Breast lumps differential diagnosis: Difference between revisions

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Revision as of 02:40, 14 January 2019

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]^[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
				Demography	History	Mass	Pain	Nipple discharge	Breast exam	Skin changes	LAP	Others	Lab findings	Histopathology	Imaging
Fibroadenoma		+		Mostly women aged 20-30 years
Breast cyst		+		Hormonal replacement therapy
Fibrocystic change		+
Galactocele		+
Cysts of montgomery		+
Hemangioma		+
Breast abscess		+
Mastitis	Inflammation Infection	+
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			+
Microinvasive breast cancer			+
Breast sarcoma			+
Paget disease			+
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		+
Pregnancy		+
Gynecomastia		+
Premenstrual syndrome		+
Breast trauma		+
Fat necrosis		+
Drugs		+
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

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.

Template:WH Template:WS

[pmid15691804-1] 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.

[pmid11560983-2] Collyar DE (2001). "Breast cancer: a global perspective". J Clin Oncol. 19 (18 Suppl): 101S–105S. PMID 11560983.

[pmid3307689-3] Lang AP, Luchsinger IS, Rawling EG (1987). "Filariasis of the breast". Arch Pathol Lab Med. 111 (8): 757–9. PMID 3307689.

[pmid8629415-4] 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.

[5] Alagaratnam, T.T. & Wong, J. World J. Surg. (1989) 13: 743. https://doi.org/10.1007/BF01658425

[pmid2623884-6] 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.

[pmid11574178-7] 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.

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[2]

[3]

[4]

[5]

[6]

[7]

