Common Breast Problems.

Common Breast Problems. Am Fam Physician. 2019 Apr 15;99(8):505-514 Authors: Salzman B, Collins E, Hersh L Abstract Palpable breast masses, mastalgia, and nipple discharge are commonly encountered symptoms in outpatient practice, causing significant patient anxiety and precipitating medical consultation. The initial workup includes a detailed clinical history and physical examination. Women presenting with a breast mass will require imaging and further assessment to exclude cancer. Diagnostic mammography is usually preferred, but ultrasonography is more sensitive in women younger than 30 years. Any suspicious mass detected on physical examination, mammography, or ultrasonography should undergo biopsy. In most cases, a core needle biopsy should be performed with imaging guidance for evaluation of a suspicious mass. Mastalgia is usually not an indication of underlying malignancy. Oral contraceptives, hormone therapy, some psychotropic drugs, and some cardiovascular agents have been associated with mastalgia. Focal breast pain should be evaluated with diagnostic imaging. Targeted ultrasonography localized to discrete areas of the breast can be used alone to evaluate focal breast pain in women younger than 30 years, and as an adjunct to mammography in women 30 years and older. Topical nonsteroidal anti-inflammatory drugs, such as diclofenac, are a first-line treatment option. The first step in the diagnostic evaluation of patients with n...
Source: American Family Physician - Category: Primary Care Authors: Tags: Am Fam Physician Source Type: research