospital.