Breast Mass Resident Survival Guide: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
Line 1: Line 1:
__NOTOC__
{{WikiDoc CMG}}; {{AE}}<br>
==Overview==
==Overview==
A [[breast mass]] <ref name="pmid21250122">{{cite journal |vauthors=Walker HK, Hall WD, Hurst JW, Perry MC |title= |journal= |volume= |issue= |pages= |date= |pmid=21250122 |doi= |url=}}</ref>is described as a mass that develops in the breast tissue. The breast consists of many different types of tissue, like mammillary glands, and mammillary ducts, and tubes. Additionally, fibrous tissue, fatty tissue, nerves, blood vessels, and lymph nodes also form important constituents of the breast. As a result, the breast mass differs widely in sizes and textures, and symptoms like pain, tenderness, or discharge <ref name="pmid21250127">{{cite journal |vauthors=Walker HK, Hall WD, Hurst JW, Barry M |title= |journal= |volume= |issue= |pages= |date= |pmid=21250127 |doi= |url=}}</ref>. They can be large or small and may either feel hard or spongy. Most of the breast masses are discovered incidentally, either by women on self-breast examination <ref name="pmid27536182">{{cite journal |vauthors=Provencher L, Hogue JC, Desbiens C, Poirier B, Poirier E, Boudreau D, Joyal M, Diorio C, Duchesne N, Chiquette J |title=Is clinical breast examination important for breast cancer detection? |journal=Curr Oncol |volume=23 |issue=4 |pages=e332–9 |date=August 2016 |pmid=27536182 |pmc=4974039 |doi=10.3747/co.23.2881 |url=}}</ref>, physical examination by the practitioner <ref name="pmid29083747">{{cite journal |vauthors=Henderson JA, Duffee D, Ferguson T |title= |journal= |volume= |issue= |pages= |date= |pmid=29083747 |doi= |url=}}</ref>, or if an imaging study was done for some other diagnosis. Sometimes, the diagnosis is made while the annual mammography is done to detect possible suspicious lesions. Women of the reproductive age group are more prone to develop breast lumps or masses. Breast masses can be physiological like adenosis or pathological like malignancy or cancer. Occasionally, breast masses can be associated with hormonal changes<ref name="pmid12927032">{{cite journal |vauthors=Travis RC, Key TJ |title=Oestrogen exposure and breast cancer risk |journal=Breast Cancer Res. |volume=5 |issue=5 |pages=239–47 |date=2003 |pmid=12927032 |pmc=314432 |doi=10.1186/bcr628 |url=}}</ref>, which have a waxing and waning course. Breast masses, although uncommon, can occur in men <ref name="pmid29558507">{{cite journal |vauthors=Yuan WH, Li AF, Chou YH, Hsu HC, Chen YY |title=Clinical and ultrasonographic features of male breast tumors: A retrospective analysis |journal=PLoS ONE |volume=13 |issue=3 |pages=e0194651 |date=2018 |pmid=29558507 |pmc=5860767 |doi=10.1371/journal.pone.0194651 |url=}}</ref>. Most of the breast masses are benign. Imaging studies like mammograms, ultrasound <ref name="pmid25241817">{{cite journal |vauthors=Tan KP, Mohamad Azlan Z, Rumaisa MP, Siti Aisyah Murni MR, Radhika S, Nurismah MI, Norlia A, Zulfiqar MA |title=The comparative accuracy of ultrasound and mammography in the detection of breast cancer |journal=Med. J. Malaysia |volume=69 |issue=2 |pages=79–85 |date=April 2014 |pmid=25241817 |doi= |url=}}</ref>, Magnetic Resonance Imaging, Fine Needle Aspiration Cytology, and Biopsy are used for confirming the diagnosis. If the diagnosis of cancer is confirmed, modalities like lumpectomy, mastectomy, chemotherapy, or radiation are used to treat that.
A [[breast mass]] <ref name="pmid21250122">{{cite journal |vauthors=Walker HK, Hall WD, Hurst JW, Perry MC |title= |journal= |volume= |issue= |pages= |date= |pmid=21250122 |doi= |url=}}</ref>is described as a mass that develops in the breast tissue. The breast consists of many different types of tissue, like mammillary glands, and mammillary ducts, and tubes. Additionally, fibrous tissue, fatty tissue, nerves, blood vessels, and lymph nodes also form important constituents of the breast. As a result, the breast mass differs widely in sizes and textures, and symptoms like pain, tenderness, or discharge <ref name="pmid21250127">{{cite journal |vauthors=Walker HK, Hall WD, Hurst JW, Barry M |title= |journal= |volume= |issue= |pages= |date= |pmid=21250127 |doi= |url=}}</ref>. They can be large or small and may either feel hard or spongy. Most of the breast masses are discovered incidentally, either by women on self-breast examination <ref name="pmid27536182">{{cite journal |vauthors=Provencher L, Hogue JC, Desbiens C, Poirier B, Poirier E, Boudreau D, Joyal M, Diorio C, Duchesne N, Chiquette J |title=Is clinical breast examination important for breast cancer detection? |journal=Curr Oncol |volume=23 |issue=4 |pages=e332–9 |date=August 2016 |pmid=27536182 |pmc=4974039 |doi=10.3747/co.23.2881 |url=}}</ref>, physical examination by the practitioner <ref name="pmid29083747">{{cite journal |vauthors=Henderson JA, Duffee D, Ferguson T |title= |journal= |volume= |issue= |pages= |date= |pmid=29083747 |doi= |url=}}</ref>, or if an imaging study was done for some other diagnosis. Sometimes, the diagnosis is made while the annual mammography is done to detect possible suspicious lesions. Women of the reproductive age group are more prone to develop breast lumps or masses. Breast masses can be physiological like adenosis or pathological like malignancy or cancer. Occasionally, breast masses can be associated with hormonal changes<ref name="pmid12927032">{{cite journal |vauthors=Travis RC, Key TJ |title=Oestrogen exposure and breast cancer risk |journal=Breast Cancer Res. |volume=5 |issue=5 |pages=239–47 |date=2003 |pmid=12927032 |pmc=314432 |doi=10.1186/bcr628 |url=}}</ref>, which have a waxing and waning course. Breast masses, although uncommon, can occur in men <ref name="pmid29558507">{{cite journal |vauthors=Yuan WH, Li AF, Chou YH, Hsu HC, Chen YY |title=Clinical and ultrasonographic features of male breast tumors: A retrospective analysis |journal=PLoS ONE |volume=13 |issue=3 |pages=e0194651 |date=2018 |pmid=29558507 |pmc=5860767 |doi=10.1371/journal.pone.0194651 |url=}}</ref>. Most of the breast masses are benign. Imaging studies like mammograms, ultrasound <ref name="pmid25241817">{{cite journal |vauthors=Tan KP, Mohamad Azlan Z, Rumaisa MP, Siti Aisyah Murni MR, Radhika S, Nurismah MI, Norlia A, Zulfiqar MA |title=The comparative accuracy of ultrasound and mammography in the detection of breast cancer |journal=Med. J. Malaysia |volume=69 |issue=2 |pages=79–85 |date=April 2014 |pmid=25241817 |doi= |url=}}</ref>, Magnetic Resonance Imaging, Fine Needle Aspiration Cytology, and Biopsy are used for confirming the diagnosis. If the diagnosis of cancer is confirmed, modalities like lumpectomy, mastectomy, chemotherapy, or radiation are used to treat that.


