Breast Lump
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Breast Lump
By medical student
Ahmed Saleh Hussein Faculty of Medicine – AinShams University – Egypt
Breast Lump
It is the growth of the tissues within the breast
The breast contains mainly fat tissue, connective tissue and glands .
Fibrocystic changes are the most common breast condition.
Breast Lump
Cystic
"Acinar "duct
Galactoceleretention cyst ofduct papilloma
Mass
Intra acinar
abscess deromoid cyst lymph cyst parasitic neoplastic -
Traumatic fat necrosis Ch. abscess br. Hematoma Fibroadenoma Cancer breast
Benign Breast Masses
Cysts Fibroadenoma Hamartoma/Adenoma Abscess Papillomas Sclerosing adenosis Radial scar Fat necrosis
Papilloma
Maligant Breast Masses
Ductal carcinoma
Lobular carcinoma
DCIS Invasive
LCIS Invasive
Inflammatory carcinoma Paget’s disease Phyllodes tumor Angiosarcoma
ASK ABOUT
Date of last period? When did she discover the lump? Family history of breast problems? Previous breast problems? Previous breast biopsy or other breast surgery? Is it hard or soft? Has lump and is grown larger or smaller Nipple discharge Any medications?
Breast Cyst
Smooth, unilateral mass Feels like a cyst Infrequently associated with malignancy Aspirate Watch for reforming of cyst Recurring cysts are more worrisome
Fibroadenoma
Common Benign Solid, rubbery, nontender Round or oval Rarely grow > 2-3 cm FNA or excisional Bx Observe in adolescents
Fat necrosis
Firm, tender, indurated, illdefined mass
Usually traumatic
damaging and disintegrating fatty tissues.
Typically occurs in obese women with very large breasts.
Misdiagnosed as cancer, so removed during a surgical biopsy.
Necrotic area is surrounded by lipid filled macrophages and foreignbody giant cells
N.B Any lump in the breast causes anxiety .but not all lumps are breast cancer After history of breast lumps and breast examination the problem is differentiation
N.B women with fibrocystic breast disease or other benign breast conditions are more likely to develop breast cancer later only if a breast biopsy shows "atypia" or abnormal breast cells.
Breast Cancer
30% of all cancers in women Treatment is successful in 3/4 Rare before age 25 Steadily increasing frequency with increasing age Affects 1/9 women reaching age 90.
Picture 2
Breast Cancer Risk Factors
Age personal history of breast cancer family history in 1st degree relatives early menarche / late menopause nulliparity or late age of 1st pregnancy post-menopausal HRT previous suspicious breast biopsy hereditary cancer syndromes (BRCA-1 & 2) 70% of women have no risk factors!
Malignant masses
Hard Mostly painless Irregular Skin dimpling Nipple retraction
Bloody or watery discharge
Possibly fixed to the skin or chest wall 06/17/09
Diagnosis Triple Assessment
If all 3 are benign: < 1% incidence of breast cancer
Follow patient
If all 3 are positive: 99.4% incidence breast cancer
If any 1 is positive: excisional biopsy recommended
Breast self examination Step 1
Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips. Here's what you should look for: Breasts that are their usual size, shape, and color. Breasts that are evenly shaped without visible distortion or swelling. If you see any of the following changes, bring them to your doctor's attention: Dimpling, puckering, or bulging of the skin. A nipple that has changed position or become inverted (pushed inward instead of sticking out). Redness, soreness, rash, or swelling.
Raise your arms and look for the same changes. While you're at the mirror, gently squeeze each nipple between your finger and thumb and check for nipple discharge (this could be a milky or yellow fluid or blood).
Step 2 &3
Feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast. Use a firm, smooth touch with the first few fingers of your hand, keeping the fingers flat and together.
Cover the entire breast from top to bottom, side to side—from your collarbone to the top of your abdomen, and from your armpit to your cleavage.
Finally, feel your breasts while you are standing or sitting.
Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower.
Cover your entire breast, using the same hand movements described in Step 4.
