Breast lumps differential diagnosis: Difference between revisions
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! align="center" style="background:#DCDCDC;" |Ductal carcinoma in situ (DCIS) | ! align="center" style="background:#DCDCDC;" |Ductal carcinoma in situ (DCIS)<ref name="pmid19001605">{{cite journal |vauthors=Brinton LA, Sherman ME, Carreon JD, Anderson WF |title=Recent trends in breast cancer among younger women in the United States |journal=J. Natl. Cancer Inst. |volume=100 |issue=22 |pages=1643–8 |date=November 2008 |pmid=19001605 |pmc=2720764 |doi=10.1093/jnci/djn344 |url=}}</ref> | ||
| align="center" style="background:#F5F5F5;" | | | align="center" style="background:#F5F5F5;" | | ||
* Unknown | |||
* May be related to genes BRCA1, BRCA2 | |||
| align="center" style="background:#F5F5F5;" |– | | align="center" style="background:#F5F5F5;" |– | ||
| align="center" style="background:#F5F5F5;" | + | | align="center" style="background:#F5F5F5;" | + | ||
| align="center" style="background:#F5F5F5;" | | | align="center" style="background:#F5F5F5;" | | ||
* Contain 25% of all breast cancers | |||
* Increase risk with aging | |||
| align="center" style="background:#F5F5F5;" | | | align="center" style="background:#F5F5F5;" | | ||
* Positive family history | |||
* nulliparity | |||
* Obesity | |||
| align="center" style="background:#F5F5F5;" |± | |||
| align="center" style="background:#F5F5F5;" |– | |||
| align="center" style="background:#F5F5F5;" |± | |||
| align="center" style="background:#F5F5F5;" |May have normal physical exam | |||
| align="center" style="background:#F5F5F5;" |– | |||
| align="center" style="background:#F5F5F5;" |– | |||
| align="center" style="background:#F5F5F5;" |NA | |||
| align="center" style="background:#F5F5F5;" |Nl | |||
| align="center" style="background:#F5F5F5;" | | | align="center" style="background:#F5F5F5;" | | ||
* Noninvasive breast cancer | |||
* Heterogenous group of neoplastic lesions | |||
| align="center" style="background:#F5F5F5;" | Suspicious microclacifications | |||
| align="center" style="background:#F5F5F5;" | Mammography | |||
| align="center" style="background:#F5F5F5;" | Na | |||
| align="center" style="background:#F5F5F5;" | | |||
| align="center" style="background:#F5F5F5;" | | |||
| align="center" style="background:#F5F5F5;" | | |||
|- | |- | ||
! align="center" style="background:#DCDCDC;" |Microinvasive breast cancer<ref name="pmid23791403">{{cite journal |vauthors=Sue GR, Lannin DR, Killelea B, Chagpar AB |title=Predictors of microinvasion and its prognostic role in ductal carcinoma in situ |journal=Am. J. Surg. |volume=206 |issue=4 |pages=478–81 |date=October 2013 |pmid=23791403 |doi=10.1016/j.amjsurg.2013.01.039 |url=}}</ref> | ! align="center" style="background:#DCDCDC;" |Microinvasive breast cancer<ref name="pmid23791403">{{cite journal |vauthors=Sue GR, Lannin DR, Killelea B, Chagpar AB |title=Predictors of microinvasion and its prognostic role in ductal carcinoma in situ |journal=Am. J. Surg. |volume=206 |issue=4 |pages=478–81 |date=October 2013 |pmid=23791403 |doi=10.1016/j.amjsurg.2013.01.039 |url=}}</ref> | ||
| align="center" style="background:#F5F5F5;" |Unknown | | align="center" style="background:#F5F5F5;" |Unknown | ||
| align="center" style="background:#F5F5F5;" | | | align="center" style="background:#F5F5F5;" | | ||
– | – | ||
| align="center" style="background:#F5F5F5;" | + | | align="center" style="background:#F5F5F5;" | + | ||
Line 335: | Line 344: | ||
* Nulliparity | * Nulliparity | ||
* Positive family history | * Positive family history | ||
| align="center" style="background:#F5F5F5;" |+ | | align="center" style="background:#F5F5F5;" | + | ||
| align="center" style="background:#F5F5F5;" |– | | align="center" style="background:#F5F5F5;" |– | ||
| align="center" style="background:#F5F5F5;" |± | | align="center" style="background:#F5F5F5;" |± | ||
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| align="center" style="background:#F5F5F5;" |Nl | | align="center" style="background:#F5F5F5;" |Nl | ||
| align="center" style="background:#F5F5F5;" |Associated with high grade DCIS | | align="center" style="background:#F5F5F5;" |Associated with high grade DCIS | ||
| align="center" style="background:#F5F5F5;" | A mass with or without calcifications | | align="center" style="background:#F5F5F5;" | | ||
* A mass with or without calcifications | |||
stromal | * stromal reaction | ||
| align="center" style="background:#F5F5F5;" | Mammography | | align="center" style="background:#F5F5F5;" | Mammography | ||
| align="center" style="background:#F5F5F5;" | NA | | align="center" style="background:#F5F5F5;" | NA | ||
Line 362: | Line 371: | ||
* Positive history of breast cancer | * Positive history of breast cancer | ||
* Rapid increase in size | * Rapid increase in size | ||
| align="center" style="background:#F5F5F5;" |+ | | align="center" style="background:#F5F5F5;" | + | ||
| align="center" style="background:#F5F5F5;" |– | | align="center" style="background:#F5F5F5;" |– | ||
