Overview

Definition

• A non-specific term without a universally agreed upon definition
• Refers tobenignBenignFibroadenoma changes in thebreastsBreastsThe breasts are found on the anterior thoracic wall and consist of mammary glands surrounded by connective tissue. The mammary glands are modified apocrine sweat glands that produce milk, which serves as nutrition for infants. Breasts are rudimentary and usually nonfunctioning in men.Breasts: Anatomy, particularlyfibrosisFibrosisAny pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury.Bronchiolitis Obliterans and cysts
• Not associated with an increased risk ofbreast cancerBreast cancerBreast cancer is a disease characterized by malignant transformation of the epithelial cells of the breast. Breast cancer is the most common form of cancer and 2nd most common cause of cancer-related death among women.Breast Cancer

Classification ofbenignBenignFibroadenoma breast lesions

• Non-proliferative lesions 
  • Classicfibrocystic changesFibrocystic changesA common and benign breast disease characterized by varying degree of fibrocystic changes in the breast tissue. There are three major patterns of morphological changes, including fibrosis, formation of cysts, and proliferation of glandular tissue (adenosis). The fibrocystic breast has a dense irregular, lumpy, bumpy consistency.Examination of the Breast
  • Examples:
    • FibrosisFibrosisAny pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury.Bronchiolitis Obliterans
    • Cysts
    • Adenosis (↑ number of acini per lobule)
• Proliferative lesions without atypia
  • Generally not included in the termfibrocystic changesFibrocystic changesA common and benign breast disease characterized by varying degree of fibrocystic changes in the breast tissue. There are three major patterns of morphological changes, including fibrosis, formation of cysts, and proliferation of glandular tissue (adenosis). The fibrocystic breast has a dense irregular, lumpy, bumpy consistency.Examination of the Breast
  • Associated with a slight ↑ risk for cancer
  • Examples:
    • Sclerosing adenosisSclerosing AdenosisFibroadenoma
    • EpithelialhyperplasiaHyperplasiaAn increase in the number of cells in a tissue or organ without tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells.Cellular Adaptation
• Atypical hyperplasias
  • Not consideredfibrocystic changesFibrocystic changesA common and benign breast disease characterized by varying degree of fibrocystic changes in the breast tissue. There are three major patterns of morphological changes, including fibrosis, formation of cysts, and proliferation of glandular tissue (adenosis). The fibrocystic breast has a dense irregular, lumpy, bumpy consistency.Examination of the Breast
  • Associated with an ↑↑ risk for cancer 
  • Often incidental findings on mammogram
  • Histologically similar tocarcinoma in situCarcinoma in situA lesion with cytological characteristics associated with invasive carcinoma but the tumor cells are confined to the epithelium of origin, without invasion of the basement membrane.Leukoplakia
  • Examples:
    • Atypical ductal hyperplasiaAtypical Ductal HyperplasiaBenign Breast Conditions
    • Atypical lobular hyperplasiaAtypical Lobular HyperplasiaBenign Breast Conditions

Epidemiology

• Most frequentbenignBenignFibroadenoma breast lesion
• Affects up to 50–60% of women
• Most common in women reproductive-age women, 30–50 years of age 
• Changes decrease (or resolve) withmenopauseMenopauseMenopause is a physiologic process in women characterized by the permanent cessation of menstruation that occurs after the loss of ovarian activity. Menopause can only be diagnosed retrospectively, after 12 months without menstrual bleeding.Menopause.