Normal breast
Cyst
Mass
By medical student
Ahmed Saleh Hussein Faculty of Medicine – AinShams University – Egypt
Breast Lump
It is the growth of the tissues within the breast
The breast contains mainly fat tissue, connective tissue and glands .
Fibrocystic changes are the most common breast condition.
Breast Lump
Cystic
"Acinar "duct
Galactoceleretention cyst ofduct papilloma
Mass
Intra acinar
abscess deromoid cyst lymph cyst parasitic neoplastic -
Traumatic fat necrosis Ch. abscess br. Hematoma Fibroadenoma Cancer breast
Benign Breast Masses
Cysts Fibroadenoma Hamartoma/Adenoma Abscess Papillomas Sclerosing adenosis Radial scar Fat necrosis
Papilloma
Maligant Breast Masses
Ductal carcinoma
Lobular carcinoma
DCIS Invasive
LCIS Invasive
Inflammatory carcinoma Paget’s disease Phyllodes tumor Angiosarcoma
ASK ABOUT
Date of last period? When did she discover the lump? Family history of breast problems? Previous breast problems? Previous breast biopsy or other breast surgery? Is it hard or soft? Has lump and is grown larger or smaller Nipple discharge Any medications?
Breast Cyst
Smooth, unilateral mass Feels like a cyst Infrequently associated with malignancy Aspirate Watch for reforming of cyst Recurring cysts are more worrisome
Fibroadenoma
Common Benign Solid, rubbery, nontender Round or oval Rarely grow > 2-3 cm FNA or excisional Bx Observe in adolescents
Fat necrosis
Firm, tender, indurated, illdefined mass
Usually traumatic
damaging and disintegrating fatty tissues.
Typically occurs in obese women with very large breasts.
Misdiagnosed as cancer, so removed during a surgical biopsy.
Necrotic area is surrounded by lipid filled macrophages and foreignbody giant cells
N.B Any lump in the breast causes anxiety .but not all lumps are breast cancer After history of breast lumps and breast examination the problem is differentiation
N.B women with fibrocystic breast disease or other benign breast conditions are more likely to develop breast cancer later only if a breast biopsy shows "atypia" or abnormal breast cells.
Breast Cancer
30% of all cancers in women Treatment is successful in 3/4 Rare before age 25 Steadily increasing frequency with increasing age Affects 1/9 women reaching age 90.
Picture 2
Breast Cancer Risk Factors
Age personal history of breast cancer family history in 1st degree relatives early menarche / late menopause nulliparity or late age of 1st pregnancy post-menopausal HRT previous suspicious breast biopsy hereditary cancer syndromes (BRCA-1 & 2) 70% of women have no risk factors!
Malignant masses
Hard Mostly painless Irregular Skin dimpling Nipple retraction
Bloody or watery discharge
Possibly fixed to the skin or chest wall 06/17/09
Diagnosis Triple Assessment
If all 3 are benign: < 1% incidence of breast cancer
Follow patient
If all 3 are positive: 99.4% incidence breast cancer
If any 1 is positive: excisional biopsy recommended
Breast self examination Step 1
Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips. Here's what you should look for: Breasts that are their usual size, shape, and color. Breasts that are evenly shaped without visible distortion or swelling. If you see any of the following changes, bring them to your doctor's attention: Dimpling, puckering, or bulging of the skin. A nipple that has changed position or become inverted (pushed inward instead of sticking out). Redness, soreness, rash, or swelling.
Raise your arms and look for the same changes. While you're at the mirror, gently squeeze each nipple between your finger and thumb and check for nipple discharge (this could be a milky or yellow fluid or blood).
Step 2 &3
Feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast. Use a firm, smooth touch with the first few fingers of your hand, keeping the fingers flat and together.
Cover the entire breast from top to bottom, side to side—from your collarbone to the top of your abdomen, and from your armpit to your cleavage.
Finally, feel your breasts while you are standing or sitting.
Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower.
Cover your entire breast, using the same hand movements described in Step 4.
Normal breast
Cyst
Mass
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