|
|
| (8 intermediate revisions by 2 users not shown) |
| Line 3: |
Line 3: |
| {{CMG}}; {{AE}} {{S.M}} | | {{CMG}}; {{AE}} {{S.M}} |
| ==Overview== | | ==Overview== |
| Management and medical therapy of [[breast lumps]] depends on women's age (age> 40 or age <40) and [[mammography]] results in women aged > 40 years. In women aged > 40 years; no further evaluation is needed in case of clearly [[benign]] mass in [[mammography]]; however, [[ultrasound]] imaging is required for the rest of the findings [[mammography]]. Approach to breast lumps in women >40 years is depended on breast imaging reporting and data systems (BI-RADS) stages. Medical therapy of breast lumps in women< 40 years is depended on [[ultrasound]] results and BI-RADS categories.
| | There is no specific medical therapy for breast lump. However, there are certain medications that may be used prophylactically to reduce the risk of transformation of breast lump into breast carcinoma. |
|
| |
|
| ==Breast lumps medical therapy== | | ==Breast lumps medical therapy== |
| | | * There is no specific medical therapy for breast lump. |
| | | * However, there are certain medications that may be used prophylactically to reduce the risk of transformation of breast lump into breast carcinoma. For more information, [[Breast lumps secondary prevention|click here]]. |
| Management of [[breast lumps]]:
| |
| *women aged >40 years with palpable mass:<ref name="pmid27814822">{{cite journal| author=Harvey JA, Mahoney MC, Newell MS, Bailey L, Barke LD, D'Orsi C et al.| title=ACR Appropriateness Criteria Palpable Breast Masses. | journal=J Am Coll Radiol | year= 2016 | volume= 13 | issue= 11S | pages= e31-e42 | pmid=27814822 | doi=10.1016/j.jacr.2016.09.022 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27814822 }} </ref>
| |
| **Diagnostic [[mammography]] is considered as the first step.
| |
| **If the last [[screening test]] is related to more than previous 6 months, both breast [[mammography]] is required to rule out occult [[malignancy]]. | |
| **No further evaluation is needed in case of clearly [[benign]] mass in [[mammography]].
| |
| **[[Ultrasound]] imaging is required for the rest of cases appeared in [[mammography]].
| |
| ***[[Stereotactic]] [[biopsy]] is recommended in negative [[ultrasound]] findings addition to suspicious mammographic results.
| |
| *Women aged< 40 years with palpable mass:<ref name="pmid25341156">{{cite journal| author=Lehman CD, Lee AY, Lee CI| title=Imaging management of palpable breast abnormalities. | journal=AJR Am J Roentgenol | year= 2014 | volume= 203 | issue= 5 | pages= 1142-53 | pmid=25341156 | doi=10.2214/AJR.14.12725 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25341156 }} </ref><ref name="pmid21098212">{{cite journal| author=Loving VA, DeMartini WB, Eby PR, Gutierrez RL, Peacock S, Lehman CD| title=Targeted ultrasound in women younger than 30 years with focal breast signs or symptoms: outcomes analyses and management implications. | journal=AJR Am J Roentgenol | year= 2010 | volume= 195 | issue= 6 | pages= 1472-7 | pmid=21098212 | doi=10.2214/AJR.10.4396 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21098212 }} </ref>
| |
| **[[Ultrasound]] or [[mammography]] is suggested for initial management of women aged between 30 to 39 years.
| |
| **[[Ultrasound]] is the first step for women< 30 years presenting with palpable mass.
| |
| | |
| Approach to [[breast lumps]] in women aged >40 years based on mammographic results:<ref name="pmid27814822" />
| |
| *If mammographic results become negative, the next step is targeted [[ultrasound|ultrasound.]]
| |
| **Negative [[ultrasound]] results considered as breast imaging reporting and data system (BI-RADS) 1, then clinical follow-up is needed.
| |
| **Benign [[ultrasound]] results considered as BI-RADS 2, then clinical follow-up is needed.
| |
| **Probably benign results considered as BI-RADS 3, then ultrasound short interval follow-up is needed.
| |
| **Suspicious [[ultrasound]] results considered as BI-RADS 4 or 5, then core-needle biopsy is needed.
| |
| *If mammographic results show only fatty tissue:
| |
| ** Considered as BI-RADS 1, then clinical follow-up is needed.
| |
| *If mammographic results show benign mass:
| |
| ** Considered as BI-RADS 2, then clinical follow-up
| |
| *If mammographic results are in favor of probably [[benign]] lumps, the next step is targeted [[ultrasound|ultrasound.]]
| |
| **Negative [[ultrasound]] results considered as BI-RADS 3, then mammographic short interval follow-up is required.
| |
| **[[Benign]] [[ultrasound]] results considered as BI-RADS 2, then clinical follow-up is required.
| |
| **Probably [[benign]] [[ultrasound]] results considered as BI-RADS 3, then [[ultrasound]] short interval follow-up.
| |
| **Suspicious [[ultrasound]] results is considered as BI-RADS 4 or 5, then core needle biopsy is required.
| |
| *If mammographic result is in favor of suspicious lesion, the next step is [[ultrasound]] to determine [[biopsy]] plan.
| |
| **Considered as BI-RADS 4 or 5, then core needle biopsy is required.
| |
| Approach to breast lumps in women aged <40 years based on targeted [[ultrasound]] findings:<ref name="pmid27814822" />
| |
| *If [[ultrasound]] results become negative, there are two approaches:
| |
| **Considered as BI-RADS 1, then clinical follow-up is required.
