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Congenital and developmental anomalies of the breast

Congenital and developmental anomalies of the breast include;

Absence of nipple,

Having more than one nipple,

Sunken or inverted nipple,

Absence or underdevelopment of one or both breasts,

Presence of more than two breasts and

She has extremely large breasts.

​These anomalies do not require any intervention unless they cause cosmetic discomfort.



What is gynecomastia? What are the symptoms?

The enlargement of one or both breasts in males in the form of female breasts is called gynecomastia.

In addition to enlargement, there is also tenderness in the breast.

It is more common in adolescent children (13-19 years old) and older men (over 50 years old).

It may be unilateral or bilateral.

What are the causes of gynecomastia?

Although the exact cause has not been determined, hormone imbalance is often detected in these patients.

The cause of gynecomastia seen in adult men should be investigated.

Various medications, drugs, kidney and liver failure can cause gynecomastia.

Unilateral or bilateral gynecomastia may occur in some testicular tumors.

What are the drugs that cause gynecomastia?

Among the drugs that cause gynecomastia:

Various antibiotics,

Drugs that suppress androgen synthesis,

Some drugs used in the treatment of ulcers,

Various drugs used in chemotherapy,

Various cardiovascular drugs,

There are various antidepressant, anti-anxiety and antipsychotic medications.

Does gynecomastia turn into cancer?

Only 1% of all breast cancers occur in males.

Cancer transformation in gynecomastia, which means excessive growth of breast tissue, is extremely rare.

How is gynecomastia treated?

If any hormonal disorders are found during the examinations, these are corrected first.

If present, liver, kidney or testicular diseases should be treated.

Finally, if there is a cosmetically disturbing appearance, the overgrown breast tissue is surgically removed while preserving the breast skin and nipple (subcutaneous mastectomy).

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Breast inflammation (mastitis) and abscess

What are mastitis and breast abscess? What are the symptoms?

Breast infections can occur in women of all ages.

Generally, all symptoms of inflammation such as pain, increased temperature, swelling and redness are detected.

Untreated breast infections cause breast abscess.

They are mainly divided into two groups: pregnancy-related and non-pregnancy-related infections.

How are pregnancy-related mastitis and breast abscess treated?

Pregnancy-related infection most often occurs within the first month after birth.

This infection is usually caused by the baby injuring the nipple while breastfeeding. This situation occurs especially in novice mothers who are inexperienced in breastfeeding and have just given birth to their first baby.

In the presence of infection, appropriate antibiotic treatment and hot or cold compress application are applied.

A bra that is not too tight should be used to prevent the breasts from sagging and becoming painful.

If there is no inflammation from the nipple, the baby should continue to breastfeed.

Drainage is performed in case of abscess development.
How are non-pregnancy-related mastitis and breast abscess treated?

There is no obvious cause for non-pregnancy-related infections.

Treatment is antibiotics and hot or cold compress application.

A bra that is not too tight should be used to prevent the breasts from sagging and becoming painful.

Drainage is performed in case of abscess development.

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Granulomatous mastitis

What is granulomatous mastitis?

Granulomatous mastitis is a rare inflammatory breast disease.

It is usually unilateral, but in rare cases it can be bilateral.

Sometimes it may develop later in the other breast.

Who gets granulomatous mastitis?

Granulomatous mastitis is most common in young women who have given birth (within five years after giving birth).

It can also be seen in women or men who have not given birth.

What are the causes of granulomatous mastitis?

The reason is not exactly known.

Although some microorganisms have been accused, it has not been proven definitively that they are the causative agent.

Although an increase in the prolactin hormone in the blood has been detected in some cases, its role in the formation of granulomatous mastitis has not been fully revealed.

Does granulomatous mastitis turn into cancer?

There is no increased risk of developing breast cancer in patients with granulomatous mastitis.

What are the symptoms of granulomatous mastitis? How is it detected?

Granulomatous mastitis may be noticed as a mass. It can appear as inflammation and abscesses on the skin.

While it may occur in a single focus, it may develop in several different parts of the breast at the same time.

Additionally, there may be a depression in the nipple, an abscess on the skin, and the appearance of cellulite.

Armpit lymph nodes may be painful and large.

Abscesses may recur over weeks or months.

This may cause confusion with cancer.

Diagnosis is usually made by ultrasonography and a thick needle biopsy (tru cut biopsy) or surgical biopsy taken from the mass.

How is granulomatous mastitis treated?

Treatment usually begins with broad-acting antibiotics and anti-inflammatory drugs.

Antibiotic treatment is then rearranged according to the culture results.

If an abscess has developed, surgical drainage is required.

In the presence of granulomatous mastitis that does not resolve or progresses despite appropriate treatment, steroids or mettrexate may be added. However, these are very serious drugs and should be used under the strict control of the surgeon.

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Mondor's disease of the breast

What is Mondor's Disease? What are the symptoms?

Mondor disease is a type of vascular inflammation that affects the anterior chest wall and the superficial veins of the breast.

It typically presents with sudden pain on the side of the breast or the anterior chest wall. It is rarely bilateral.

On examination, it is felt as a tender, hard cord along one of the large superficial veins.

