Materiały źródłowe

• #1 New Palpable Breast Mass – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560757/

  A palpable breast mass requires careful evaluation as this is the most common presenting symptom of breast cancer, although many cases are proven to be benign. […] A breast mass is associated with a broad spectrum of differential diagnoses, from benign breast abnormalities to advanced malignancies; therefore, a structured evaluation approach is required to appropriately assess these lesions without submitting patients to unnecessary procedures. […] Approximately 3% of women are seen in the primary care setting due to a breast complaint. […] Although the majority of these masses are associated with benign breast conditions, patients with palpable breast masses have an increased likelihood of having a breast malignancy. […] According to recent studies, breast cancer is the leading cause of cancer in women.

• #2 Breast diseases: Detection, Management, and Surveillance of Breast Disease | Obgyn Key

  https://obgynkey.com/breast-diseases-detection-management-and-surveillance-of-breast-disease/

  The gynecologists role in managing breast problems is broad because they often serve as a womans primary health care advocate. […] In the United States 7.8% of office visits by women (51 million/year) related to breast disease. […] Breast cancer accounts for 30% of all new cancer diagnoses in women, is the second most common cause of cancer-related death in women, and is the leading cause of premature mortality from cancer in U.S. women. […] The risk factors for breast cancer may be divided into several categories: demographic, estrogen exposure, lifestyle, personal breast characteristics, familial and inherited genetic mutations, and radiation exposure. […] Age continues to remain the strongest risk factor for developing breast cancer. […] The incidence of breast cancer varies based on geographic region.

• #3 Pulsenotes | Breast lumps

  https://app.pulsenotes.com/surgery/breast-surgery/notes/benign-breast-lumps

  Breast lumps are common and may be seen in women of all ages. […] An estimated 50% of women will experience a benign breast lump during their lifetime. […] Fortunately, at least 90% of all breast masses are benign.

• #4 Breast lumps epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Breast_lumps_epidemiology_and_demographics

  The incidence rate of breast lumps is not particularly clear due to the fact that breast lumps is not considered as a life threatening condition. […] The prevalence of benign breast disease is approximately 68% among all breast diseases. […] African American women have worse prognosis and higher mortality rate in comparison to European American women. […] The prevalence of fibroadenoma is higher in black women than white individuals.

• #5 Breast diseases: Detection, Management, and Surveillance of Breast Disease | Obgyn Key

  https://obgynkey.com/breast-diseases-detection-management-and-surveillance-of-breast-disease/

  The incidence of benign breast disorders begins to rise during the second decade of life and peaks in the fourth and fifth decades. […] In malignant diseases the incidence continues to increase after menopause. […] One out of eight women (12.5%) in the United States will develop carcinoma of the breast over the course of her lifetime. […] Approximately 50% of newly diagnosed breast cancers are attributable to known risk, whereas 10% are associated with a positive family history. […] Approximately 5% to 10% of breast cancers have a familial or genetic link. […] A genetic predisposition to develop breast carcinoma has been recognized in some families. […] Mutations in the BRCA family of genes have been identified that confer a lifetime risk of breast cancer that approaches 85%. […] Screening mammography is the primary imaging technique for breast cancer detection.

• #6 Palpable breast lumps: An age-based approach to evaluation and diagnosis | Malherbe | South African Family Practice

  https://safpj.co.za/index.php/safpj/article/view/5571/7557

  A palpable breast lump is a common presentation of breast disease to a general practitioner. […] More than 25% of women are affected by breast disease during their lifetime, the vast majority of whom will complain of a new breast lump. […] Fortunately, most of these will be benign, with breast cancer only diagnosed in 10% of new breast lumps. […] The risk of a breast lump representing a breast cancer increases with age, with a 1/204 (0.49%) chance of breast cancer for a woman in her thirties, compared with 1/28 (3.54%) chance for a woman in her sixties. […] With very few exceptions, every patient who presents with a breast lump needs to undergo a triple assessment. […] The triple assessment consists of a history and physical examination, some form of breast imaging and a biopsy. […] It is the gold standard in breast cancer diagnosis, with a positive predictive value of 100% if all three modalities are positive for breast cancer.

