Benign Neoplasm of the Breast

Chang, Eil Sung

Abstract

The discovery of a breast lump is one of the most anxiety-provoking occurrences in a woman's life. The initial purpose of a surgical consultation is to determine whether a true mass exists. The majority of breast masses are self-discovered or are identified by a primary care provider. Once a breast mass has been identified, the first determination to be made is whether it is benign or malignant by using breast imaging techniques or pathologic examination. Once a breast lesion has been shown to be benign on pathologic examination, the most improtant clinical consideration is the risk of subsequent breast cancer associated with that lesion. The diagnosis of a fibroadenoma can be made using excisional biopsy or the combined modalities of CBE, ultrasound, and FNA. A true intraductal papilloma develops in one of the major subareolar ducts and is the most common lesion causing a serous or serosanguinous discharge. A mass may be felt on examination in as many as one-third of cases. The treatment of choice is microdochectomy. Hamartomas can produce a classic mammographic image that is virtually diagnostic. Because the clinical and radiologic characteristics of fat necrosis resemble those of carcimoma in the majority of cases, a needle localization or excisional biopsy is required.