Breast lumps differential diagnosis: Difference between revisions

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Revision as of 19:20, 15 January 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shadan Mehraban, M.D.[2]

Overview

Breast lumps must be differentiated from other diseases such as malignancy, cysts, inflammation and non-inflammatory solid lumps. Breast symptoms such as nipple discharge and mastalgia require assessment as well.

Differentiating Breast lumps from other Diseases

Differential diagnosis of breast lumps include: ^[1]^[2]^[3]^[4]^[5]^[6]^[7]

Diseases	Etiology	Benign	Malignant	Clinical manifestation									Paraclinical findings			Gold standard diagnosis	Associated findings
				Demography	History	Symptoms			Signs				Lab findings	Histopathology	Imaging
				Demography	History	Mass	Mastalgia	Nipple discharge	Breast exam	Skin changes	LAP	Others	Lab findings	Histopathology	Imaging
Fibroadenoma^[8]	Unknown	+	Very slight increased risk of breast cancer in complex fibroadenoma	Most common benign tumor, women aged 20-30 years	Increased in size during pregnancy or with estrogen therapy, and regress after menopause	+	±	–	Solitary, well-defined mobile mass	–	–	NA	Nl	Proliferative breast lesion without atypia	Well-defined, solid mass	Mammography or ultrasound + biopsy	NA
Breast cyst^[9]	Hormonal fluctuation	+	No increased risk of malignancy for simple cyst <1% for complicated cyst <1% to 23% for complex cyst	Hormonal replacement therapy (HRT)	Found in premenopausal, perimenopausal, and postmenopausal women Mostly seen among HRT users	+	±	–	Solitary Cluster of small masses or an ill-defined mass Smooth, firm, and frequently tender	–	–	NA	Nl	Nonproliferative breast lesions	simple cyst: Well circumscribed,posterior acoustic enhancement without internal echoes Complicated cyst: Homogenous low-level internal echoes due to without solid components Complex cyst: thick walls greater than 0.5 mm with solid component	Ultrasound Fine needle aspiration (FNA) for confirmation	NA
Fibrocystic change		+
Galactocele		+
Cysts of montgomery		+
Hemangioma		+
Breast abscess		+
Mastitis	Inflammation Infection	+
Diseases	Etiology	Benign	Malignant	Demography	History	Mass	Pain	Nipple discharge	Breast exam	Skin changes	LAP	Others	Lab findings	Histopathology	Imaging	Gold standard diagnosis	Associated findings
Breast carcinoma			+		Positive family history
Ductal carcinoma in situ			+
Microinvasive breast cancer			+
Breast sarcoma			+
Paget disease			+
Phyllodes tumor			+
Lymphoma			+
Metastasis			+
Duct ectasia		+
Intraductal papilloma		+
Lipoma		+
Diseases	Etiology	Benign	Malignant	Demography	History	Mass	Pain	Nipple discharge	Breast exam	Skin changes	LAP	Others	Lab findings	Histopathology	Imaging	Gold standard diagnosis	Associated findings
Neurofibroma		+
Pregnancy		+
Gynecomastia		+
Premenstrual syndrome		+
Breast trauma		+
Fat necrosis		+
Drugs		+
Diseases	Etiology	Benign	Malignant	Demography	History	Mass	Pain	Nipple discharge	Breast exam	Skin changes	LAP	Others	Lab findings	Histopathology	Imaging	Gold standard diagnosis	Associated findings

NA

References

↑ Cheung KL, Lam TP (2005). "Approach to a lump in the breast: a regional perspective". Asian J Surg. 28 (1): 65–70. doi:10.1016/S1015-9584(09)60264-5. PMID 15691804.
↑ Collyar DE (2001). "Breast cancer: a global perspective". J Clin Oncol. 19 (18 Suppl): 101S–105S. PMID 11560983.
↑ Lang AP, Luchsinger IS, Rawling EG (1987). "Filariasis of the breast". Arch Pathol Lab Med. 111 (8): 757–9. PMID 3307689.
↑ Varghese R, Raghuveer CV, Pai MR, Bansal R (1996). "Microfilariae in cytologic smears: a report of six cases". Acta Cytol. 40 (2): 299–301. doi:10.1159/000333755. PMID 8629415.
↑ Alagaratnam, T.T. & Wong, J. World J. Surg. (1989) 13: 743. https://doi.org/10.1007/BF01658425
↑ Shukla HS, Kumar S (1989). "Benign breast disorders in nonwestern populations: Part II--Benign breast disorders in India". World J Surg. 13 (6): 746–9. PMID 2623884.
↑ Leung TN, Haines CJ, Chung TK (2001). "Five-year compliance with hormone replacement therapy in postmenopausal Chinese women in Hong Kong". Maturitas. 39 (3): 195–201. PMID 11574178.
↑ Pinto, Joana; Aguiar, Ana Teresa; Duarte, Hálio; Vilaverde, Filipa; Rodrigues, Ângelo; Krug, José Luís (2014). "Simple and Complex Fibroadenomas". Journal of Ultrasound in Medicine. 33 (3): 415–419. doi:10.7863/ultra.33.3.415. ISSN 0278-4297.
↑ Courtillot C, Plu-Bureau G, Binart N, Balleyguier C, Sigal-Zafrani B, Goffin V; et al. (2005). "Benign breast diseases". J Mammary Gland Biol Neoplasia. 10 (4): 325–35. doi:10.1007/s10911-006-9006-4. PMID 16900392.