• #7 New Palpable Breast Mass – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560757/

  A palpable breast mass is the most common presenting symptom of breast cancer. However, of the 3% of general practitioners’ encounters with female patients that are due to breast complaints, benign breast disease is a more common cause of breast symptoms (eg, palpable masses and pain), with malignancy accounting for 10% of these cases. […] The incidence of benign breast conditions varies based on age and type of lesion. […] Fibroadenomas account for 95% of palpable breast masses in adolescent girls and 12% of menopausal women. […] A recent study found fibroadenomas, epithelial proliferation, and fibrocystic changes are most common in women aged 25, with incidence rates of 45, 32, and 42 per 100,000 person-years, which increases to 81, 55, and 140 per 100,000, respectively, at age 40, and declines after age 55.

• #8 Fibroadenoma (breast) | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/fibroadenoma-breast?lang=us

  Fibroadenomas typically occur in women between the ages of 10 and 40 years. It is the most common solid breast mass in women of all ages and the most common breast mass in the adolescent and young adult population. Their peak incidence is between 25 and 40 years and decreases after 40 years. […] They are benign lesions with minimal or no malignant potential. The risk of malignant transformation is extremely low and has been reported to range around 0.01-0.3%.

• #8 Breast diseases: Detection, Management, and Surveillance of Breast Disease | Obgyn Key

  https://obgynkey.com/breast-diseases-detection-management-and-surveillance-of-breast-disease/

  The gynecologists role in managing breast problems is broad because they often serve as a womans primary health care advocate. […] In the United States 7.8% of office visits by women (51 million/year) related to breast disease. […] Breast cancer accounts for 30% of all new cancer diagnoses in women, is the second most common cause of cancer-related death in women, and is the leading cause of premature mortality from cancer in U.S. women. […] The risk factors for breast cancer may be divided into several categories: demographic, estrogen exposure, lifestyle, personal breast characteristics, familial and inherited genetic mutations, and radiation exposure. […] Age continues to remain the strongest risk factor for developing breast cancer. […] The incidence of breast cancer varies based on geographic region.

• #9

  https://www.breastimagingvictoria.com.au/breast-lumps

  Most breast lumps will turn out to be benign but they should all be investigated. […] The majority of breast lumps are benign in nature, however they should always be investigated. […] Causes of benign breast lumps can be: Fibroadenomas, Cysts, Hamartomas, Lipomas, Mastitis and Breast Abscesses, Breast bruising and trauma (often termed Fat Necrosis). […] About one in six (15%) women have fibroadenoma at some time in their life. […] Fibroadenomas do not increase the risk of breast cancer. […] Women who get many cysts may ignore breast lumps and do not go for check-ups by their physician, which results in delayed diagnosis in case it is a sign of breast cancer. Therefore, it is essential to get every new breast lump examined immediately. […] Typical breast cysts are not cancerous, and cysts do not increase breast cancer risk. […] Fat necrosis is a benign breast condition and does not increase breast cancer risk.

• #10 Breast Lumps and Breast Examination. Information. Patient

  https://patient.info/doctor/breast-lumps-and-breast-examination

  Breast cancer is the most common cancer in the UK, accounting for 15% of all new cancer cases (2017). In females in the UK, breast cancer is the most common cancer (30% of all new female cancer cases). 99% of breast cancer cases in the UK are in females, and 1% are in males. […] Age-standardised rates for White females with breast cancer range from 122.4 to 125.7 per 100,000. Rates for Asian females are significantly lower, ranging from 59.7 to 92.3 per 100,000, and the rates for Black females are also significantly lower, ranging from 68.8 to 107.9 per 100,000. […] The majority of palpable breast lumps are not breast cancer.