| |
| **Perform diagnostic [[mammography]]:
| |
| ***Negative results are in favor of BI-RADS 1, then clinical follow-up is required.
| |
| ***Benign results are considered as BI-RADS 2, then clinical follow-up is required.
| |
| ***Probably benign results considered as BI-RADS 3, Mammographic short interval follow-up is required.
| |
| ***Suspicious results considered as BI-RADS 4 or 5, then core needle biopsy is required.
| |
| *If [[ultrasound]] results show benign findings:
| |
| **Considered as BI-RADS 2, then clinical follow-up is required.
| |
| *If [[ultrasound]] results show probably benign findings:
| |
| **Considered as BI-RADS 3, then short interval follow-up is required.
| |
| *If [[ultrasound]] results become suspicious:
| |
| **Considered as BI-RADS 4 or 5, then core needle biopsy is required.
| |
| | |
| {{familytree/start}}
| |
| {{familytree | | | | | | | | | | A01 | | | | | |A01=Women age > 40 years}}
| |
| {{familytree | | | | | | | | | | |!| | | | | | | | }}
| |
| {{familytree | | | | | | | | | | B01 | | | | | |B01=Mammographic findings}}
| |
| {{familytree | | |,|-|-|-|v|-|-|-|+|-|-|-|v|-|-|-|-|.|}}
| |
| {{familytree | | C01 | | C02 | | C03 | | C04 | | | C05 | |C01=Negative|C02=Fatty tissue|C03=Benign|C04=Probably benign|C05=Suspicious }}
| |
| {{familytree | | |!| | | |!| | | |!| | | |!| | | | |!| }}
| |
| {{familytree | | C06 | | C07 | | C08 | | C09 | | | C010 |C06=Ultrasound|C07=BI-RADS 1, then clinical follow-up|C08=BI-RADS 2, then clinical follow-up|C09=Ultrasound|C010=Ultrasound for biopsy plan determination}}
| |
| {{familytree | | |!| | | | | | | | | | | |!| | | | |!| |}}
| |
| {{familytree | | |!| | | | | | | | | | | |!| | | | C019|C019=BI-RADS 4 or 5, then core needle biopsy}}
| |
| {{familytree | | |!| | | | | | | | | | | |)|-|-|-|v|-|-|-|v|-|-|-|.|}}
| |
| {{familytree | | |!| | | | | | | | | | | |!| | | |!| | | |!| | | |!|}}
| |
| {{familytree | | |!| | | | | | | | | | | C011| | C012| | C013| | C014|C011=Negative|C012=Benign|C013=Probably benign|C014=Suspicious}}
| |
| {{familytree | | |!| | | | | | | | | | | |!| | | |!| | | |!| | | |!|}}
| |
| {{familytree | | |!| | | | | | | | | | | C015| | C016| | C017| | C018|C015=BI-RADS 3, then mammographic short interval follow-up|C016=BI-RADS 2, then clinical follow-up|C017=BI-RADS 3, then ultrasound short interval follow-up|C018=BI-RADS 4 or 5, then core needle biopsy}}
| |
| {{familytree | | |)|-|-|-|v|-|-|-|v|-|-|-|.|}}
| |
| {{familytree | | |!| | | |!| | | |!| | | |!|}}
| |
| {{familytree | | D01 | | D02 | | D03 | | D04 | | |D01=Negative results|D02=Benign|D03=Probably benign|D04=Suspicious}}
| |
| {{familytree | | |!| | | |!| | | |!| | | |!| | | | }}
| |
| {{familytree | | E01 | | E02 | | E03 | | E04 | | |E01=BI-RADS 1, then clinical follow-up|E02=BI-RADS 2, then clinical follow-up|E03=BI-RADS 3, then ultrasound short interval follow-up|E04= BI-RADS 4 or 5, then core needle biopsy}}
| |
| {{familytree/end}}
| |
| | |
| | |
| {{familytree/start}}
| |
| {{familytree | | | | | | | | | | A01 | | | | | |A01=Women age < 40 years}}
| |
| {{familytree | | | | | | | | | | |!| | | | | | | | }}
| |
| {{familytree | | | | | | | | | | B01 | | | | | |B01=Targeted ultrasound}}
| |
| {{familytree | | |,|-|-|-|v|-|-|-|^|-|-|-|v|-|-|-|.|}}
| |
| {{familytree | | C01 | | C02 | | | | | | C03 | | C04 | | | |C01=Negative|C02=Benign|C03=Probably benign|C04=Suspicious}}
| |
| {{familytree | | |!| | | | | |}}
| |
| {{familytree | | |)|-|-|-|-|.| |}}
| |
| {{familytree | | |!| | | | |!|}}
| |
| {{familytree | | C05 | | | C06|C05=BI-RADS 1, then clinical follow-up|C06=Perform diagnostic mammography}}
| |
| {{familytree | | | | | | | |!| }}
| |
| {{familytree/end}}
| |
|
| |
|
| ==References== | | ==References== |
| Line 93: |
Line 15: |
| {{WikiDoc Sources}} | | {{WikiDoc Sources}} |
|
| |
|
| [[Category:primary care]]
| | [[Category:Up-To-Date]] |
| [[Category:Disease]]
| |
| [[Category:Musculoskeletal Disease]]
| |
| [[Category:Physical examination]]
| |
| [[Category:Needs content]]
| |
| [[Category:Up-To-Date]]
| |
| [[Category:Oncology]] | | [[Category:Oncology]] |
| [[Category:Medicine]]
| |
| [[Category:Gynecology]] | | [[Category:Gynecology]] |
| [[Category:Surgery]] | | [[Category:Surgery]] |