Breast Mass - Benign Fibroadenoma

Breast Mass - Benign Fibroadenoma - Breast Mass Linda M....

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Breast Mass Linda M. Barney, MD Wright State University
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Ms. Marcus Ms. Marcus is a 23-year-old woman who was referred by her Gynecologist for evaluation of a breast mass.
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History What other points of the history do you want to know?
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History, Ms. Marcus Consider the following: Characterization of Symptoms: Temporal sequence Alleviating / Exacerbating factors: Associated signs/symptoms: Pertinent PMH ROS MEDS Relevant Family Hx.
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Characterize Symptoms 4 month history of left breast lump. 1 st noticed in the shower ~ 1 week before menses Olive sized and nontender May have increased in size slightly No change with menstrual cycles
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Denies pain, skin change, nipple discharge No prior history of lumps or breast complaints No change with menstrual cycles, LMP 2 weeks prior Denies trauma
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Pertinent PMH Healthy, exercises regularly No prior surgeries No chronic medical problems Menarche age 12, no pregnancies, regular cycles, OCP’s x 2 years Denies smoking, alcohol or drugs Works as a systems analyst
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Alleviating/ Exacerbating factors No change with activity Uses Ibuprofen for cramps with no change in the lump Drinks decaffeinated tea and sodas only
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Family History Maternal grandmother with breast cancer at age 70 Mother and older sister with Fibrocystic Breast Condition No Gyn or Colon CA in family
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Differential Diagnosis Based on History and Presentation
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Differential Diagnosis Consider the following Fibrocystic Mass Cyst Fibroadenoma Breast Cancer Hematoma Abscess Fat necrosis Lactational Adenoma
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Physical Examination What would you look for?
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Physical Examination, Ms. Marcus
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Breast Mass - Benign Fibroadenoma - Breast Mass Linda M....

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