• #11 Breast diseases: Detection, Management, and Surveillance of Breast Disease | Obgyn Key

  https://obgynkey.com/breast-diseases-detection-management-and-surveillance-of-breast-disease/

  The incidence of benign breast disorders begins to rise during the second decade of life and peaks in the fourth and fifth decades. […] In malignant diseases the incidence continues to increase after menopause. […] One out of eight women (12.5%) in the United States will develop carcinoma of the breast over the course of her lifetime. […] Approximately 50% of newly diagnosed breast cancers are attributable to known risk, whereas 10% are associated with a positive family history. […] Approximately 5% to 10% of breast cancers have a familial or genetic link. […] A genetic predisposition to develop breast carcinoma has been recognized in some families. […] Mutations in the BRCA family of genes have been identified that confer a lifetime risk of breast cancer that approaches 85%. […] Screening mammography is the primary imaging technique for breast cancer detection.

• #12 Breast diseases: Detection, Management, and Surveillance of Breast Disease | Obgyn Key

  https://obgynkey.com/breast-diseases-detection-management-and-surveillance-of-breast-disease/

  The incidence of carcinoma in biopsy specimens corresponds directly with the patients age. […] Breast cancer is usually asymptomatic before the development of advanced disease. […] The initial size of the breast carcinoma is the single best predictor of the likelihood of positive axillary nodes. […] A multidisciplinary team approach is necessary in the treatment of breast cancer. […] The primary therapy for the majority of women with stages I and II breast cancer is conservative surgery, which preserves the breast, followed by radiation therapy. […] The role of the gynecologist in the management of breast disease has been addressed in a number of published clinical opinions and practice bulletins from the American College of Obstetrics and Gynecology. […] Despite the fact that 50% of cases of breast cancer in women 50 years and older and 71% of cases of breast cancer in women younger than 50 years are detected by women themselves, most guidelines have questioned the benefit of breast self-examination.

• #13 Breast Cancer in Teens: Incidence, Symptoms, Causes

  https://www.healthline.com/health/childrens-health/breast-cancer-in-teens

  Breast cancer is very rare in teens. Between 2012 and 2016, the incidence rate for female breast cancer in 15- to 19-year-olds in the United States was 0.1 in 100,000. This equals 1 teen in 1 million. […] The chances increase slightly as girls move through their teenage years, but breast cancer in this age group is still very rare. […] The most common type of breast cancer found in teens is secretory adenocarcinoma. This is generally a slow growing, nonaggressive cancer. […] Most breast lumps in teenage girls are fibroadenomas, which are noncancerous. An overgrowth of connective tissue in the breast causes fibroadenomas. […] The ACS no longer recommends regular breast self-exams, since theres no evidence that they help reduce breast cancer deaths. […] Because breast cancer is so rare in teens, doctors and teens may adopt a watch-and-wait approach, and delay treatment. That may account for the lower survival rate for teens with breast cancer compared with adult women with the condition.

• #14 Breast Imaging: Breast Cancer Screening, Diagnosis, Staging, and Surveillance | Springer Publishing

  https://connect.springerpub.com/highwire_display/entity_view/node/56089/content_details

  Imaging is essential in detecting, diagnosing, staging, and providing surveillance of diseases of the breast. Breast imaging plays a fundamental role, as clinical examination of the breast and surrounding regional lymph nodes is extremely challenging and nonpalpable abnormalities in the breast are common. […] A standardized set of guidelines was developed by international experts in breast imaging with support from the American College of Radiology (ACR). […] Breast cancer is the most common cancer in women of all races and ethnicities and a leading cause of premature mortality among U.S. women. Early detection is associated with reduced mortality. Mammogram is the primary test recommended to identify early breast cancer. Supplemental screening with other modalities, such as breast MRI and ultrasound, in selected subgroups of women has shown increased detection of breast cancer.

• #15 Breast Imaging: Breast Cancer Screening, Diagnosis, Staging, and Surveillance | Springer Publishing

  https://connect.springerpub.com/highwire_display/entity_view/node/56089/content_details

  Imaging surveillance of breast cancer survivors may entail multiple imaging modalities. […] Mammography is considered the main surveillance-imaging modality for patients following curative primary breast conservation treatment. Studies have shown improved survival for early detection of recurrence in posttreatment patients. Current guidelines from the American Society of Clinical Oncology (ASCO) and NCCN suggest annual mammogram based on expert opinion.

