Breast lumps differential diagnosis
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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 [1].
Differentiating Breast lumps from other Diseases
Differential diagnosis of breast lumps include: [1]
- Malignancy or breast cancer
- Associated with following factors[2]:
- Geographical area
- Age
- Ethnicity
- Positive family history
- Pathology results such as:
- Atypical ductal hyperplasia (ADH)
- Atypical lobular hyperplasia (ALH)
- Lobular carcinoma in situ (LCIS)
- Previous history of radiotherapy
- Associated with following factors[2]:
- Inflammatory lumps:[3][4]
- Associated to personal habit and disease pattern:
- Infective lumps
- Non-infective lumps such as chronic granulomatous infection
- Associated to personal habit and disease pattern:
- Solid non-inflammatory lumps [5] [6]
- Related to age, geographical area and ethnicity
- Mostly fibroadenomas in women aged 20-30 years
- Phyllodes tumor are prevalent in various centers, racial groups in different frequencies
- Cysts[7]
- Related to age and usage of hormonal replacement therapy
- Symptomatic cysts are often seen in women age 30 years to early 50 years
- If menopausaed women may be present due to hormone replacement therapy (HRT)
Benign | Palpable breast masses in women between 20 to 50 years old[8]The most common types of benign breast lumps are[9]:
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Malignant | The most common types are infiltrating ductal breast carcinoma, infiltrating lobular breast carcinoma, mixed of ductal and lobular carcinoma and usually present as a hard mass in breast[10] |
Differentiating Breast lumps from other Diseases
Diseases | Etiology | Benign | Malignant | Clinical manifestation | Paraclinical findings | Gold standard diagnosis | Associated findings | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Demography | History | Symptoms | Signs | ||||||||||||||
Mass | Pain | Nipple discharge | Breast exam | Skin changes | LAP | Others | Lab findings | Histopathology | Imaging | ||||||||
Fibroadenoma | |||||||||||||||||
Breast cyst | |||||||||||||||||
Fibrocystic change | |||||||||||||||||
Galactocele | |||||||||||||||||
Cysts of montgomery | |||||||||||||||||
Hemangioma | |||||||||||||||||
Breast abscess | |||||||||||||||||
Mastitis | |||||||||||||||||
Breast carcinoma | |||||||||||||||||
Ductal carcinoma in situ | |||||||||||||||||
Microinvasive breast cancer | |||||||||||||||||
Breast sarcoma | |||||||||||||||||
Paget disease | |||||||||||||||||
Phyllodes tumor | |||||||||||||||||
Lymphoma | |||||||||||||||||
Metastasis | |||||||||||||||||
Duct ectasia | |||||||||||||||||
Intraductal papilloma | |||||||||||||||||
Lipoma | |||||||||||||||||
Neurofibroma | |||||||||||||||||
Pregnancy | |||||||||||||||||
Gynecomastia | |||||||||||||||||
Premenstrual syndrome | |||||||||||||||||
Breast trauma | |||||||||||||||||
Fat necrosis | |||||||||||||||||
Drugs |
References
- ↑ 1.0 1.1 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.
- ↑ 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.
- ↑ Elmore JG, Barton MB, Moceri VM, Polk S, Arena PJ, Fletcher SW (1998). "Ten-year risk of false positive screening mammograms and clinical breast examinations". N Engl J Med. 338 (16): 1089–96. doi:10.1056/NEJM199804163381601. PMID 9545356.
- ↑ Morrow M (2000). "The evaluation of common breast problems". Am Fam Physician. 61 (8): 2371–8, 2385. PMID 10794579.
- ↑ Schoonjans JM, Brem RF (2001). "Fourteen-gauge ultrasonographically guided large-core needle biopsy of breast masses". J Ultrasound Med. 20 (9): 967–72. PMID 11549157.