| align="center" style="background:#F5F5F5;" |– | | align="center" style="background:#F5F5F5;" |– |
Revision as of 17:30, 17 January 2019
Breast lumps Microchapters |
Diagnosis |
---|
Treatment |
Case Studies |
Breast lumps differential diagnosis On the Web |
American Roentgen Ray Society Images of Breast lumps differential diagnosis |
Risk calculators and risk factors for Breast lumps differential diagnosis |
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 | |||||||||||
Mass | Mastalgia | Nipple discharge | Breast exam | Skin changes | LAP | Others | |||||||||||
Fibroadenoma[8] |
|
+ |
|
|
|
+ | ± | – |
|
– | – | NA | Nl | Proliferative breast lesion without atypia | Well-defined, solid mass | Mammography or ultrasound + biopsy | NA |
Breast cyst[9] |
|
+ |
|
|
|
+ | ± | – |
|
– | – | NA | Nl |
|
|
|
NA |
Fibrocystic change[10] |
|
+ |
|
|
|
+ | + | ± |
|
– | – | NA | Nl | Nonproliferative breast lesions |
|
|
NA |
Galactocele[11] | Milk duct obstruction | + | No increased risk of malignancy |
|
|
+ | ± | ± |
|
– | – | NA | Nl | Nonproliferative breast lesions |
|
|
NA |
Cysts of montgomery[12] | Obstruction of periareolar glands of montgomery | + | No increased risk of malignancy | Most common in age of 10-20 years old |
|
+ | ± | ± |
|
± | – | NA | Nl | Nonproliferative breast lesions | Single cystic lesion in retroareolar area | Ultrasound | NA |
Hamartoma[13] | Unknown | + | Coexisting malignancy can occur | Common in women older than 35 years old |
|
± | – | – |
|
± | – | NA | Nl | Nonproliferative breast lesions |
|
|
NA |
Breast abscess[14] | Complication of breast mastitis | + | No increased risk of malignancy |
|
Resolve after drainage/
anti-biotic therapy |
+ | + | – |
|
+ | – |
|
Blood culture is required in severe infection | Nonproliferative breast lesions | Fluid collection | Ultrasound | NA |
Mastitis[15][16] |
|
+ | No increased risk of malignancy |
|
Resolve after anti-biotic therapy/
drainage |
± | + | ± | Breast tenderness
Swollen breast tissue |
+ | – |
|
Leukocytosis | Nonproliferative breast lesions |
|
Ultrasound | NA |
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 (DCIS)[17] |
|
– | + |
|
|
± | – | ± | May have normal physical exam | – | – | NA | Nl |
|
Suspicious microclacifications | Mammography | Na |
Microinvasive breast cancer[18] | Unknown |
– |
+ |
|
|
+ | – | ± |
|
– | ± | NA | Nl | Associated with high grade DCIS |
|
Mammography | NA |
Breast sarcoma[19] |
|
– | + | Rare type, < 1% of all breast malignancies, average age of between 45-50 years, |
|
+ | – | – | Well-defined, firm mass | ± | – | NA | Nl |
|
|
Mammography | NA |
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 | + | ||||||||||||||||
Gynecomastia | + | ||||||||||||||||
Premenstrual syndrome | + | ||||||||||||||||
Breast trauma | + | ||||||||||||||||
Fat necrosis |
|
+ | No increased risk of malignancy | + | Ultrasound | 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.
- ↑ Templeman C, Hertweck SP (2000). "Breast disorders in the pediatric and adolescent patient". Obstet Gynecol Clin North Am. 27 (1): 19–34. PMID 10693180.
- ↑ Sabate JM, Clotet M, Torrubia S, Gomez A, Guerrero R, de las Heras P; et al. (2007). "Radiologic evaluation of breast disorders related to pregnancy and lactation". Radiographics. 27 Suppl 1: S101–24. doi:10.1148/rg.27si075505. PMID 18180221.
- ↑ De Silva NK, Brandt ML (2006). "Disorders of the breast in children and adolescents, Part 2: breast masses". J Pediatr Adolesc Gynecol. 19 (6): 415–8. doi:10.1016/j.jpag.2006.09.002. PMID 17174833.
- ↑ Tse GM, Law BK, Ma TK, Chan AB, Pang LM, Chu WC; et al. (2002). "Hamartoma of the breast: a clinicopathological review". J Clin Pathol. 55 (12): 951–4. PMC 1769817. PMID 12461066.
- ↑ Dixon JM (2007). "Breast abscess". Br J Hosp Med (Lond). 68 (6): 315–20. doi:10.12968/hmed.2007.68.6.23574. PMID 17639835.
- ↑ Dixon JM, Ravisekar O, Chetty U, Anderson TJ (1996). "Periductal mastitis and duct ectasia: different conditions with different aetiologies". Br J Surg. 83 (6): 820–2. PMID 8696751.
- ↑ Committee on Health Care for Underserved Women, American College of Obstetricians and Gynecologists (2007). "ACOG Committee Opinion No. 361: Breastfeeding: maternal and infant aspects". Obstet Gynecol. 109 (2 Pt 1): 479–80. PMID 17267864.
- ↑ Brinton LA, Sherman ME, Carreon JD, Anderson WF (November 2008). "Recent trends in breast cancer among younger women in the United States". J. Natl. Cancer Inst. 100 (22): 1643–8. doi:10.1093/jnci/djn344. PMC 2720764. PMID 19001605.
- ↑ Sue GR, Lannin DR, Killelea B, Chagpar AB (October 2013). "Predictors of microinvasion and its prognostic role in ductal carcinoma in situ". Am. J. Surg. 206 (4): 478–81. doi:10.1016/j.amjsurg.2013.01.039. PMID 23791403.
- ↑ Smith TB, Gilcrease MZ, Santiago L, Hunt KK, Yang WT (April 2012). "Imaging features of primary breast sarcoma". AJR Am J Roentgenol. 198 (4): W386–93. doi:10.2214/AJR.11.7341. PMID 22451578.