Benign breast disease and breast examination

39 Benign breast disease and breast examination





Questions



image What is the most common of cause of a breast lump in a 25-year-old woman?

image What is fibrocystic change?

image How do you examine a breast?

The majority of women who present with a breast problem have a benign disease. They can present with a lump, breast enlargement, pain, nipple changes or discharge (Fig. 3.39.1). Any suspicious lump should be investigated with triple assessment (Ch. 38) to exclude malignancy. The causes of single lumps are:


image breast cancer: firm, fixed, irregular

image fibroadenoma

image breast cyst: fluctuant, mobile.

image

Fig. 3.39.1 Features of fibrocystic change.


The causes of multiples lumps are:


image fibroadenomas

image fibrocystic change (cyclical symptoms)

image breast cysts.



Benign breast conditions





Fibroadenoma

This benign tumour is the most common breast lump in women under 30 years. It is a hard, mobile and painless lump. If a definite diagnosis of fibroadenomas is confirmed, the lump need not be excised.



Fibrocystic change

This is a common presentation and is now considered to be simply a variant of normal (it is not premalignant). It is caused by cyclical proliferation and involution of breast tissue, and so symptoms change with the menstrual cycle. It occurs in women between 25 and 45 years, and may present with:


image cyclical breast pain

image multiple or single lumps: triple assessment is performed if a solitary lump is present

image cysts: treat with aspiration.

Pain relief, oral contraceptives and evening primrose oil may also be used in its treatment.



Breast cysts

Cysts are a very common abnormality, and are predominately seen in women aged 40–60 years, when 50% develop one or more cysts. They are fluctuant and are diagnosed with ultrasound scanning. They are treated with needle aspiration during triple assessment if palpable.

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Jul 3, 2016 | Posted by in MUSCULOSKELETAL MEDICINE | Comments Off on Benign breast disease and breast examination

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