Does Mondor Disease turn into cancer?

This benign disease is not an indicator of cancer .

However, when the diagnosis is not completely certain or there is a mass near the sensitive cord, a biopsy can be performed.

How is Mondor Disease treated?

Antibiotics and anti-inflammatory drugs are used in treatment.

A warm compress is applied along the affected vein.

It usually resolves within 4-6 weeks.

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Breast pain (mastalgia, mastodynia)

What causes breast pain (mastodynia, mastalgia)?

Breast pain is the main complaint of the majority of women who apply to breast clinics.

Although the real reason is not well known;

Disturbance in estrogen-progesterone balance,

Excess prolactin or disorder in the rhythm of secretion,

Enlargement of milk ducts,

The presence of large tense-walled cysts is among the main reasons.

No serious findings are detected with mammography and ultrasonography .

Is breast pain (mastodynia, mastalgia) a sign of cancer?

Breast pain alone is far from being a symptom of cancer.

The rate of breast cancer, which manifests itself only with breast pain without other signs and symptoms of cancer, is only 5%.

How is breast pain (mastodynia, mastalgia) treated?

Menstrual-related breast pain is pain that usually gets worse in the week before bleeding and decreases or disappears with the onset of bleeding. It is generally more common in the upper outer quadrants of the breast. Sometimes the pain is accompanied by a feeling of swelling and stretching in the breast. It may benefit from some pain-regulating medications .

Breast pains that are not related to menstruation are more sharp and limited pains. Sometimes the breast may hurt constantly . They do not respond well to treatment .

Pain that occurs in cases such as cervical disc herniation, arthritis in the neck or shoulder, or rheumatism may also feel like it originates from the breast.



What is fibroadenoma? Who gets it?

Fibroadenomas are the most common benign breast masses in young women, especially in the 20 years after puberty.

10-15% of patients have more than one fibroadenoma.

Typically, fibroadenoma manifests itself as an oval, rubbery, partially immobile and painless mass.

Although it can be easily diagnosed by examination and ultrasonography in young women, it requires careful evaluation in terms of fibrocystic changes and cancer risk in women over the age of 30.

Although fibroadenoma is not normally seen after menopause, it can develop in women taking hormone replacement therapy.
Does fibroadenoma turn into cancer?

The risk of fibroadenomas turning into cancer is extremely low.

No large-scale study has been reported on this subject in the world.

How is fibroadenoma treated?

If diagnosis can be made by thick or fine needle biopsy, no other treatment is required.

However, if the diagnosis is uncertain, they must be removed surgically .

While fibroadenomas smaller than one centimeter are considered normal, those between 1-3 centimeters in size can be monitored.

Surgical removal of giant fibroadenomas larger than three centimeters in diameter is recommended.

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Fibrocystic changes of the breast

What do fibrocystic changes of the breast mean? Who gets it?

Fibrocystic changes are the most common lesions of the breast.

It is not essentially a disease but rather a pathological or anatomical disorder.

It is mostly seen in women between the ages of 30-50.

It is rare in women who have gone through menopause and are not receiving hormone support treatment.

Cysts are the most common fibrocystic changes. One third of women between the ages of 35 and 50 have cysts. The probability of cysts occurring under the age of thirty and over the age of 65 is low.

​What are the symptoms of fibrocystic changes of the breast?

They are usually detected incidentally as a mass that does not cause any symptoms.

Pain and tenderness often accompany the mass, especially during the premenstrual period.

Sometimes there may also be nipple discharge.

Some patients may experience a feeling of discomfort during the premenstrual period due to the tendency of cysts to expand.

They can often occur in more than one and in both breasts.

Some patients may feel it as masses that grow before menstruation and shrink after menstruation.

Do fibrocystic changes of the breast cause cancer?

The risk of fibrocystic changes turning into cancer alone is extremely low.

However, it may be confused with cancer at the diagnosis stage. For this reason, in cases where it is not possible to distinguish between FKD and cancer clinically, a needle biopsy is performed.

If a diagnosis is still not made, a surgical biopsy can also be performed.

How are fibrocystic changes of the breast treated?

Cysts are usually just monitored.

Pain medications can be used when necessary.

In cases of widespread fibrocystic changes accompanied by pain, trauma to the breast should be avoided.

It is appropriate to wear a bra day and night for support.

Some anti-inflammatory creams can be tried in the treatment. However, hormone drugs have no place in modern treatment.

Synthetic hormone medication can be used in patients with extreme pain. Hormone support therapy (if used) should be discontinued in post-menopausal women to reduce pain.

The role of caffeine cessation in FKD is controversial. Some patients may benefit from restricting coffee, tea and chocolate consumption.

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Phylloid tumor of the breast

What is a phyllodes tumor of the breast?

Phyllodes tumor of the breast is a very rapidly growing tumor with a cell-rich stroma that resembles a fibroadenoma.

Well circumscribed, hard, 3-4 cm. They come as mobile masses across the world.

They can reach very large sizes and recur if they are not removed by surgery properly.
Does breast phyllodes tumor turn into cancer?

While 65% of phyllodes tumors are benign, 10% are cancer .