Etiology

• Tied toestrogenEstrogenCompounds that interact with estrogen receptors in target tissues to bring about the effects similar to those of estradiol. Estrogens stimulate the female reproductive organs, and the development of secondary female sex characteristics. Estrogenic chemicals include natural, synthetic, steroidal, or non-steroidal compounds.Ovaries: Anatomy andprogesteroneProgesteroneThe major progestational steroid that is secreted primarily by the corpus luteum and the placenta. Progesterone acts on the uterus, the mammary glands and the brain. It is required in embryo implantation; pregnancy maintenance, and the development of mammary tissue for milk production. Progesterone, converted from pregnenolone, also serves as an intermediate in the biosynthesis of gonadal steroid hormones and adrenal corticosteroids.Gonadal Hormones levels
• Risk factors:
  • Nulliparity
  • First live birth at age > 30 years old
  • EarlymenarcheMenarcheThe first menstrual cycle marked by the initiation of menstruation.Menstrual Cycle

Pathophysiology

Anatomy

• Breast tissue consists of:
  • Epithelial components → glands and ducts
  • Stroma → adipose and fibrousconnective tissueConnective tissueConnective tissues originate from embryonic mesenchyme and are present throughout the body except inside the brain and spinal cord. The main function of connective tissues is to provide structural support to organs. Connective tissues consist of cells and an extracellular matrix.Connective Tissue: Histology
• LobulesLobulesBreasts: Anatomyare functional units (milk-producing sacs), separated byCooper ligamentsCooper ligamentsBreasts: Anatomy
  • Each contains multiple acini (tubuloalveolar glands) andadipose tissueAdipose tissueAdipose tissue is a specialized type of connective tissue that has both structural and highly complex metabolic functions, including energy storage, glucose homeostasis, and a multitude of endocrine capabilities. There are three types of adipose tissue, white adipose tissue, brown adipose tissue, and beige or “brite” adipose tissue, which is a transitional form.Adipose Tissue: Histology.
  • Acini empty into thelactiferous ductsLactiferous ductsBreasts: Anatomy.

Pathophysiology

• The pathogenesis is incompletely understood, but appears to be associated with hormone levels.
  • EstrogenEstrogenCompounds that interact with estrogen receptors in target tissues to bring about the effects similar to those of estradiol. Estrogens stimulate the female reproductive organs, and the development of secondary female sex characteristics. Estrogenic chemicals include natural, synthetic, steroidal, or non-steroidal compounds.Ovaries: Anatomy stimulates ductal elements (including adenosis).
  • ProgesteroneProgesteroneThe major progestational steroid that is secreted primarily by the corpus luteum and the placenta. Progesterone acts on the uterus, the mammary glands and the brain. It is required in embryo implantation; pregnancy maintenance, and the development of mammary tissue for milk production. Progesterone, converted from pregnenolone, also serves as an intermediate in the biosynthesis of gonadal steroid hormones and adrenal corticosteroids.Gonadal Hormones stimulates stromal elements.
• Classicfibrocystic changesFibrocystic changesA common and benign breast disease characterized by varying degree of fibrocystic changes in the breast tissue. There are three major patterns of morphological changes, including fibrosis, formation of cysts, and proliferation of glandular tissue (adenosis). The fibrocystic breast has a dense irregular, lumpy, bumpy consistency.Examination of the Breast:
  • Cystic lesions:
    • Derived from the terminal duct lobular unit
    • Form by dilation and obstruction of theefferentEfferentNeurons which send impulses peripherally to activate muscles or secretory cells.Nervous System: Histology duct
    • Often associated with apocrinemetaplasiaMetaplasiaA condition in which there is a change of one adult cell type to another similar adult cell type.Cellular Adaptation
    • Grow and shrink cyclically asestrogenEstrogenCompounds that interact with estrogen receptors in target tissues to bring about the effects similar to those of estradiol. Estrogens stimulate the female reproductive organs, and the development of secondary female sex characteristics. Estrogenic chemicals include natural, synthetic, steroidal, or non-steroidal compounds.Ovaries: Anatomy levels fluctuate → cyclic mastalgia
    • Blue-dome cysts: fluid-filled blue-brown unopened breast cysts
  • FibrosisFibrosisAny pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury.Bronchiolitis Obliterans:
    • Ruptured cysts → chronic stromalinflammationInflammationInflammation is a complex set of responses to infection and injury involving leukocytes as the principal cellular mediators in the body’s defense against pathogenic organisms. Inflammation is also seen as a response to tissue injury in the process of wound healing. The 5 cardinal signs of inflammation are pain, heat, redness, swelling, and loss of function.Inflammation → ↑ stromalfibrosisFibrosisAny pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury.Bronchiolitis Obliterans
    • Results in palpable firmness on exam
• Comparison with proliferative lesions without atypia:
  • Sclerosing adenosisSclerosing AdenosisFibroadenoma
    • ↑ acini and intralobularfibrosisFibrosisAny pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury.Bronchiolitis Obliterans → enlarged and distortedlobulesLobulesBreasts: Anatomy
    • Associated stromalfibrosisFibrosisAny pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury.Bronchiolitis Obliterans and interspersed glandular cells
  • EpithelialhyperplasiaHyperplasiaAn increase in the number of cells in a tissue or organ without tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells.Cellular Adaptation:↑ in number of epithelial cell layers in the ductal space or lobule