• #16 The Triple Assessment – Breast Lumps – Biopsy – Imaging – TeachMeSurgery

  https://teachmesurgery.com/breast/presentations/triple-assessment/

  The breast triple assessment is a hospital-based assessment clinic that allows for the early and rapid detection of breast cancer. […] Women (and men) can be referred to this one stop clinic by their GP if they have signs or symptoms that meet the breast cancer 2 week wait referral criteria, or if there has been a suspicious finding on their routine breast cancer screening mammography. […] The triple assessment aims to provide a quick and simple outpatient approach to diagnosis and allow for the early intervention in the treatment of breast cancer. […] A biopsy is required of any suspicious mass or lesion presenting to the clinic, most commonly obtained via core biopsy. […] At each stage of the triple assessment, the suspicion for malignancy is graded to create an overall risk index, as discussed below. […] From the clinical, radiological and pathological information gained about a breast lump at the Triple Assessment, a diagnosis of breast cancer can be made. […] Cases suspicious for breast cancer are discussed by the MDT to create a suitable treatment plan.

• #17 Palpable Lump – Radiology | UCLA Health

  https://www.uclahealth.org/departments/radiology/education/breast-imaging-teaching-resources/how-work-up-patient-with/palpable-lump

  Palpable breast lumps can cause anxiety for patients. Most palpable breast lumps are benign. However, a new palpable breast mass is also a common presenting sign of breast cancer. In almost all cases, imaging evaluation is necessary to characterize the palpable lesion. Recommended imaging options include diagnostic mammography and targeted breast ultrasound (US). The choice of modality is dependent on patient age and degree of radiologic suspicion. Any highly suspicious mass detected by imaging or palpation should undergo core biopsy with image guidance (US, stereotactic, tomosynthesis, or MRI) unless contraindicated. […] Diagnostic mammography (DM) is indicated for women 30 years of age who present with a palpable lump. If a clearly benign correlate for a palpable finding can be identified on DM, no further imaging may be indicated with appropriate clinical follow-up. If an imaging correlate is identified that is not clearly benign or the DM is negative, targeted US should be performed. Additionally, digital breast tomosynthesis (DBT) can address some of the limitations encountered with standard DM views. DM or DBT may also be helpful for women ages 30 to 39 with palpable lumps and women younger than 30 with palpable lumps and suspicious findings on US.

• #18 Palpable Lump – Radiology | UCLA Health

  https://www.uclahealth.org/departments/radiology/education/breast-imaging-teaching-resources/how-work-up-patient-with/palpable-lump

  Ultrasound is the first-line recommendation for a palpable lump in women under 30 years of age. If there is a suspicious finding on US, DM or DBT is recommended for further characterization to identify features of malignancy. US is also an essential next step in evaluating women 30 years of age with a palpable mass and either a negative mammogram or a finding not clearly benign on mammogram.

• #19 Does chest CT have a role in breast imaging? | AuntMinnie

  https://www.auntminnie.com/clinical-news/ct/article/15628652/does-chest-ct-have-a-role-in-breast-imaging

  Chest CT isn’t usually associated with breast cancer detection, but maybe it should be: The modality can identify incidental, suspicious breast lesions in women undergoing the exam for other reasons, and many of these lesions are malignant, according to a study published June 14 in Breast. […] The study findings suggest that radiologists should keep breast cancer in mind when interpreting chest CT scans acquired in women for other indications, wrote a team of German researchers led by Dr. Martina Georgieva of the University Hospital Regensburg. […] „Breast lesions can be incidental findings on chest CT,” the group noted. „Even though chest CT cannot provide all information necessary for classifying breast lesions, it seems to be helpful for evaluation of tumor suspicious changes in dense breast tissue. This may ultimately influence patient management and lead to further imaging. Therefore, a thorough examination of the breast, even on routine chest CT for other indications, is crucial.”

