DDx

Surgical Referral DDx

• Breast cancer → must rule out (US)
  • In 75 yo (post- Menopause women) -> very very likely BC
    • As other DDx are common stopped after menopause
• ADH (Atypia), LCIS, Benign Intraductal papilloma

Observation DDx

• Young women breast are lumpy
• Breast Cyst → Peri-menopausal
• Fibroadenoma → Pre-menopausal
• Hematoma, Breast Fat Necrosis (Hx of trauma to the breast)
• Usual ductal hyperplasia → duct
• Sclerosing adenosis → lobule

Inflammatory conditions:

• Mammary duct ectasia (± obstruction)
• Lactational and non-lactational abscesses

Investigation

• If breast mass detected from breast exam:
  • send for Breast US if not sure  (Diagnostic US)
  • suspect BC: despite normal Mammogram -> normal US -> still need MRI
• Core Needle Biopsy

Resources

Common Breast Problems

Office management of a palpable breast lump with aspiration