Breast mass: Causes & Work-ups
There are many symptoms in the breast, and it is important to distinguish between the typical symptoms and the diseases that can occur. If mass is present, it should be confirmed whether it is malignant. If there is firm, less circumscribed, and fixed characteristic in promotion, possibility of malignancy is great. When pain occurs, it is not related to cancer, and may be caused by premenstrual symptoms, fibrocystic changes, excessive caffeine intake, and the like. In the case of cyst formation, there are cases such as galactocele, which can be distinguished and treated by fine needle aspiration. Skin dimpling is the result of the shortening of the cooper's ligament, which is a sensitive, specific sign indicating underlying cancer. Erythema is a characteristic of inflammatory breast cancer and may be accompanied by peau d'orange findings. Carcinoma cell embolism is a phenomenon that the lymphatic duct of the dermis is clogged and edema of the skin occurs. In the case of nipple inversion, the history of inversion is important. Both cases are likely to be fibrosis due to benign disease if persisted for several years. However, if the symptoms develop in one week, it may be malignant. Eczematoid, and psoriatic lesions should be suspected of paget's disease, and bloody discharge may be present, which should be distinguished from intraductal carcinoma.
Work-ups
In the history taking process, it is important to investigate the hormonal factor. In the case of breast cancer, history of menarche age, pregnancy frequency, and the number of births is very important because the risk of cancer increases as estrogen exposure is prolonged. In addition, the higher the age of acetic acid and obesity, the greater the risk. We also need to investigate the patient's benign breast disease, history of breast cancer, previous breast, uterine surgical ability as medical factor. After that, family factors are examined. In order to distinguish between familiar breast cancer and hereditary breast cancer, the family history of breast cancer and ovarian cancer are examined. After that, factors such as radiation exposure, alcohol consumption, etc. are examined. The subsequent physical examination consists of prompting followed by prompting. The size, shape, mass change, skin change, nipple retraction, and inversion of the breast are observed. In the acceleration, the axillary and supraclavicular lymph nodes are observed along with the size, consistency and position of the mass.
Thereafter, radiology tests are performed, typically mammography and ultrasonography. Mammography is a low-energy x-ray test to examine the breast and can be used for both diagnostic and screening purposes. This test has the advantage of being able to detect the breast as a whole and as a sensitive way to detect micarocalcification. On the other hand, there is a disadvantage in that the sensitivity of the test is low when used in many dense breasts in Korean women. Malignancy may be suspected if distorsion, spiculation, stellate shape, or microcalcification is observed on mammography.
Ultrasonography is a method that can compensate for the drawbacks of mammography, which is less sensitive to dense breast. It is a good test to observe cystic mass and solid mass. If the US branch pattern, spiculation and microlobulation are observed, malignancy can be suspected.
After the radiological examination, the diagnosis is made through large core needle biopsy. Pathologic examination can be used to classify the lesions as ductal carcinoma in situ, invasive ductal carcinoma, and invasive lobular carcinoma.
Work-ups
In the history taking process, it is important to investigate the hormonal factor. In the case of breast cancer, history of menarche age, pregnancy frequency, and the number of births is very important because the risk of cancer increases as estrogen exposure is prolonged. In addition, the higher the age of acetic acid and obesity, the greater the risk. We also need to investigate the patient's benign breast disease, history of breast cancer, previous breast, uterine surgical ability as medical factor. After that, family factors are examined. In order to distinguish between familiar breast cancer and hereditary breast cancer, the family history of breast cancer and ovarian cancer are examined. After that, factors such as radiation exposure, alcohol consumption, etc. are examined. The subsequent physical examination consists of prompting followed by prompting. The size, shape, mass change, skin change, nipple retraction, and inversion of the breast are observed. In the acceleration, the axillary and supraclavicular lymph nodes are observed along with the size, consistency and position of the mass.
Thereafter, radiology tests are performed, typically mammography and ultrasonography. Mammography is a low-energy x-ray test to examine the breast and can be used for both diagnostic and screening purposes. This test has the advantage of being able to detect the breast as a whole and as a sensitive way to detect micarocalcification. On the other hand, there is a disadvantage in that the sensitivity of the test is low when used in many dense breasts in Korean women. Malignancy may be suspected if distorsion, spiculation, stellate shape, or microcalcification is observed on mammography.
Ultrasonography is a method that can compensate for the drawbacks of mammography, which is less sensitive to dense breast. It is a good test to observe cystic mass and solid mass. If the US branch pattern, spiculation and microlobulation are observed, malignancy can be suspected.
After the radiological examination, the diagnosis is made through large core needle biopsy. Pathologic examination can be used to classify the lesions as ductal carcinoma in situ, invasive ductal carcinoma, and invasive lobular carcinoma.
