Benign disorders of the breast in older women

Five hundred and eighty-one women over the age of 55 years with a benign disorder of the breast have been studied out of a total of 4,379 consecutive consultations for a perceived mammary problem. The relative age specific incidence of benign disorders of the breast dropped dramatically after menopause. Eighty per cent of older patients seen with these phenomena were between 55 and 69 years of age. Older women with benign disorders of the breast were more likely to have had a previous benign finding at biopsy or aspiration than younger patients. The use of hormonal supplements in these women was no different than that believed to occur in the regular population, except in the patients with cysts of the breast. The most common complaint was nodularity with or without pain. Cysts and fibroadenomas were proportionately much less common than in younger women and one-half of the patients who had cysts were taking hormonal supplements. In women more than 55 years of age, papillomas of the duct are responsible for approximately one-third of the nipple discharges, although the most common cause is ectasia of the duct. The postmenopausal involution makes the breast much easier to examine, both clinically and roentgenographically so that diagnosis of benign disorders can be made with reasonable confidence. Cysts can be safely aspirated because cystic carcinomas which do occur in this age group can be fairly easily recognized by gross clinical features.