Revision as of 14:21, 29 September 2020

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

Overview

A breast mass [1]is described as a mass that develops in the breast tissue. The breast consists of many different types of tissue, like mammillary glands, and mammillary ducts, and tubes. Additionally, fibrous tissue, fatty tissue, nerves, blood vessels, and lymph nodes also form important constituents of the breast. As a result, the breast mass differs widely in sizes and textures, and symptoms like pain, tenderness, or discharge [2]. They can be large or small and may either feel hard or spongy. Most of the breast masses are discovered incidentally, either by women on self-breast examination [3], physical examination by the practitioner [4], or if an imaging study was done for some other diagnosis. Sometimes, the diagnosis is made while the annual mammography is done to detect possible suspicious lesions. Women of the reproductive age group are more prone to develop breast lumps or masses. Breast masses can be physiological like adenosis or pathological like malignancy or cancer. Occasionally, breast masses can be associated with hormonal changes[5], which have a waxing and waning course. Breast masses, although uncommon, can occur in men [6]. Most of the breast masses are benign. Imaging studies like mammograms, ultrasound [7], Magnetic Resonance Imaging, Fine Needle Aspiration Cytology, and Biopsy are used for confirming the diagnosis. If the diagnosis of cancer is confirmed, modalities like lumpectomy, mastectomy, chemotherapy, or radiation are used to treat that.

