The connective tissues (stroma), ducts and lobules of the breast respond to the female sex hormones (oestrogen and progesterone), becoming fibrous (irregular and hard) and cystic (fluid-filled). However, fibrocystic breast changes, and generalised lumpiness to the breast, is considered a variation of normal and not a disease. Complex fibroadenomas and a positive family history of breast cancer may indicate a higher risk.įibrocystic breast changes were previously called fibrocystic breast disease. Mobile (moves freely under the skin and above the chest wall)įibroadenomas are not cancerous and are not usually associated with an increased risk of developing breast cancer.Well circumscribed (well-defined borders).They respond to the female hormones (oestrogen and progesterone), which is why they are more common in younger women and often regress after menopause. They are more common in younger women, aged between 20 and 40 years. They are sometimes called a “breast mouse”, as they move around within the breast tissue. They are typically small and mobile within the breast tissue. The NICE guidelines suggest considering non-urgent referral for unexplained breast lumps in patients under 30 years.įibroadenomas are common benign tumours of stromal/epithelial breast duct tissue. Skin changes suggestive of breast cancer.An unexplained lump in the axilla in patients aged 30 or above.The NICE guidelines recommend also considering a two week wait referral for: Unilateral nipple changes in patients aged 50 or above (discharge, retraction or other changes).An unexplained breast lump in patients aged 30 or above.The NICE guidelines (updated January 2021) recommend a two week wait referral for suspected breast cancer for: Skin dimpling or oedema (peau d’orange). Lumps may be tethered to the skin or the chest wall.Lumps that are hard, irregular, painless or fixed in place.Histology (fine needle aspiration or core biopsy)Ĭlinical features that may suggest breast cancer are:.Clinical assessment (history and examination).Triple assessment of a breast lump is standard practice to exclude or diagnose cancer. The most significant differential of a breast lump is breast cancer. Milk is secreted through the ducts and out of openings on the nipple. Behind the nipple are the ducts, which lead into the lobules, where breast milk is produced. Most of the breast is adipose (fatty) tissue. The breasts sit in front of the chest wall, which contains the ribs and pectoral muscles. Any breast lump needs a thorough assessment to exclude breast cancer. There are numerous causes of breast lumps, many of which are benign.
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