DIFFERENCES BETWEEN A MALIGNANT AND BENIGN TUMOR

What Is a Tumor?

A tumor is an abnormal lump or growth of cells. When the cells in the tumor are
normal, it is benign. Something just went wrong, and they overgrew and produced
a lump. When the cells are abnormal and can grow uncontrollably, they are
cancerous cells, and the tumor is malignant.

To determine whether a tumor is benign or cancerous, a doctor can take a sample

of the cells with a biopsy procedure. Then the biopsy is analyzed under a
microscope by a pathologist, a doctor specializing in laboratory science.

Definition of Benign Tumors: Noncancerous

If the cells are not cancerous, the tumor is benign. It won't invade nearby tissues or
spread to other areas of the body (metastasize). A benign tumor is less worrisome
unless it is pressing on nearby tissues, nerves, or blood vessels and causing
damage. Fibroids in the uterus or lipomas are examples of benign tumors.

Benign tumors may need to be removed by surgery. They can grow very large,
sometimes weighing pounds. They can be dangerous, such as when they occur in
the brain and crowd the normal structures in the enclosed space of the skull. They
can press on vital organs or block channels. Also, some types of benign tumors
such as intestinal polyps are considered precancerous and are removed to prevent
them becoming malignant. Benign tumors usually don't recur once removed, but if
they do it is usually in the same place.

Definition of Malignant Tumors: Cancerous

Malignant means that the tumor is made of cancer cells, and it can invade nearby
tissues. Some cancer cells can move into the bloodstream or lymph nodes, where
they can spread to other tissues within the body—this is called metastasis. Cancer
can occur anywhere in the body including the breast, intestines, lungs, reproductive
organs, blood, and skin.

For example, breast cancer begins in the breast tissue and may spread to lymph
nodes in the armpit if it's not caught early enough and treated. Once breast cancer
has spread to the lymph nodes, the cancer cells can travel to other areas of the
body, like the liver or bones. The breast cancer cells can then form tumors in those
locations. A biopsy of these tumors might show characteristics of the original
breast cancer tumor.
Differences Between Benign and Malignant Tumors

Although there are exceptions—for example, although most malignant tumors

grow rapidly and most benign ones do not, there are examples of both slow-
growing cancerous tumors and non-cancerous ones that grow quickly—the main
differences between the two types of tumors are clear and consistent.

Characteristics of Benign Tumors

 Cells tend not to spread
 Most grow slowly
 Do not invade nearby tissue
 Do not metastasize (spread) to other parts of the body
 Tend to have clear boundaries
 Under a pathologist's microscope, shape, chromosomes, and DNA of cells
appear normal
 Do not secrete hormones or other substances
 May not require treatment if not health-threatening
 Unlikely to recur if removed or require further treatment such as radiation or
chemotherapy

Characteristics of Malignant Tumors

 Cells can spread
 Usually grow fairly rapidly
 Often invade basal membrane that surrounds nearby healthy tissue
 Can spread via bloodstream or lymphatic system, or by sending "fingers"
into nearby tissue
 May recur after removal, sometimes in areas other the original site
 Cells have abnormal chromosomes and DNA characterized by large, dark
nuclei; may have abnormal shape
 Can secrete substances that cause fatigue and weight loss (paraneoplastic
syndrome)
 May require aggressive treatment, including surgery, radiation,
chemotherapy, and immunotherapy medications

Can a Benign Tumor Turn Malignant?

Some types of benign tumors only very rarely transform into malignant tumors.
But some types, such as adenomatous polyps (adenomas) in the colon have a
greater risk of transforming into cancer. That is why polyps, which are benign, are
removed during colonoscopy. Removing them is one way of preventing colon
cancer.

It's not always clear-cut whether a tumor is benign or malignant, and your doctor
may use several different factors to diagnose it as one or the other. You may end
up with an uncertain diagnosis. Also, it is possible that a biopsy finds precancerous
cells or misses the area where the cancerous cells are more prevalent. In these
cases, what was thought to be benign might turn out to be malignant as it further
grows and develops.

