Breast lumps natural history, complications and prognosis

If benign breast lumps left untreated, those proved to be benign both by clinical examination and cytological diagnosis, do not become malignant and 68% of benign breast lumps resolve by time mostly after 2 years. Benign breast lumps should approved to be benign both clinically and cytologicaly. Because some of breast lumps which thought to be benign ones can turn to be malignant by cytological results. Breast lumps which approved to be benign both clinically and cytologicaly in women under 35 years can resolve over time if do not excised.

• Natural history of breast lumps is not well-studied and the related information is limited. ^[1]
• In order to prevent missed malignancy and patient’s reassurance, benign breast lumps may be excised.
• The symptoms of benign breast lumps, especially fibroadenomas, usually develop in the second and third decade of life, and discrete breast lumps are considered to be benign on the basis of clinical examination.
• If left untreated, 68% of patients with benign breast lumps may regress over 2 years.
• The histological mechanism for resolution of breast lumps is associated with the fact that lumps may merge into stroma and hyalinize.^[2]
• The risk of malignancy in fibroadenoma is low.^[3]
• No adenocarcinoma reported in fibroadenoma yet, only lobular neoplasia was seen in fibroadenoma.^[4]

• Common complications of breast lumps include:
  • May develop into malignant lesion^[1]

The relative risk (RR) of following breast cancer in different types of breast lumps:^[5][6][7]

• Non-proliferative breast lesions have RR 1.2-1.4.
• Proliferative diseases (PD) have RR 1.7-2.1.
• Proliferative diseases (PD) with atypia have RR more than 4 for breast cancer.
• PD and PD with atypia may be considered as early stages of breast cancer.

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