Cause and Treatment Adenosis of the Breast

Adenosis of the breast is a condition in which milk-producing glands (called lobules) become enlarged, creating lumps that you can sometimes feel. Adenosis is a benign (non-cancerous) condition often spotted during a breast self-exam or mammogram. Premenopausal women are most commonly affected.

While certain types of adenosis may increase the risk of breast cancer—specifically the sclerosing adenosis that causes tissue scarring—adenosis in and of itself is not cancerous. Treatment is usually not necessary unless there is pain.

This article describes the symptoms and causes of adenosis of the breast, including how the condition is diagnosed and treated. It also explains why this benign condition is sometimes monitored for breast cancer.

Symptoms of Breast Adenosis

Adenosis of the breast may not be detectable during a breast self-exam or clinical breast exam. This is because the lumps are often small and not situated near the surface of the skin.

Adenosis is more likely to be felt when there are several lumps or you have sclerosing adenosis which tends to cause larger, hardened lumps.

Symptoms of breast adenosis include:

• One or more painless lumps
• Pain and swelling
• Breast engorgement

These symptoms can get better and worse in line with the phases of your menstrual cycle. One or both breasts may be affected.

Unlike many types of breast cancer, adenosis does not change the skin or shape of the breast. It also does not affect lymph nodes.

What Causes Adenosis of the Breast?

Scientists do not know what causes adenosis. Some research suggests that, in some people, the hormone estrogen triggers the rapid growth of cells lining milk-producing glands. This would explain why the lumps get larger or smaller during the menstrual cycle.

Risk factors for breast adenosis include:

• Being female
• Being overweight
• Drinking alcohol excessively
• Starting your menstrual cycle before age 12
• Using hormone replacement therapy (HRT)
• Using birth control pills
• Having your first child after 35 or never having a child
• Not breastfeeding if you have had a child

Having these risk factors does not mean you will get adenosis of the breasts. Other factors such as genetics may contribute. More research is needed.

How Breast Adenosis Is Diagnosed

Given that adenosis can feel similar to other breast lumps, a physical exam is not enough to confirm a diagnosis. Imaging tests such as a mammogram or ultrasound can certainly help, but even those have limitations.

On a mammogram, adenosis may look like a solid mass or an area of white spots or flecks (caused by the deposits of calcium in tissue, known as calcification). The problem is that the same can occur when looking at breast cancer on a mammogram.

To definitively diagnose adenosis, your healthcare provider will need to perform a biopsy to obtain a tissue sample to evaluate in the lab.

Three different biopsy techniques can be used for this:

• Core biopsy: This involves the insertion of a large hollow needle through the skin and into the breast mass. An ultrasound can help direct the placement of the needle.
• Stereotactic core biopsy: This is the same as a core biopsy, but the placement of the needle is directed by a mammogram or live X-ray.
• Vacuum-assisted biopsy: This involves specialized equipment that suctions more tissue into the core needle. This can be done with an ultrasound or magnetic resonance imaging (MRI).

When viewed under the microscope, the cells lining the wall of the growth will look compressed. With sclerosing adenosis, there will be extensive calcification and tangled, fibrous cells both in the wall and surrounding membranes.

How Is Breast Adenosis Treated?

Since adenosis is not cancer, no treatment is necessary. If the breasts are painful, wearing a bra with good support may help. For some females, reducing caffeine consumption has been known to help (although it is unclear why).

If you have been diagnosed with sclerosing adenosis, your healthcare provider may recommend routine screening for breast cancer. This is because sclerosing adenosis may increase the risk of breast cancer by nearly 40% compared to females without sclerosing adenosis.

Summary

Adenosis of the breast is a noncancerous condition in which the milk glands increase in size. This can cause lumps that may be painful and change in size during your menstrual cycles.

Adenosis lumps can be seen on a mammogram but require a breast biopsy to ensure that the growth isn't breast cancer. While no surgical treatment is needed, routine breast cancer screening may be recommended if you have a type of adenosis called sclerosing adenosis.