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Breast Disorders

Breast cancer is twice as common as all gynecologic pelvic malignancies combined. When a persistent, palpable, dominant breast mass is identified, breast cancer should be excluded. All women should begin breast self-examination and have annual clinical breast examinations by age 20 years. Women age

The breasts are composed mostly of adipose tissue with interwoven fibrous bands (Cooper's ligaments). The glandular tissue and ducts are organized into separate, anatomically distinct lobes, each with a s

Common benign breast disorders include the following:

Adenolipoma (hamartoma)

Cysts

Ductal hyperplasia

Fat necrosis

Fibroadenoma

Fibrocystic changes

Galactocele

Intraductal papilloma

Lipoma

Lobular hyperplasia

Mammary duct ectasia (periductal mastitis)

Mastitis

Mondor disease (superficial venous thrombosis) keywords" content="fibrocystic, breast, disease, adenoma, fibroadenoma, mass, fibrosistic, fibrocistic

 

BREAST MASSES

A persistent, palpable, dominant breast mass must be diagnosed definitively. This can be accomplished in the ambulatory environment by using the diagnostic triad of clinical breast examination, mammography, and fine-needle aspiration. A specific pathologic diagnosis can be obtained by fine-needle asp

MASTALGIA

In obtaining a pertinent history for the assessment of breast pain, it is important to ascertain 1) if the pain is cyclic (premenstrual) or noncyclic (constant or intermittent) and 2) if it is localized or diffuse. Most premenopausal women will experience some degree of physiologic diffuse cyclic mastalgia. A basic breast-oriented history should be obtained, which includes the following factors:

Presenting complaint

Age

Reproductive history

Medications

Family history of breast cancer

Personal history of breast cancer

Breast surgeries

Last mammogram--date and result

Nipple Discharge

Nipple discharge is a common breast symptom during a woman's reproductive years. More than 80% of premenopausal women can produce discharge from their nipples with manipulation. Pathologic nipple discharge is spontaneous and most often presents from a single duct opening on the nipple. A benign intraductal papilloma is the most common etiology. Galactography can identify intraluminal lesions and

Mastitis

Breast pain, fever, and clinical signs of infection indicate mastitis. Most cases occur during pregnancy or lactation. S aureus is the most common cause. Dicloxacillin is usually effective therapy and should be