Clinical Presentation

Fibrocystic changesFibrocystic changesA common and benign breast disease characterized by varying degree of fibrocystic changes in the breast tissue. There are three major patterns of morphological changes, including fibrosis, formation of cysts, and proliferation of glandular tissue (adenosis). The fibrocystic breast has a dense irregular, lumpy, bumpy consistency.Examination of the Breast typically present in reproductive-aged women as either “lumpybreastsBreastsThe breasts are found on the anterior thoracic wall and consist of mammary glands surrounded by connective tissue. The mammary glands are modified apocrine sweat glands that produce milk, which serves as nutrition for infants. Breasts are rudimentary and usually nonfunctioning in men.Breasts: Anatomy,” a discrete breastmassMassThree-dimensional lesion that occupies a space within the breastImaging of the Breast, or mammographic abnormalities found on routinescreeningScreeningPreoperative Care. 

• Ill-defined, diffuse ↑ in breastconsistencyConsistencyDermatologic Examination (firmness)
• Palpable breast lumps
  • SinglemassMassThree-dimensional lesion that occupies a space within the breastImaging of the Breast ormultifocalMultifocalRetinoblastoma (more common)
  • Discrete, well-circumscribed, mobile, and compressible
  • May be tender or nontender
  • Size and number of lesions can fluctuate throughout themenstrual cycleMenstrual cycleThe menstrual cycle is the cyclic pattern of hormonal and tissular activity that prepares a suitable uterine environment for the fertilization and implantation of an ovum. The menstrual cycle involves both an endometrial and ovarian cycle that are dependent on one another for proper functioning. There are 2 phases of the ovarian cycle and 3 phases of the endometrial cycle.Menstrual Cycle
• Cyclic breastpainPainAn unpleasant sensation induced by noxious stimuli which are detected by nerve endings of nociceptive neurons.Pain: Types and Pathways
  • Generally mid-cycle
  • Fullness or heaviness
• Findings are often similar in bothbreastsBreastsThe breasts are found on the anterior thoracic wall and consist of mammary glands surrounded by connective tissue. The mammary glands are modified apocrine sweat glands that produce milk, which serves as nutrition for infants. Breasts are rudimentary and usually nonfunctioning in men.Breasts: Anatomy.

Diagnosis and Management

Diagnosis

The most important thing is to differentiatebenignBenignFibroadenomafibrocystic changesFibrocystic changesA common and benign breast disease characterized by varying degree of fibrocystic changes in the breast tissue. There are three major patterns of morphological changes, including fibrosis, formation of cysts, and proliferation of glandular tissue (adenosis). The fibrocystic breast has a dense irregular, lumpy, bumpy consistency.Examination of the Breast from malignant conditions. 

