Snap Shot
- A 28-year-old female recently discovered a lump in her right breast. She has no family history of breast cancer, and her menstrual cycle began at 13 years of age. On exam you find a 1-cm movable mass in the right outer/upper quadrant. There is no skin dimpling. A mammogram is shown.
Introduction
- Most common cause of benign breast masses in premenopausal women
- Caused by exaggerated response to hormones and fluctuations in mass size
- Not typically associated with progression to cancer
- Several histologic types
- fibrosis
- breast stromal hyperplasia
- cystic
- may show large or small cysts
- “blue domed”
- ductal dilation
- may show large or small cysts
- sclerosing adenosis
- acini proliferation with intralobular fibrosis
- associated with calcifications
- commonly mistaken for infiltrating ductal cancer
- ductal/epithelial hyperplasia
- epithelial cell proliferation in terminal duct lobule
- fibrosis
- ↑ risk of carcinoma with atypical cells secondary to estrogen stimulation
Presentation
- Symptoms
- bilateral breast pain or tenderness
- size/pain varies with the menstrual cycle
- bilateral breast pain or tenderness