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].

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
Inflammatory lumps:^[3]^[4]
- 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 ^[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)

↑ ^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.
↑ @article{Collyar2001BreastCA, title={Breast cancer: a global perspective.}, author={Deborah E. Collyar}, journal={Journal of clinical oncology : official journal of the American Society of Clinical Oncology}, year={2001}, volume={19 18 Suppl}, pages={101S-105S} }
↑ 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.