• #20 Does chest CT have a role in breast imaging? | AuntMinnie

  https://www.auntminnie.com/clinical-news/ct/article/15628652/does-chest-ct-have-a-role-in-breast-imaging

  Of the 31 incidental breast lesions, 23 were cancerous (74.2%) and eight were benign. […] It’s not that women should be routinely referred to CT for breast imaging, but radiologists would do well to keep a patient’s breast health in mind when reading CT exams taken for other reasons, according to Georgieva and colleagues. […] „[It] is important for radiologists to examine the breast tissue more thoroughly on routine chest CT examinations and characterize incidental lesions as either clearly benign, indeterminate, or suspicious with necessity for biopsy,” they wrote.

• #21 Palpable breast lumps: An age-based approach to evaluation and diagnosis | Malherbe | South African Family Practice

  https://safpj.co.za/index.php/safpj/article/view/5571/7557

  The risk of breast cancer increases with age, and a full triple assessment of every patient regardless of age would lead to an increase in costs at no benefit to the patient. […] Therefore, age has been proposed to guide investigations in the work-up of breast lumps. […] Breast lumps are common and cause significant emotional stress for the patient when detected. An age-based approach to breast lumps allows for a cost-effective, safe and systematic pathway to investigate and treat breast lumps.

• #22 Common Breast Problems | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0415/p505.html

  The sensitivity of CBE ranges from 49% to 69%, and specificity is 86% to 99%. […] Detection of malignancy increases when imaging is added to the evaluation. […] Diagnostic mammography is the most appropriate initial imaging modality for women 40 years and older who present with a breast mass, whereas ultrasonography is recommended for women younger than 30 years. […] Because of the imperfect sensitivity and specificity of CBE and imaging, patients should be referred for tissue sampling if suspicious findings are noted at any stage of the evaluation, regardless of benign findings at other stages. […] A highly suspicious breast mass found on CBE should be biopsied regardless of imaging findings, and suspicious masses on imaging should be biopsied even if the CBE suggested benign findings.

• #23 Breast diseases: Detection, Management, and Surveillance of Breast Disease | Obgyn Key

  https://obgynkey.com/breast-diseases-detection-management-and-surveillance-of-breast-disease/

  The gynecologists role in managing breast problems is broad because they often serve as a womans primary health care advocate. […] In the United States 7.8% of office visits by women (51 million/year) related to breast disease. […] Breast cancer accounts for 30% of all new cancer diagnoses in women, is the second most common cause of cancer-related death in women, and is the leading cause of premature mortality from cancer in U.S. women. […] The risk factors for breast cancer may be divided into several categories: demographic, estrogen exposure, lifestyle, personal breast characteristics, familial and inherited genetic mutations, and radiation exposure. […] Age continues to remain the strongest risk factor for developing breast cancer. […] The incidence of breast cancer varies based on geographic region.

• #24 Breast diseases: Detection, Management, and Surveillance of Breast Disease | Obgyn Key

  https://obgynkey.com/breast-diseases-detection-management-and-surveillance-of-breast-disease/

  Breast cancer risk is increased with high endogenous estrogen levels in both premenopausal and postmenopausal women. […] Breastfeeding decreases the risk of breast cancer. […] Hormone replacement therapy is an established risk factor for breast cancer. […] The relationship between dietary habits and the risk of breast cancer is not clear. […] Alcohol consumption has been associated with increased risk for multiple cancers, including breast cancer. […] Women with a personal history of breast cancer or ductal carcinoma in situ are at an increased risk of developing invasive breast cancer in the contralateral breast. […] Women with dense breasts, as defined by more fibrous tissue, have a relative risk of 4.7 for breast cancer.

