Breast Lumps

CLINICAL DIAGNOSTIC MANUAL

Breast lumps are one of the most common reasons people seek medical attention for their breasts. These lumps can be benign or malignant and may present with a variety of clinical symptoms and signs.

Appropriate evaluation of a breast lump is crucial to determine the underlying cause and appropriate management. The characteristics of the lumps, such as their size, texture, mobility, and whether they are associated with pain or nipple discharge, can help guide the diagnosis.

Pathology	Clinical Symptoms and Signs	Suspicion Diagnosis	Confirmation Diagnosis
Benign Fibrous Dysplasia of the Breast	Breast tenderness, especially before menstruation. Multiple lumps, generally mobile and with an irregular texture.	Clinical history and physical examination. Breast ultrasound and mammography.	Confirmation with ultrasound and/or biopsy.
Fibroadenoma	Generally asymptomatic, but may cause discomfort. Firm, smooth, mobile, and painless lump to the touch.	Clinical history and physical examination. Breast ultrasound and mammography.	Confirmation with fine needle aspiration or core biopsy.
Cyst	Feeling of heaviness or pain in the breast. Smooth, soft, mobile, and often painful lump, especially before menstruation.	Clinical history and physical examination. Breast ultrasound.	Confirmation with fluid aspiration and analysis of the content.
Acute and Chronic Abscess	Severe pain, fever, general malaise. Painful, red, warm to the touch lump, pus drainage may be present.	Clinical history and physical examination. Breast ultrasound.	Confirmation with aspirate culture and ultrasound.
Sclerosing Adenosis and Fat Necrosis	May be painful or painless. Firm, irregular lump, may be mistaken for cancer in imaging.	Clinical history and physical examination. Breast ultrasound and mammography.	Confirmation with fine needle aspiration or core biopsy.
Infiltrative Ductal Carcinoma	May be asymptomatic in early stages, pain in advanced stages. Firm, irregular lump, adhered to the skin or deep tissues, nipple retraction or bloody discharge may be present.	Clinical history and physical examination. Mammography and ultrasound.	Confirmation with biopsy and histopathological analysis.