Breast cancer differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]Associate Editor(s)-in-Chief: Mirdula Sharma, MBBS [3]

Overview

Breast cancer must be differentiated from other diseases that cause mass in the breast such as fibroadenoma, fibrocystic disease of the breast, mastitis, galactocele, traumatic fat necrosis, intraductal papilloma and lipoma.

Differential Diagnosis

The table below summarizes the findings that differentiate Breast cancer from other conditions that present similarly:

Disease	Findings
Fibroadenoma	The typical case is the presence of a painless, firm, solitary, mobile, slowly growing lump in the breast of a woman of child-bearing years.
Fibrocystic disease of the breast	These lumps are smooth with defined edges, and are usually free-moving in regard to adjacent structures. Women with fibrocystic changes may experience a persistent or intermittent breast aching or breast tenderness related to periodic swelling. Breasts and nipples may be tender or itchy. Symptoms follow a periodic trend tied closely to the menstrual cycle.
Mastitis	Disease onset is usually sudden, with flu-like symptoms, breast tenderness, warmth to the touch, swelling of the breast, pain or burning sensation continuously or while breast-feeding, skin redness, often in a wedge-shaped pattern, and fever of 101 F (38.3 C) or greater The affected breast can then start to appear lumpy and red. Can develop into breast abscess
Galactocele	It presents as a large, soft, fluctuating lump in the lower part of breast. It is not usually painful.
Traumatic fat necrosis	Hard lump, or like a section of thick skin May be painful or tender Nipple discharge Dimpling of the breast skin above the necrosis
Intraductal papilloma	The masses are often too small to be palpated or felt. They are the most common cause of bloody nipple discharge in women age 20-40.
Lipoma	A slow-growing, doughy mass that's usually harmless