What Your Tumor Diagnosis Means

If you have been diagnosed with a malignant tumor, your oncologist (cancer
doctor) will devise a treatment plan with you based on the stage of cancer. Early-
stage cancers haven't spread much, if at all, whereas later-stage cancers have
spread to more areas of the body. Determining the stage of cancer may require
biopsies, surgery, and/or imaging tests. Once the cancer stage is determined, you
can proceed with therapy.

If you have been diagnosed with a benign tumor, your doctor will provide
reassurance that you do not have cancer. Depending on the type of benign tumor,
your doctor may recommend observation or removal for cosmetic or health
purposes (for instance, the tumor may be compromising an important organ in your
body).

Non-cancerous tumours of the breast

The following are non-cancerous tumours of the breast.

Fibro adenoma

Fibroadenomas are made up of connective and gland tissues. They are common in
young women between 20 and 30 years of age. One or several fibroadenomas can
occur, and they can develop in one or both breasts. Most fibroadenomas are 1–
2 cm in size, but they can grow as large as 5 cm.
Simple fibro adenomas are the most common type of fibroadenoma. They are
made up of one type of tissue. Simple fibroadenomas don’t increase the risk for
breast cancer.

Complex fibro adenomas are made up of different tissues,

including cysts, calcifications and enlarged groups of glands that make milk (called
lobules). Having a complex fibroadenoma slightly increases the risk for developing
breast cancer.

A fibroadenoma is usually found as a lump in the breast. The lump feels rubbery or
smooth, it is easy to move in the breast tissue and it has well-defined edges.

A fibroadenoma usually doesn’t need to be treated. If it grows over time or

changes the shape of the breast, doctors may do surgery to remove it.

Intraductal papilloma
An intraductal papilloma is a wart-like tumour that develops in a breast duct. They
are usually found close to the nipple. Both women and men can develop an
intraductal papilloma, but it is more common in women.

Most intraductal papillomas do not increase your risk of developing breast cancer.
But if there is a type of abnormal cell growth (called atypical hyperplasia), your
risk may be slightly higher. Your risk for breast cancer may also be a bit higher if
you have several intraductal papillomas.

The most common symptom of an intraductal papilloma is nipple discharge, which

can be clear or bloody. Sometimes a lump can be felt near or under the nipple.
Some people may have pain in the area.

Phylloides tumours

Phylloides tumours may also be called phyllodes or cystosarcoma phylloides. They

start in the connective and gland tissues of the breast.

Almost all phylloides tumours are non-cancerous. In rare cases, a phylloides

tumour may be cancerous. Other phylloides tumours are classified as borderline, or
uncertain malignant potential, tumours. This means that doctors can’t tell if the
phylloides tumour is, or will become, cancerous.

A phylloides tumour can cause a firm round lump. Sometimes it can cause pain.
Phylloides tumours often grow very quickly, and they may be quite large when
they are diagnosed.

Doctors will do surgery (called a lumpectomy) to remove a phylloides tumour.

They remove a wide area of normal breast tissue around the tumour (called the
surgical margin) because these tumours tend to come back (recur) if all of the
tumour isn’t removed. They may need to do a mastectomy for large cancerous
phylloides tumours or phylloides tumours that recur.

