Benign Breast Diseases

Mastalgia means breast pain. It can be cyclical or acyclical mastalgia. Cyclical mastalgia occures in particular days of cycle especially before the menses and it is called premenstrual syndrome.
Acyclical mastalgia occures at any times and is not related to menstal cycle. Both can be managed with medicines.

When infection occurs in breast it is called mastitis. Breast ducts open at the nipple from where bacteria gets the entry and cause mastitis. At early stage there is only redness over the breast , pain, lump and fever. Later on pus formation occurs. If neglected pus may come out through breast skin causing pus discharge.
Symptoms of mastitis :

• breast pain
• redness on breast
• lump
• fever
• pustule / pus discharge
• lump in axilla (lymph nove)

Mastitis is very common in lactating ladies. It can also occur in diabetic patients.
Early mastitis can be curded with medicines. But when pus is formed it need to be drained out by small surgical procedure (I & D)

Cyst can be of many types like simple cyst, complex cyst or also galactocele (milk cyst)
Simple Cysts occurs due to hormonal changes. Sometime complex cyst may show changes of cancer. Galactocele or milk cyst commonly occures in lactating ladies.

Most common solid lump in breast is fibroadenoma. It is common in teenager (age group 15-25 years). It is a well defined round , lobulated , firm and mobile lump in the breast. It is also called mouse in the breast (As it is extremly movable). Small fibroadenomas can be left like that. Big fibroadenoma can be removed.
Other solid lump can be other tumous like Giant fibroademona , phylloids tumour etc.

The protocol for doing sonography or mammography in a patient with lump in breast is as shown below –

Sonography and mammography have their own benefits and limitations. Usually sonography is done in young patients to look for benign lesions. Mammography is done when breast cancer is suspected. Sonography differentiates between solid and cystic lesions very well. It is normally done in patients with fibrodenosis, cyst, galactocele, mastitis, abscess etc.