Causes

Life Threatening Causes

  • Breast cancer
    • Breast cancer [8]is a type of cancer that originates in the breast tissue and occurs when the breast tissue starts growing at an uncontrollable rate. Although it is predominantly present in females, cases have been seen in men also. Often it presents as a mass or lump in the breast which can also have associated symptoms like discharge, discoloration, pain, itching, induration, and lymph engorgement. Breast cancer can be either ductal when it involves the mamillary ducts, or lobular when it starts in the glands. It is the most prevalent cancer in females and the second most common cause of death. Several factors like increasing age, high hormone levels, economic status, and ethnic groups have a modifying effect on the incidence of breast cancer [9].
    • Breast cancer can present as a lump or mass in the breast or area of the armpit, thickening or dimpling of the skin, redness of skin irritation around the nipple, any abnormal discharge, abnormality in the shape and size of the breast, or subjective symptoms like pain and traction.
    • The risk of breast cancer increases with increasing age; and most of the cases are often seen after the age of 50 years. Certain genetic mutations like BRCA1 and BRCA2, also predispose to the occurrence of breast cancer [10]. Furthermore, early menarche and late menopause also increase the risk, due to prolonged exposure to hormones. Moreover, dense breast tissue, due to more connective tissue, has increased chances of breast cancer, also making it hard to diagnose. Women with a history of breast cancer, have an increased risk of future recurrences of the same. Also, a history of breast cancer in mother, sister, or any first-degree relative or breast or ovarian cancer in other relatives, also increase the chances of breast cancer. Any radiation treatment in the past, also makes breast cancer more common [11].

Common Causes

  • Breast cysts
    • These are the fluid-filled, sacs in the breast tissue. They can be either round or oval-shaped and of varied sizes. In the majority of cases, they are palpable as a smooth, round, movable mass, which can present with symptoms like pain and tenderness. Mostly seen in women in their reproductive years, like in the 30s and 40s. The size of the cyst can vary intermittently based on hormonal influences, like menstruation and pregnancy. The cysts can be simple, which are just comprised of fluid, or complex, which have a combination of both fluid and solid components [12]. The exact diagnosis can be confirmed by biopsy.
  • Adenosis
    • Adenosis is basically a nonmalignant breast condition, which is categorized by enlargement and increase in the number of the milk-producing glands. These are more predominant in women with underlying fibrosis and cysts. A biopsy is needed for definitive diagnosis.
  • Galactocele
    • Galactoceles are benign breast lesions, which are predominantly seen in lactating women. The leading factor of galactocele is the cessation of breastfeeding, which leads to retention of milk in the ducts and stagnation, which causes pouches to form known as galactoceles. Usually, it presents as a painless mass or lump in the breast. On palpation, they feel like simple cysts but instead of fluid, they contain milk. Although they are symptomatic, they are not dangerous.
  • Fat Necrosis
    • Fat necrosis is a benign non-cancerous condition affecting the breast, which occurs after damage or injury to the fatty tissue of the breast [13]. Moreover, it can be a side effect of breast surgery or any radiation therapy. it usually causes a firm mass or lump in the breast [14]. Although it is mostly painless, occasionally it can be tender with symptoms like tenderness, or discoloration.
  • Fibroadenoma
    • Fibroadenomas are known as benign, non-malignant breast masses, which are made up of a combination of both glandular and stromal connective tissue [15] [16]. These lesions are more common in the women in the age group of the 20s and 30s and often show a regressing pattern after menopause. The biopsy is needed for a definitive diagnosis.
  • Intraductal papilloma
    • Intra-ductal papillomas are non-cancerous, tumors that grow inside the mammillary ducts of the breast. They comprise of glandular tissue, fibrous tissue, and various blood vessels. These can be either solitary or multiple papillomas. The solitary papillomas are single tumors, growing in the larger mammillary ducts close to the nipple. They present with a nipple discharge, which can be clear or bloody [17]. The multiple papillomas are present in breast tissue, which is farther away from the nipple. Ductograms, ultrasound, and mammograms are used for the diagnosis, which can be often confirmed by biopsy.
  • Lipoma
    • A lipoma is a benign lesion or tumor which is composed of adipose tissue, enclosed within a thin fibrous capsule. Although they can occur at any age, they are more common after the age of 40. On palpation, they are freely mobile, soft, smooth, and pliable and generally do not cause any other symptoms like pain.
  • Mastitis
    • Mastitis is defined as the inflammation or swelling in the breast tissue, preceded by an infection. The infection is caused by either an obstructed or clogged milk duct, which does not drain the milk completely, leading to stagnation and bacterial colonization. Sometimes, cracks or breaks in the skin surrounding the nipple can also lead to bacterial infection. Mostly it affects breastfeeding women and the involvement is unilateral. The affected part is swollen, engorged, painful, and warm to the touch. Also, constitutional symptoms like fever, headache, and fatigue can be seen. Treatment involves mainly milk expression to avoid stagnation of milk in the ducts and glands and antibiotics.

