powerpoint presentation in pathology about "Differential diagnosis of breast mass". It was made in March 2016

1. Differential diagnosis of
breast mass

2. Prepared By
Kareem Fisal Alnakeeb

3. Objectives
• Definition
• Types of breast lumps
• Diagnosis
• Treatment

4. Breast lumps(masses)
• localized swellings that feel different from the surrounding breast tissue.
• It is a symptom/sign for a variety of conditions.
• It is important for women with a breast lump to receive appropriate
evaluation.

5. Types of breast lumps
• Cysts
• Abscess
• Growths
• Fatty lumps
• Other causes of swelling

6. sebaceous cystbreast cyst
• non-cancerous,
• closed sac or cyst below the skin
• non-cancerous,
• fluid-filled sac in the breast.
Def
• plugged ducts at the site of a hair
follicle.
• They generally feel smooth or
rubbery under the skin
NE
• Hormone stimulation or injury may
cause them to enlarge
• hormones that control the menstrual
cycle
• So, rare in women older than 50.
caused by
• if no symptoms are present,
medical treatment is not required
• can be quite painful
or cause no pain at all.
Symptoms

7. breast cyst sebaceous cyst

8. • are non-cancerous pockets of infection within the breast.
• They can be quite painful
• cause the skin over the breast to turn red or feel hot or solid.
• Abscesses of the breast are most common in women who are breast-feeding

10. B) Intraductal papillomasA) Adenomas
• wart-like growths in the ducts of the
breast.
• can cause a bloody discharge from the
nipple.
• non-cancerous abnormal growths of
the glandular tissue in the breast.
Def
• usually felt just under the nipple• usually feel round and firm
• with smooth borders
NE
• Women close to menopause may have
only one growth,
while
• younger women are more likely to have
multiple growths in one or both breasts
 fibroadenomas
 The most common form of these
growths
 occur most frequently in :
1. women between the ages of 15 and 30
2. women of African descent.

11. Adenomas Intraductal papilloma

12. C) Breast cancer
• usually feels like a hard or firm lump
• irregular in shape
• may feel like it is attached to skin or tissue deep inside the breast.
• Breast cancer is rarely painful
• can occur anywhere in the breast or nipple

15. lipomaFat necrosis
• non-cancerous lump of fatty tissue
• soft to the touch,
• usually movable
• generally painless
• a condition in which the normal fat cells of the
breast become round lumps.
• Symptoms can include :
( pain, firmness, redness, and/or bruising. )
• Fat necrosis usually goes away without
treatment
• But can form permanent scar tissue that may
show up as an abnormality on a mammogram.

16. Fat necrosis lipoma

17. HematomasSeromas
can occur :
1. after breast surgery
2. after breast injury
3. spontaneously in patients with coagulopathy.
(Very Rare)
are a common complication of breast surgery.
contain red blood cellspocket of clear serous fluid

18. Seroma Hematoma

19. Fibrocystic breast changes
40%
No disease
30%
Fibroadenoma
7%
benign dysplasias &
neoplasms
13%
Breast cancer
10%
Findings in women seeking evaluation of apparent breast lump
Fibrocystic breast changes
No disease
Fibroadenoma
benign dysplasias & neoplasms
Breast cancer

20. Differential diagnosis of breast mass
Inflammatory mass
• Breast Abscess ( pyogenic mastitis )
• Periductal plasma cell mastitis ( mammary duct ectasia )
• Granuloma e.g. TB – Syphilis - actinomycosis
Traumatic
• Hematoma
• Traumatic fat necrosis
Hyperplastic mass • Fibrocystic disease of the breast ( fibroadenosis )
Neoplastic mass
• Benign : Fibroadenoma – Duct papilloma – papillary cystadenoma
• Malignant : Breast cancer – metastatic tumor

21. Diagnosis
• Breast lumps are often discovered during a breast self-examination or during
a routine check-up.
• Upon noticing an unusual lump in the breast the best course of action is to
schedule an examination with a physician who can best diagnose the type of
breast lump and strategy for treatment.
• Patients should make sure that the medical records of any breast-related
illnesses are retained to facilitate diagnosis in case of recurrence or follow-up.

23. Treatments
(vary depending on the type of lump)
• breast cysts and abscesses require drainage for treatment,
• sebaceous cysts and fatty lumps are best treated by surgical removal
• Fibroadenoma treatment :
1. "wait and watch,“
2. open surgery
3. minimally-invasive surgical alternatives.

25. Fibroadenoma treatment
Minimally-invasive surgical
alternatives
Open surgeryWaiting and watching
the most common method for
removing large fibroadenomas
• common for very small
fibroadenomas
Include :
1. biopsy-removal techniques
2. cryoablation.
Has several disadvantages:
1. Requires general anesthesia
2. Requires a day in the hospital
3. can leave significant scarring
at the site of the incision
• involves routine check-ups
with a physician every 6–12
months

26. 1. biopsy-removal techniques :
• using a vacuum-assisted biopsy device to remove fibroadenoma bit by bit.
• This procedure can be effective
• but often does not remove all of the fibroadenoma, resulting in a possible
re-growth.
2. cryoablation :
• an ultrasound-guided probe is inserted into the fibroadenoma through a
small incision in the breast.
• Extremely cold temperatures are then used to freeze the lesion, which
eventually dies and is reabsorbed into the body.

27. biopsy-removal techniquesOpen surgery Cryoablation