Breast Mass Resident Survival Guide: Difference between revisions

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==Overview==
==Overview==


A [[breast mass]] 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="pmid28659675">{{cite journal |vauthors=Sultania M, Kataria K, Srivastava A, Misra MC, Parshad R, Dhar A, Hari S, Thulkar S |title=Validation of Different Techniques in Physical Examination of Breast |journal=Indian J Surg |volume=79 |issue=3 |pages=219–225 |date=June 2017 |pmid=28659675 |pmc=5473793 |doi=10.1007/s12262-016-1470-5 |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, 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, Magnetic Resonance Imaging, Fine Needle Aspiration Cytology, and Biopsy <ref name="pmid32351857">{{cite journal |vauthors=Karim MO, Khan KA, Khan AJ, Javed A, Fazid S, Aslam MI |title=Triple Assessment of Breast Lump: Should We Perform Core Biopsy for Every Patient? |journal=Cureus |volume=12 |issue=3 |pages=e7479 |date=March 2020 |pmid=32351857 |pmc=7188022 |doi=10.7759/cureus.7479 |url=}}</ref> are used for confirming the diagnosis <ref name="pmid9831579">{{cite journal |vauthors=Duijm LE, Guit GL, Hendriks JH, Zaat JO, Mali WP |title=Value of breast imaging in women with painful breasts: observational follow up study |journal=BMJ |volume=317 |issue=7171 |pages=1492–5 |date=November 1998 |pmid=9831579 |pmc=28731 |doi=10.1136/bmj.317.7171.1492 |url=}}</ref>. If the diagnosis of cancer is confirmed, modalities like lumpectomy, mastectomy, chemotherapy, or radiation are used to treat that.
A [[breast mass]] 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="pmid28659675">{{cite journal |vauthors=Sultania M, Kataria K, Srivastava A, Misra MC, Parshad R, Dhar A, Hari S, Thulkar S |title=Validation of Different Techniques in Physical Examination of Breast |journal=Indian J Surg |volume=79 |issue=3 |pages=219–225 |date=June 2017 |pmid=28659675 |pmc=5473793 |doi=10.1007/s12262-016-1470-5 |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, 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 <ref name="pmid32351857">{{cite journal |vauthors=Karim MO, Khan KA, Khan AJ, Javed A, Fazid S, Aslam MI |title=Triple Assessment of Breast Lump: Should We Perform Core Biopsy for Every Patient? |journal=Cureus |volume=12 |issue=3 |pages=e7479 |date=March 2020 |pmid=32351857 |pmc=7188022 |doi=10.7759/cureus.7479 |url=}}</ref> are used for confirming the diagnosis <ref name="pmid9831579">{{cite journal |vauthors=Duijm LE, Guit GL, Hendriks JH, Zaat JO, Mali WP |title=Value of breast imaging in women with painful breasts: observational follow up study |journal=BMJ |volume=317 |issue=7171 |pages=1492–5 |date=November 1998 |pmid=9831579 |pmc=28731 |doi=10.1136/bmj.317.7171.1492 |url=}}</ref>. If the diagnosis of cancer is confirmed, modalities like lumpectomy, mastectomy, chemotherapy, or radiation are used to treat that.


==Causes==
==Causes==

Revision as of 17:34, 27 September 2020


Overview

A breast mass 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 [1]. 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 [2], physical examination by the practitioner [3], 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, which have a waxing and waning course. Breast masses, although uncommon, can occur in men [4]. Most of the breast masses are benign. Imaging studies like mammograms, ultrasound [5], Magnetic Resonance Imaging, Fine Needle Aspiration Cytology, and Biopsy [6] are used for confirming the diagnosis [7]. 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 abscess
  • Fat necrosis

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. 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
  • Fibrocystic masses
  • Fibroadenoma
    • Fibroadenomas are known as benign, non-malignant breast masses, which are made up of a combination of both glandular and stromal connective tissue. 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.
  • Hamartoma
  • 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. 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
  • 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. The affected part is swollen, engorged, painful, and warm to the touch. Also, constitutional symptoms like fever, headache, and fatigue can be seen.
  • Trauma
  1. ↑ Walker HK, Hall WD, Hurst JW, Barry M. PMID 21250127. Missing or empty |title= (help)
  2. ↑ 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.
  3. ↑ Sultania M, Kataria K, Srivastava A, Misra MC, Parshad R, Dhar A, Hari S, Thulkar S (June 2017). "Validation of Different Techniques in Physical Examination of Breast". Indian J Surg. 79 (3): 219–225. doi:10.1007/s12262-016-1470-5. PMC 5473793. PMID 28659675.
  4. ↑ 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.
  5. ↑ 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.
  6. ↑ Karim MO, Khan KA, Khan AJ, Javed A, Fazid S, Aslam MI (March 2020). "Triple Assessment of Breast Lump: Should We Perform Core Biopsy for Every Patient?". Cureus. 12 (3): e7479. doi:10.7759/cureus.7479. PMC 7188022 Check |pmc= value (help). PMID 32351857 Check |pmid= value (help).
  7. ↑ Duijm LE, Guit GL, Hendriks JH, Zaat JO, Mali WP (November 1998). "Value of breast imaging in women with painful breasts: observational follow up study". BMJ. 317 (7171): 1492–5. doi:10.1136/bmj.317.7171.1492. PMC 28731. PMID 9831579.
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