Rare non-cancerous tumours of the breast

The following are rare non-cancerous tumours that can start in different breast
tissues:

 lipoma
A lipoma is a benign tumor made of fat tissue. They are generally soft
to the touch, movable, and painless. They usually occur just under the skin,
but occasionally may be deeper. Most are less than 5 cm in size. Common
locations include upper back, shoulders, and abdomen.
  hemangioma
Hemangioma is a benign tumor derived from blood vessel cell types,
most commonly infantile hemangioma, a common benign tumor of infancy.
Infantile hemangiomas, known colloquially as strawberry marks and seen at
birth or in the first weeks of life, are most commonly seen on the skin

 hamartoma

A hamartoma is a mostly benign, focal malformation that

resembles a neoplasm in the tissue of its origin. While traditionally considered
developmental malformation, many hamartomas have clonal chromosomal
aberrations that are acquired through somatic mutations and on this basis are now
considered to be neoplastic

 Adenoma

Adenoma is a benign tumor of glandular tissue, such as the

mucosa of stomach, small intestine, and colon, in which tumor cells form glands or
gland like structures. In hollow organs (digestive tract), theadenoma grows into
the lumen - adenomatouspolyp or polypoid adenoma.

Neurofibroma
A neurofibroma is a non-cancerous (benign) tumor that develops from
the cells and tissues that cover nerves. Some people who
develop neurofibromashave a genetic condition known asneurofibromatosi

What Is Breast Cancer?

Breast cancer starts when cells in the breast begin to grow out of control. These
cells usually form a tumor that can often be seen on an x-ray or felt as a lump. The
tumor is malignant (cancer) if the cells can grow into (invade) surrounding tissues
or spread (metastasize) to distant areas of the body. Breast cancer occurs almost
entirely in women, but men can get breast cancer, too.
Cells in nearly any part of the body can become cancer and can spread to other
areas. To learn more about cancer and how all cancers start and spread, see Cancer
Basics.
Where breast cancer starts
Breast cancers can start from different parts of the breast. Most breast cancers
begin in the ducts that carry milk to the nipple (ductal cancers). Some start in the
glands that make breast milk (lobular cancers). There are also other types of breast
cancer that are less common.
A small number of cancers start in other tissues in the breast. These cancers
are called sarcomas and lymphomas and are not really thought of as breast cancers.
Although many types of breast cancer can cause a lump in the breast, not all
do. Many breast cancers are found on screening mammograms which can detect
cancers at an earlier stage, often before they can be felt, and before symptoms
develop. There are other symptoms of breast cancer you should watch for and
report to a health care provider.

It’s also important to understand that most breast lumps are benign and not cancer
(malignant). Non-cancerous breast tumors are abnormal growths, but they do not
spread outside of the breast and they are not life threatening. But some benign
breast lumps can increase a woman's risk of getting breast cancer. Any breast lump
or change needs to be checked by a health care professional to determine if it is
benign or malignant (cancer) and if it might affect your future cancer risk.
How breast cancer spreads
Breast cancer can spread when the cancer cells get into the blood or lymph system
and are carried to other parts of the body.
The lymph system is a network of lymph (or lymphatic) vessels found throughout
the body that connects lymph nodes (small bean-shaped collections of immune
system cells). The clear fluid inside the lymph vessels, called lymph,
contains tissue by-products and waste material, as well as immune system cells.
The lymph vessels carry lymph fluid away from the breast. In the case of breast
cancer, cancer cells can enter those lymph vessels and start to grow in lymph
nodes. Most of the lymph vessels of the breast drain into:

 Lymph nodes under the arm (axillary nodes)

 Lymph nodes around the collar bone (supraclavicular [above the collar
bone] and infraclavicular [below the collar bone] lymph nodes)
 Lymph nodes inside the chest near the breast bone (internal mammary
lymph nodes)

If cancer cells have spread to your lymph nodes, there is a higher chance that the
cells could have traveled through the lymph system and spread (metastasized) to
other parts of your body. The more lymph nodes with breast cancer cells, the more
likely it is that the cancer may be found in other organs. Because of this, finding
cancer in one or more lymph nodes often affects your treatment plan. Usually, you
will need surgery to remove one or more lymph nodes to know whether the cancer
has spread.
Still, not all women with cancer cells in their lymph nodes develop metastases, and
some women with no cancer cells in their lymph nodes develop metastases later.

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