@@ Line 8: / Line 8: @@
 Breast symptoms such as [[nipple discharge]] and [[mastalgia]] require assessment as well <ref name="pmid15691804" />.
 ==Differentiating Breast lumps from other Diseases==
-Differential diagnosis of [[breast lumps]] include: <ref name="pmid15691804">{{cite journal| author=Cheung KL, Lam TP| title=Approach to a lump in the breast: a regional perspective. | journal=Asian J Surg | year= 2005 | volume= 28 | issue= 1 | pages= 65-70 | pmid=15691804 | doi=10.1016/S1015-9584(09)60264-5 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15691804  }} </ref>
+Differential diagnosis of [[breast lumps]] include: <ref name="pmid15691804">{{cite journal| author=Cheung KL, Lam TP| title=Approach to a lump in the breast: a regional perspective. | journal=Asian J Surg | year= 2005 | volume= 28 | issue= 1 | pages= 65-70 | pmid=15691804 | doi=10.1016/S1015-9584(09)60264-5 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15691804  }} </ref><ref name="pmid11560983">{{cite journal| author=Collyar DE| title=Breast cancer: a global perspective. | journal=J Clin Oncol | year= 2001 | volume= 19 | issue= 18 Suppl | pages= 101S-105S | pmid=11560983 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11560983  }} </ref><ref name="pmid3307689">{{cite journal| author=Lang AP, Luchsinger IS, Rawling EG| title=Filariasis of the breast. | journal=Arch Pathol Lab Med | year= 1987 | volume= 111 | issue= 8 | pages= 757-9 | pmid=3307689 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3307689  }} </ref><ref name="pmid8629415">{{cite journal| author=Varghese R, Raghuveer CV, Pai MR, Bansal R| title=Microfilariae in cytologic smears: a report of six cases. | journal=Acta Cytol | year= 1996 | volume= 40 | issue= 2 | pages= 299-301 | pmid=8629415 | doi=10.1159/000333755 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8629415  }} </ref><ref>Alagaratnam, T.T. & Wong, J. World J. Surg. (1989) 13: 743. https://doi.org/10.1007/BF01658425</ref><ref name="pmid2623884">{{cite journal| author=Shukla HS, Kumar S| title=Benign breast disorders in nonwestern populations: Part II--Benign breast disorders in India. | journal=World J Surg | year= 1989 | volume= 13 | issue= 6 | pages= 746-9 | pmid=2623884 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2623884  }} </ref><ref name="pmid11574178">{{cite journal| author=Leung TN, Haines CJ, Chung TK| title=Five-year compliance with hormone replacement therapy in postmenopausal Chinese women in Hong Kong. | journal=Maturitas | year= 2001 | volume= 39 | issue= 3 | pages= 195-201 | pmid=11574178 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11574178  }} </ref>
-*[[Malignancy]] or [[breast cancer]]
-**Associated with following factors<ref name="pmid11560983">{{cite journal| author=Collyar DE| title=Breast cancer: a global perspective. | journal=J Clin Oncol | year= 2001 | volume= 19 | issue= 18 Suppl | pages= 101S-105S | pmid=11560983 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11560983  }} </ref>:
-***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]]
-*[[Inflammatory]] lumps:<ref name="pmid3307689">{{cite journal| author=Lang AP, Luchsinger IS, Rawling EG| title=Filariasis of the breast. | journal=Arch Pathol Lab Med | year= 1987 | volume= 111 | issue= 8 | pages= 757-9 | pmid=3307689 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3307689  }} </ref><ref name="pmid8629415">{{cite journal| author=Varghese R, Raghuveer CV, Pai MR, Bansal R| title=Microfilariae in cytologic smears: a report of six cases. | journal=Acta Cytol | year= 1996 | volume= 40 | issue= 2 | pages= 299-301 | pmid=8629415 | doi=10.1159/000333755 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8629415  }} </ref>
-**Associated to personal habit and disease pattern:
-***Infective lumps
-****Lactational [[mastitis]] or [[abscess]]
-****Non-lactational [[mastitis]]
-*****Periductal [[mastitis]] in chronic smokers
-*****[[Lobular]] [[mastitis]] in tuberculosis and [[parasitic infection]]
-***Non-infective lumps such as [[chronic]] [[granulomatous]] [[infection]]
-*Solid non-inflammatory lumps <ref>Alagaratnam, T.T. & Wong, J. World J. Surg. (1989) 13: 743. https://doi.org/10.1007/BF01658425</ref> <ref name="pmid2623884">{{cite journal| author=Shukla HS, Kumar S| title=Benign breast disorders in nonwestern populations: Part II--Benign breast disorders in India. | journal=World J Surg | year= 1989 | volume= 13 | issue= 6 | pages= 746-9 | pmid=2623884 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2623884  }} </ref>
-**Related to age, geographical area and ethnicity
-**Mostly [[Fibroadenoma|fibroadenomas]] in women aged 20-30 years
-**[[Phyllodes tumor]] are prevalent in various centers, racial groups in different frequencies
-*[[Cysts]]<ref name="pmid11574178">{{cite journal| author=Leung TN, Haines CJ, Chung TK| title=Five-year compliance with hormone replacement therapy in postmenopausal Chinese women in Hong Kong. | journal=Maturitas | year= 2001 | volume= 39 | issue= 3 | pages= 195-201 | pmid=11574178 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11574178  }} </ref>
-**Related to age and usage of [[Hormone replacement therapy|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)
-{| class="wikitable"
-|+Differential diagnosis of breast lumps
-! style="background:#DCDCDC;" align="center" + |[[Benign]]
-| style="background:#F5F5F5;" + |Palpable breast masses in women between 20 to 50 years old<ref name="pmid9545356">{{cite journal| author=Elmore JG, Barton MB, Moceri VM, Polk S, Arena PJ, Fletcher SW| title=Ten-year risk of false positive screening mammograms and clinical breast examinations. | journal=N Engl J Med | year= 1998 | volume= 338 | issue= 16 | pages= 1089-96 | pmid=9545356 | doi=10.1056/NEJM199804163381601 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9545356  }}</ref>The most common types of benign breast lumps are<ref name="pmid10794579">{{cite journal| author=Morrow M| title=The evaluation of common breast problems. | journal=Am Fam Physician | year= 2000 | volume= 61 | issue= 8 | pages= 2371-8, 2385 | pmid=10794579 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10794579  }}</ref>:
-*[[Fibroadenoma]]
-*[[Cysts]]
-*Fibrocystic changes
-*[[Galactocele]]
-*[[Fat necrosis]]
-*[[Breast abscess]]
-|-
-! style="background:#DCDCDC;" align="center" + |[[Malignant]]
-| style="background:#F5F5F5;" + |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<ref name="pmid115491572">{{cite journal| author=Schoonjans JM, Brem RF| title=Fourteen-gauge ultrasonographically guided large-core needle biopsy of breast masses. | journal=J Ultrasound Med | year= 2001 | volume= 20 | issue= 9 | pages= 967-72 | pmid=11549157 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11549157  }}</ref>
-|}
-==Differentiating Breast lumps from other Diseases==
 {|
 ! rowspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
@@ Line 84: / Line 40: @@
 | align="center" style="background:#F5F5F5;" |
 | align="center" style="background:#F5F5F5;" |
+* Mostly women aged 20-30 years
 | align="center" style="background:#F5F5F5;" |
 | align="center" style="background:#F5F5F5;" |
@@ Line 103: / Line 60: @@
 | align="center" style="background:#F5F5F5;" |
 | align="center" style="background:#F5F5F5;" |
+* Hormonal replacement therapy
 | align="center" style="background:#F5F5F5;" |
 | align="center" style="background:#F5F5F5;" |
@@ Line 214: / Line 172: @@
 ! align="center" style="background:#DCDCDC;" |Mastitis
 | align="center" style="background:#F5F5F5;" |
+* Inflammation
+* Infection
 | align="center" style="background:#F5F5F5;" | +
 | align="center" style="background:#F5F5F5;" |
@@ Line 255: / Line 215: @@
 | align="center" style="background:#F5F5F5;" | +
 | align="center" style="background:#F5F5F5;" |
-| align="center" style="background:#F5F5F5;" |
+| align="center" style="background:#F5F5F5;" |Positive [[family history]]
 | align="center" style="background:#F5F5F5;" |
 | align="center" style="background:#F5F5F5;" |

Breast lumps differential diagnosis: Difference between revisions

Revision as of 02:40, 14 January 2019

Overview

Differentiating Breast lumps from other Diseases

References

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