Management

 
 
 
 
 
 
 
Breast Mass [18]
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Greater than 30 years
 
 
 
 
 
 
 
 
 
Less than 30 years
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Mammogram
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Mass not present
 
 
 
 
 
Mass present
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
MALIGNANT
 
 
BENIGN
 
INDETERMINATE
 
 
 
 
 
ULTRASOUND
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
END WORK UP
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
MASS NOT PRESENT
 
 
MASS PRESENT
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
BIOPSY
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 





  1. ↑ Walker HK, Hall WD, Hurst JW, Perry MC. PMID 21250122. Missing or empty |title= (help)
  2. ↑ Walker HK, Hall WD, Hurst JW, Barry M. PMID 21250127. Missing or empty |title= (help)
  3. ↑ Provencher L, Hogue JC, Desbiens C, Poirier B, Poirier E, Boudreau D, Joyal M, Diorio C, Duchesne N, Chiquette J (August 2016). "Is clinical breast examination important for breast cancer detection?". Curr Oncol. 23 (4): e332–9. doi:10.3747/co.23.2881. PMC 4974039. PMID 27536182.
  4. ↑ Henderson JA, Duffee D, Ferguson T. PMID 29083747. Missing or empty |title= (help)
  5. ↑ Travis RC, Key TJ (2003). "Oestrogen exposure and breast cancer risk". Breast Cancer Res. 5 (5): 239–47. doi:10.1186/bcr628. PMC 314432. PMID 12927032.
  6. ↑ Yuan WH, Li AF, Chou YH, Hsu HC, Chen YY (2018). "Clinical and ultrasonographic features of male breast tumors: A retrospective analysis". PLoS ONE. 13 (3): e0194651. doi:10.1371/journal.pone.0194651. PMC 5860767. PMID 29558507.
  7. ↑ Tan KP, Mohamad Azlan Z, Rumaisa MP, Siti Aisyah Murni MR, Radhika S, Nurismah MI, Norlia A, Zulfiqar MA (April 2014). "The comparative accuracy of ultrasound and mammography in the detection of breast cancer". Med. J. Malaysia. 69 (2): 79–85. PMID 25241817.
  8. ↑ Akram M, Iqbal M, Daniyal M, Khan AU (October 2017). "Awareness and current knowledge of breast cancer". Biol. Res. 50 (1): 33. doi:10.1186/s40659-017-0140-9. PMC 5625777. PMID 28969709.
  9. ↑ Steiner E, Klubert D, Knutson D (December 2008). "Assessing breast cancer risk in women". Am Fam Physician. 78 (12): 1361–6. PMID 19119554.
  10. ↑ Feng Y, Spezia M, Huang S, Yuan C, Zeng Z, Zhang L, Ji X, Liu W, Huang B, Luo W, Liu B, Lei Y, Du S, Vuppalapati A, Luu HH, Haydon RC, He TC, Ren G (June 2018). "Breast cancer development and progression: Risk factors, cancer stem cells, signaling pathways, genomics, and molecular pathogenesis". Genes Dis. 5 (2): 77–106. doi:10.1016/j.gendis.2018.05.001. PMC 6147049. PMID 30258937.
  11. ↑ Ataollahi MR, Sharifi J, Paknahad MR, Paknahad A (2015). "Breast cancer and associated factors: a review". J Med Life. 8 (Spec Iss 4): 6–11. PMC 5319297. PMID 28316699.
  12. ↑ Athanasiou A, Aubert E, Vincent Salomon A, Tardivon A (February 2014). "Complex cystic breast masses in ultrasound examination". Diagn Interv Imaging. 95 (2): 169–79. doi:10.1016/j.diii.2013.12.008. PMID 24433921.
  13. ↑ Genova R, Garza RF. PMID 31194348. Missing or empty |title= (help)
  14. ↑ Pignatelli V, Basolo F, Bagnolesi A, Cartei F, Grassi L, Savino A, Lischi DM (1995). "[Hematoma and fat necrosis of the breast: mammographic and echographic features]". Radiol Med (in Italian). 89 (1–2): 36–41. PMID 7716309.
  15. ↑ Ajmal M, Van Fossen K. PMID 30570966. Missing or empty |title= (help)
  16. ↑ Lee M, Soltanian HT (2015). "Breast fibroadenomas in adolescents: current perspectives". Adolesc Health Med Ther. 6: 159–63. doi:10.2147/AHMT.S55833. PMC 4562655. PMID 26366109.
  17. ↑ Racz JM, Carter JM, Degnim AC (October 2017). "Challenging Atypical Breast Lesions Including Flat Epithelial Atypia, Radial Scar, and Intraductal Papilloma". Ann. Surg. Oncol. 24 (10): 2842–2847. doi:10.1245/s10434-017-5980-6. PMID 28766216.
  18. ↑ Kumar A, Vohra LS, Bhargava S, Reddy PS (October 1999). "INVESTIGATION OF BREAST LUMPS: AN EVALUATION". Med J Armed Forces India. 55 (4): 299–302. doi:10.1016/S0377-1237(17)30353-2. PMC 5531917. PMID 28790593.
Retrieved from "https://www.wikidoc.org/index.php?title=Breast_Mass_Resident_Survival_Guide&oldid=1667197"