The remaining 25% constitutes the intermediate form.

How is phyllodes tumor of the breast treated?

The treatment of benign and intermediate form phyllodes tumors is to surgically remove the tumor along with some healthy breast tissue around it.

The treatment of cancerous phyllodes tumors is controversial. While complete removal of the tumor with a breast tissue of appropriate width is usually sufficient, in some cases, removal of the entire breast (mastectomy) may be necessary.


Breast hamartoma

What is breast hamartoma?

Hamartomas are benign, non-cancerous tumors of the breast.

They have varying amounts of glandular, fatty and fibrous tissue.

What are the symptoms of breast hamartoma?

They may occur as solitary, encapsulated, painless masses in the breast.

Sometimes they are detected incidentally during screening mammography .

How is breast hamartoma treated?

In case of suspicion of hamartoma , surgical removal of the mass provides both diagnosis and treatment at the same time.


Breast papilloma

What is solitary breast papilloma? How is it treated?

Single papillomas in the form of finger-like protrusions located in the milk ducts just below the nipple are the most common type of papillomas.

What are the symptoms of solitary breast papilloma?

Solitary breast papilloma is more common in women between the ages of 35-55.

It is rarely palpable.

It often occurs with nipple discharge in the form of bloody or clear water.

How is solitary breast papilloma treated?

It is sufficient to surgically remove these lesions along with the canal they are located in.

What is multiple breast papilloma (papillomatosis)? What are the symptoms?

In papillomatosis, papillomas that develop in other parts of the breast are more than one in number.

They can be detected by mammography.

They do not cause nipple discharge.

How is multiple breast papilloma (papillomatosis) treated?

The recurrence rate of these lesions after surgical removal is around 30%.

What is juvenile papillomatosis?

Juvenile papillomatosis is the growth of epithelial cells in the breast tissue that occurs between the ages of 20-30.

They are not true papillary lesions.

It is usually seen in young women with a family history of breast cancer and they have a high risk of developing breast cancer.

Do breast papillomas turn into cancer?

The probability of single (solitary) breast papillomas turning into cancer is between 0-15%.

This rate increases to 30% in multiple (papillomatosis) breast papillomas and juvenile papillomatosis.

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Nipple discharge

What causes nipple discharge?

Even though it is not during breastfeeding, discharge from the nipple is a common condition in women.

The most common reasons can be listed as follows:

Enlargement of milk ducts (most common),

papilloma in the milk duct and

Cancer (most rare).

In these distinctions, the characteristics of the flow should be fully revealed:

Characteristics of the discharge (serous, bloody, other),

The presence of a crowd together,

Discharge from one breast or both breasts,

Flow from a single or multiple channels,

The discharge is spontaneous (continuous or intermittent) or squeezed,

Relationship with menstruation,

Whether or not you are in menopause and

Patients taking birth control pills or estrogen.

Unilateral, spontaneous serous or partially bloody discharge from a single duct is often due to intraductal papilloma. Rarely, it may occur due to cancer. A mass may not be felt.

The cause of bloody discharge is mostly benign intraductal papilloma. However, the possibility of cancer should also be taken into consideration.

In pre-menopausal women, spontaneous discharge from multiple ducts just before menstruation is often due to benign changes of the breast, whether unilateral or bilateral. The color of the discharge may be green or brown.

In women who are not breastfeeding, milky discharge (galactorrhea) coming from more than one channel occurs due to endocrine problems as a result of excessive secretion of prolactin from the brain. In these patients, serum prolactin levels are checked to investigate a pituitary tumor. In addition, some psychiatric medications and some other medications are among the causes of milky discharge. When these medications are stopped, the discharge also stops.

Birth control pills or estrogen support therapy can also cause clear, serous or milky discharge, often from more than one duct. In these patients, discharge often occurs just before menstruation, and when the medications are stopped, the discharge also stops.

Inflammatory discharge is usually due to an abscess under the nipple.

Is nipple discharge a sign of cancer?

Nipple discharge is rarely caused by cancer, except in some special cases.

Bloody discharge coming from a single nipple with a mass and a single hole spontaneously (without squeezing the nipple) may be a sign of cancer, although it is rare.

How is nipple discharge treated?

If no mass is detected along with the discharge and the discharge is not bloody, the patient is checked every 2-3 months within a year.

If the cause can be determined, treatments are given based on the cause:

Antibiotic treatment in the presence of infection,

Discontinuation of medications that cause discharge,

Giving medications to suppress high prolactin hormone levels.

In order to rule out discharge and thus for both diagnosis and treatment, the relevant milk duct is surgically removed.



What is Galactocele? What are the reasons?

Galactocele is a milk-filled cyst that is round, well-circumscribed and can move easily within the breast.

It usually occurs after breastfeeding is stopped or when the frequency of breastfeeding is significantly reduced.

However, galactocele may occur 6 to 10 months after cessation of breastfeeding.

The reason is not exactly known.

Samples taken from the cyst reveal a thick, creamy fluid that may have dark green or brown tones.

​How is galactocele treated?

For the treatment of galactocele, it is sufficient to drain the cyst with a needle.

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