Template:WikiDoc Sources

[pmid15691804-1] Cheung KL, Lam TP (2005). "Approach to a lump in the breast: a regional perspective". Asian J Surg. 28 (1): 65–70. doi:10.1016/S1015-9584(09)60264-5. PMID 15691804.

[pmid11560983-2] Collyar DE (2001). "Breast cancer: a global perspective". J Clin Oncol. 19 (18 Suppl): 101S–105S. PMID 11560983.

[pmid3307689-3] Lang AP, Luchsinger IS, Rawling EG (1987). "Filariasis of the breast". Arch Pathol Lab Med. 111 (8): 757–9. PMID 3307689.

[pmid8629415-4] Varghese R, Raghuveer CV, Pai MR, Bansal R (1996). "Microfilariae in cytologic smears: a report of six cases". Acta Cytol. 40 (2): 299–301. doi:10.1159/000333755. PMID 8629415.

[5] Alagaratnam, T.T. & Wong, J. World J. Surg. (1989) 13: 743. https://doi.org/10.1007/BF01658425

[pmid2623884-6] Shukla HS, Kumar S (1989). "Benign breast disorders in nonwestern populations: Part II--Benign breast disorders in India". World J Surg. 13 (6): 746–9. PMID 2623884.

[pmid11574178-7] Leung TN, Haines CJ, Chung TK (2001). "Five-year compliance with hormone replacement therapy in postmenopausal Chinese women in Hong Kong". Maturitas. 39 (3): 195–201. PMID 11574178.

[PintoAguiar2014-8] Pinto, Joana; Aguiar, Ana Teresa; Duarte, Hálio; Vilaverde, Filipa; Rodrigues, Ângelo; Krug, José Luís (2014). "Simple and Complex Fibroadenomas". Journal of Ultrasound in Medicine. 33 (3): 415–419. doi:10.7863/ultra.33.3.415. ISSN 0278-4297.

[pmid16900392-9] Courtillot C, Plu-Bureau G, Binart N, Balleyguier C, Sigal-Zafrani B, Goffin V; et al. (2005). "Benign breast diseases". J Mammary Gland Biol Neoplasia. 10 (4): 325–35. doi:10.1007/s10911-006-9006-4. PMID 16900392.

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@@ Line 60: / Line 60: @@
 | style="background:#F5F5F5;" align="center" |NA
 |-
-! style="background:#DCDCDC;" align="center" |Breast cyst
+! style="background:#DCDCDC;" align="center" |[[Breast]] [[cyst]]<ref name="pmid16900392">{{cite journal| author=Courtillot C, Plu-Bureau G, Binart N, Balleyguier C, Sigal-Zafrani B, Goffin V et al.| title=Benign breast diseases. | journal=J Mammary Gland Biol Neoplasia | year= 2005 | volume= 10 | issue= 4 | pages= 325-35 | pmid=16900392 | doi=10.1007/s10911-006-9006-4 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16900392  }}</ref>
 | style="background:#F5F5F5;" align="center" |
 * Hormonal fluctuation
@@ Line 69: / Line 69: @@
 * <1% to 23% for complex cyst
 | style="background:#F5F5F5;" align="center" |
-* Hormonal replacement therapy
+* Hormonal replacement therapy (HRT)
 | style="background:#F5F5F5;" align="center" |
-| style="background:#F5F5F5;" align="center" |+
+* Found in premenopausal, perimenopausal, and postmenopausal women
-| style="background:#F5F5F5;" align="center" |
+* Mostly seen among HRT users
-{|
+| style="background:#F5F5F5;" align="center" | +
-|-
 | style="background:#F5F5F5;" align="center" |±
-|}
 | style="background:#F5F5F5;" align="center" |–
 | style="background:#F5F5F5;" align="center" |
@@ Line 85: / Line 83: @@
 | style="background:#F5F5F5;" align="center" |–
 | style="background:#F5F5F5;" align="center" |NA
+| style="background:#F5F5F5;" align="center" |Nl
 | style="background:#F5F5F5;" align="center" |
+* Nonproliferative breast lesions
 | style="background:#F5F5F5;" align="center" |
-| style="background:#F5F5F5;" align="center" |
+* simple cyst: Well circumscribed,posterior acoustic enhancement without internal echoes
+* Complicated cyst: Homogenous low-level internal echoes due to without solid components
+* Complex cyst: thick walls greater than 0.5 mm with solid component
 | style="background:#F5F5F5;" align="center" |
 * Ultrasound
-| style="background:#F5F5F5;" align="center" | NA
+* Fine needle aspiration (FNA) for confirmation
+|NA
 |-
 ! style="background:#DCDCDC;" align="center" |Fibrocystic change
@@ Line 606: / Line 609: @@
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard diagnosis
 ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated findings
-|}
+|}NA
 ==References==
 {{Reflist|2}}

Breast lumps differential diagnosis: Difference between revisions

Revision as of 19:20, 15 January 2019

Overview

Differentiating Breast lumps from other Diseases

References

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