Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
Benign Breast Disorders
Mastalgia Breast pain
Most common breast-related complaint Cyclic mastalgia coincides with menstrual
cycle and is related to hormonal sensitivity Noncyclic mastalgia can be constant or
intermittent May be due to trauma, fat necrosis, duct
ectasia, costochronditis, or arthritic pain
Benign Breast Disorders
Mastitis Lactational mastitis
Inflammatory condition that occurs most frequently in lactating women Localized area that is erythematous, painful,
and tender to palpation Fever is often present Organisms obtain access through cracked nipple Can be cured with antibiotics in early stages
Benign Breast Disorders
Lactational breast abscess From persistent lactational mastitis
Palpable mass with red, edematous skin over involved breast; possibly fever
Drainage of abscess is necessary Cultured and treated with appropriately
sensitive antibiotics Breastfeeding can usually continue
Benign Breast Disorders
Fibrocystic changes Benign condition with tissue changes
Development of excess fibrous tissue Hyperplasia of the epithelial lining of the
mammary ducts Proliferation of mammary ducts Cyst formation
Exaggerated response to hormones
Benign Breast Disorders
Fibrocystic changes Not linked to breast cancer risk↑ Occur most commonly in 35- to 50-
year-old women Women with premenstrual abnormalities,
nulliparity, history of spontaneous abortion, no use of oral contraceptives, with early menarche and late menopause
Palpable round, well-delineated, freely movable lumps
Nursing/Collaborative ManagementFibrocystic Changes
Excisional biopsy No fluid on aspiration Fluid is hemorrhagic Residual mass remains after fluid
aspiration Treat with good support bra, dietary
therapy, vitamin E, analgesics, danazol, diuretics, hormone therapy, antiestrogen
Benign Breast Disorders
Fibroadenoma Common cause of discrete benign
breast lumps in young women Occurs between 15 and 40 years of age Most frequent cause of breast masses
in women younger than 25 May be due to estrogen sensitivity↑
Benign Breast Disorders
Fibroadenoma Easily detected on physical
examination Definitively diagnosed by biopsy Treat with
Observation Excision Cryoablation
Nipple Discharge
Galactorrhea Milky secretion due to inappropriate
lactation May result from
Drug therapy Endocrine problems Neurologic disorders Idiopathic causes
Nipple Discharge
Serous, grossly bloody, or brown to green secretions Malignant or benign disease Cytology slide to determine disease
Malignancies, cystic disease, intraductal papilloma, ductal ectasia
Treatment depends on cause Usually not related to malignancy
Intraductal Papilloma
Benign, soft, wartlike growth In mammary ducts Usually unilateral Bloody discharge from nipple Difficult to palpate Usually found in 40- to 60-year-old
women May be associated with risk of cancer↑
Ductal Ectasia
Duct dilation Benign breast disease of
perimenopausal and postmenopausal women
Involves ducts in subareolar area Multicolored, sticky nipple discharge Not associated with malignancy Treatment: warm compresses and
antibiotics
Gynecomastia in Men
Transient, noninflammatory enlargement of 1 or both breasts Most common breast problem in men Usually a temporary, benign condition Not a risk factor for breast cancer
May signal hormonal problems or drug effects
Senescent Gynecomastia
Occurs in many older men Probably caused by plasma estrogen
elevation Tender, firm, centrally located
enlargement Usually regresses in 6 to 12 months Biopsy can rule out breast cancer
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