Benign breast lumps

Question 1

Fibroadenoma

Answer 1

'Breast mouse' - mobile, firm
Develop from whole lobule
12% of all breast masses
30% will shrink over 2 years
>3cm: surgical excision

Question 2

Breast cyst

Answer 2

7% all western females
Smooth discrete lump
May be fluctuant
Small increased risk of cancer (esp if younger)
Aspirate
If bloodstained or persistently recurrent, biopsy or excise

Question 3

Sclerosing adenosis

Answer 3

What? sclerosis in lobules
Lump or pain
Mammogram may mimic carcinoma
Distortion of distal lobular unit, no hyperplasia
No increase in cancer risk
Biopsy, do not need to excise

Question 4

Epithelial hyperplasia

Answer 4

Variable presentation - generalised lumpiness or discrete lump
Increased cellularity of terminal lobular unit
Increased risk of cancer - esp if atypical features or FH of breast cancer
No atypical features: conservative management
Atypical features: close monitoring or surgical resection

Question 5

Fat necrosis

Answer 5

40% have traumatic aetiology
Painless
More common in obese patients
May mimic carcinoma
May increase in size initially
Imaging and core biopsy

Question 6

Duct papillom

Answer 6

Nipple discharge - usually originates from single duct
Lump if large
No increased risk of cancer
Microdochectomy