• #25 Suspicious breast lumps – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/suspicious-breast-lumps/symptoms-causes/syc-20352786

  Other breast conditions that are not cancer still can raise the risk of breast cancer later on. These include conditions that can cause lumps, such as atypical ductal hyperplasia, atypical lobular hyperplasia and lobular carcinoma in situ. If you have a breast condition that raises the risk of cancer, it doesn’t mean that you’ll definitely get breast cancer. Ask your healthcare professional what the risk means for you and whether you can make lifestyle changes to lower it.

• #26 Suspicious breast lumps | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/suspicious-breast-lumps

  A breast lump is a growth of tissue that forms in the breast. Most breast lumps are not irregular or cancerous. But it’s key to have your healthcare professional check them promptly. […] A breast lump that’s painless, hard, has irregular edges and is different from the breast tissue around it might be breast cancer. The skin covering the lump may thicken, change color or look red. There also may be skin changes such as dimpled or pitted areas that look like the skin of an orange. Your breast size and shape may change. You may notice fluid leaking from the nipple, or the nipple may turn inward. The lymph nodes under the arm or near the collarbone might be swollen. […] Other breast conditions that are not cancer still can raise the risk of breast cancer later on. These include conditions that can cause lumps, such as atypical ductal hyperplasia, atypical lobular hyperplasia and lobular carcinoma in situ. If you have a breast condition that raises the risk of cancer, it doesn’t mean that you’ll definitely get breast cancer. Ask your healthcare professional what the risk means for you and whether you can make lifestyle changes to lower it.

• #27 Complex cystic and solid breast mass | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/complex-cystic-and-solid-breast-mass?lang=us

  Breast cysts are extremely common and are present in most women over 40 years old. Breast ultrasound allows its detection and the correct diagnosis of cyst has been reported to be almost 100%. […] 5% of breast ultrasound examinations report complex cyst. […] Complex breast cysts have a malignancy rate of 0.3%. Among breast neoplasms, it still has a substantial probability of being malignant (23% and 31% in two series).

• #28 Breast Lump: Types, Causes, How to Check Them & Treatment

  https://www.nationalbreastcancer.org/breast-lump/

  A breast lump is a mass, growth, or swelling within the breast tissue. While finding a lump in your breast can be concerning, it is important to remember that the majority of breast lumps are not breast cancer. […] However, all breast lumps should be investigated by a healthcare professional. While breast lumps should be checked and monitored by a healthcare professional, it is important to note that the absence of a noticeable breast lump does not mean breast cancer cannot or has not developed. Beginning at age 40, all women should receive an annual mammogram, and women over the age of 18 should perform a monthly breast self-exam. […] Breast lumps are common, and not all breast lumps are cancerous. According to the National Institute of Health, 60-80% of all breast lumps are non-cancerous. Non-cancerous breast lumps are referred to as “benign”; cancerous breast lumps, or tumors, are referred to as “malignant.”

• #29 Common Breast Problems | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0415/p505.html

  Palpable breast masses, mastalgia, and nipple discharge are commonly encountered symptoms in outpatient practice, causing significant patient anxiety and precipitating medical consultation. […] Women presenting with a breast mass will require imaging and further assessment to exclude cancer. […] Any suspicious mass detected on physical examination, mammography, or ultrasonography should undergo biopsy. […] Breast masses are associated with an increased risk of breast cancer. […] Patients presenting with a palpable breast mass should be evaluated with a detailed history, clinical breast examination (CBE), and, for almost all women, imaging. […] Although CBE has poor predictive value for determining whether a breast mass is cancerous, some features of breast masses may help distinguish between benign and malignant lesions.

• #30 Breast Lump: Types, Causes, How to Check Them & Treatment

  https://www.nationalbreastcancer.org/breast-lump/

  While some breast cancers may produce a noticeable lump or other symptoms, it is important to remember that in its early stages, breast cancer does not produce any noticeable symptoms or signs. This is why practicing early detection methods, such as receiving annual mammograms, annual well-woman visits that include clinical exams, and monthly breast self-exams are critical to diagnosing breast cancer early, when it is most treatable. […] All breast lumps or changes should be reported to your doctor!

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