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Benign Breast Conditions

Article Last Updated: 15 February 2026

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This article should be read in conjunction with the breast cancer article.

Benign Breast Tumours

The suspected breast cancer referral pathway also applies to benign breast tumours

Refer via the suspected breast cancer pathway if:	≥30 y/o + unexplained breast lump, or ≥50 y/o + unilateral nipple discharge / retraction / other changes of concern
CONSIDER refer via suspected breast cancer pathway if:	Skin changes suggest breast cancer, or ≥30 y/o + unexplained lump in the axilla
Consider non-urgent referral if:	<30 y/o + unexplained breast lump

Fibroadenoma

Definition

Aetiology

Diagnosis – Triple Assessment

Triple assessment component	Findings / description ^[Ref1]^[Ref2]
Clinical examination	Most commonly solitary Well-circumscribed, mobile, non-tender breast mass with a rubbery consistency Usually 1-3 cm (only ~20% cases are >4cm) Slow growth The term “breast mouse” is sometimes used to describe the typical feel and mobility of a fibroadenoma in palpation. The mass is highly mobile, such that on palpation it seems to slip away / move under the fingers, like a mouse running under the skin
Imaging	Ultrasound is typically 1st line (as fibroadenoma is rare in >40 y/o) (rule of imaging for breast mass) Ultrasound finding: well-defined, oval, hypoechoic or isoechoic mass Mammogram finding: sharply circumscribed, homogenous round / oval mass
Biopsy	Gold standard: core needle biopsy Diagnostic findings: biphasic proliferation of stromal and epithelial elements The lesion is sharply demarcated from the surrounding tissue No atypia, and low mitotic activity

Complications

Management

Phyllodes Tumour

Definition

Diagnosis – Triple Assessment

Triple assessment component	Findings / description ^[Ref]
Clinical examination	Rapidly growing mass Often >3-5 cm Well-circumscribed, firm and mobile breast mass
Imaging	Rule of imaging for breast mass Ultrasound finding: lobulated margins, heterogeneous hypoechoic internal echoes Mammogram finding: high-density, well-defined mass, sometimes with lobulated contours
Biopsy	Gold standard: core needle biopsy Biphasic proliferation of stromal and epithelial elements Marked stromal hypercellularity, increased stromal mitotic activity The epithelial component may show fronded or leaf-like architecture Depending on histological findings, phyllodeous tumour can be classified into benign, borderline or malignant

Complications

Management

Intraductal Papilloma

Triple assessment component	Findings / description ^[Ref]
Clinical examination	Palpable mass near the subareolar region Bloody nipple discharge (seen in 1/3 cases)
Imaging	Rule of imaging for breast mass Ultrasound findings: well-defined, smooth-walled, solid hypoechoic nodule, often accompanied by ductal dilatation and visible intraluminal echoes Mammogram findings: smooth, well-circumscribed mass
Biopsy	Gold standard: core needle biopsy Diagnostic findings: papillary proliferation with a fibrovascular core lined by both luminal epithelial cells and myoepithelial cells

Other Benign Breast Conditions

Note that mastitis and breast abscess are also important benign breast conditions, but are covered in a separate article.

Condition	Presentation	Management
Fibrocytic breast disease	Most common type of benign breast condition Clinical features: Bilateral pre-menstrual breast pain (cyclic mastalgia) Bilateral ‘lumpy’ breasts (from breast masses) Ultrasound findings: Scattered calcifications Clustered microcysts	Conservative management for most patients Surgical excision is necessary for those with atypia (e.g. atypical ductal hyperplasia)
Breast cyst	Most common in peri-menopausal women Single / multiple breast masses Smooth, soft and firm texture Usually mobile Maybe tender Ultrasound is used to differentiate between cystic and solid breast masses A biopsy is necessary for cysts with suspicious features (e.g. solid component, Doppler flow)	A simple breast cyst doesn’t need any specific management Ultrasound-guided fine needle aspiration can be used to manage symptomatic cysts Complicated / complex breast cysts needs surveillance +/- excision (due to risk of malignncy)
Galactocele	Galactoceles are cysts that form from milk retention during lactation Presents as a firm mass in the subareolar region that typically occurs after lactation	A galactocele doesn’t need any specific management Fine needle aspiration / drainage catheter can be used to manage symptomatic ones
Fat necrosis of the breast	Typically occurs after breast trauma / surgery / radiation Presents as a poorly defined breast mass with irregular borders (may mimic breast cancer) Imaging +/- biopsy is often necessary to exclude malignancy	Fat necrosis doesn’t need any specific management if malignancy is excluded by biopsy
Mammary duct ectasia	Most common in peri-menopausal women Typical presentation: Green / milky nipple discharge Nipple inversion A tender subareolar mass may be present	Mammary duct ectasia doesn’t need any specific management Consider surgical duct excision in those with persistent symptoms / nipple discharge
Mondor’s disease of the breast	This is superficial thrombophlebitis of the breast Sudden onset, painful thickened cord-like lesions Overlying redness	Conservative management

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