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 Mass

Traumatic fat necrosis

Ch. abscess
"Acinar "duct Intra acinar br. Hematoma
Fibroadenoma
Cancer breast

abscess -
Galactocele- deromoid cyst -
retention cyst of- lymph cyst -
parasitic -
duct papilloma neoplastic -
 Benign Breast Masses
 Cysts
 Fibroadenoma

 Hamartoma/Adenoma
 Abscess

 Papillomas
 Sclerosing adenosis

 Radial scar
 Fat necrosis Papilloma
 Maligant Breast Masses
 Ductal carcinoma
 DCIS
 Invasive

 Lobular carcinoma
 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, non-
tender
 Round or oval
 Rarely grow > 2-3 cm

 FNA or excisional Bx
 Observe in adolescents
 Fat necrosis
 Firm, tender, indurated, ill-
defined mass

 Usually traumatic

 damaging and disintegrating

fatty tissues.

 Typically occurs in obese

women with very large
breasts.

 Misdiagnosed as cancer, so Necrotic area is surrounded by

removed during a surgical lipid
biopsy. filled macrophages and foreign-
body 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 Step 2 &3 

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).
 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