• Imaging approach (palpablemassMassThree-dimensional lesion that occupies a space within the breastImaging of the Breast):
  • <30 years: ultrasound is the initial test; addmammographyMammographyRadiographic examination of the breast.Breast Cancer Screening only if indicated by US/suspicion.
  • 30–39 years: ultrasound is appropriate; diagnosticmammographyMammographyRadiographic examination of the breast.Breast Cancer Screening may also be used based on clinicaljudgmentJudgmentThe process of discovering or asserting an objective or intrinsic relation between two objects or concepts; a faculty or power that enables a person to make judgments; the process of bringing to light and asserting the implicit meaning of a concept; a critical evaluation of a person or situation.Psychiatric Assessment.
  • ≥40 years: diagnosticmammographyMammographyRadiographic examination of the breast.Breast Cancer Screening (often with adjunct ultrasound)
• MammographyMammographyRadiographic examination of the breast.Breast Cancer Screening:
  • Recommended for all women ≥ 30 years old with a breastmassMassThree-dimensional lesion that occupies a space within the breastImaging of the Breast
  • Reveals round or oval-shaped masses with defined boundaries 
  • May contain densities or dispersed calcifications
• Breast ultrasound:
  • Recommended for all women with a breastmassMassThree-dimensional lesion that occupies a space within the breastImaging of the Breast (including those < 30 years old)
  • Findings:
    • AnechoicAnechoicA structure that produces no echo at all (looks completely black)Ultrasound (Sonography), well-circumscribed, compressible lesions
    • Posterior wall enhancement
    • Thickened parenchyma
    • Increased echogenicity
  • Findings suspicious for cancer (these would be lacking infibrocystic changesFibrocystic changesA common and benign breast disease characterized by varying degree of fibrocystic changes in the breast tissue. There are three major patterns of morphological changes, including fibrosis, formation of cysts, and proliferation of glandular tissue (adenosis). The fibrocystic breast has a dense irregular, lumpy, bumpy consistency.Examination of the Breast):
    • Thickened walls
    • Septa
    • VascularflowFlowBlood flows through the heart, arteries, capillaries, and veins in a closed, continuous circuit. Flow is the movement of volume per unit of time. Flow is affected by the pressure gradient and the resistance fluid encounters between 2 points. Vascular resistance is the opposition to flow, which is caused primarily by blood friction against vessel walls.Vascular Resistance, Flow, and Mean Arterial Pressure
    • Solid or other echogenic components
    • Absence of posterior wall enhancement
• Core needlebiopsyBiopsyRemoval and pathologic examination of specimens from the living body.Ewing Sarcoma (CNB): 
  • Histologic evaluation of suspicious imaging findings
  • PossiblebenignBenignFibroadenoma findings include:
    • Cystic structures
    • FibrosisFibrosisAny pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury.Bronchiolitis Obliterans of stromal tissue
    • EpithelialhyperplasiaHyperplasiaAn increase in the number of cells in a tissue or organ without tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells.Cellular Adaptation
    • ApocrinemetaplasiaMetaplasiaA condition in which there is a change of one adult cell type to another similar adult cell type.Cellular Adaptation

Management

• Observation:
  • ForpatientsPatientsIndividuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures.Clinician–Patient Relationship without significant discomfort 
  • ProvidereassuranceReassuranceClinician–Patient Relationship.
  • Routine breastscreeningScreeningPreoperative Care based on age
• TreatpainPainAn unpleasant sensation induced by noxious stimuli which are detected by nerve endings of nociceptive neurons.Pain: Types and Pathways:
  • Supportive bra
  • Warm compressesWarm CompressesChalazion
  • AvoidcaffeineCaffeineA methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Caffeine’s most notable pharmacological effect is as a central nervous system stimulant, increasing alertness and producing agitation. Several cellular actions of caffeine have been observed, but it is not entirely clear how each contributes to its pharmacological profile. Among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling.Stimulants (limited evidence)
  • Non-steroidal anti-inflammatory drugs (NSAIDsNSAIDSPrimary vs Secondary Headaches) oracetaminophenAcetaminophenAcetaminophen is an over-the-counter nonopioid analgesic and antipyretic medication and the most commonly used analgesic worldwide. Despite the widespread use of acetaminophen, its mechanism of action is not entirely understood.Acetaminophen
• Hormonal issues:
  • ↓ or discontinue postmenopausalhormone replacement therapyHormone Replacement TherapyHormone replacement therapy (HRT) is used to treat symptoms associated with female menopause and in combination to suppress ovulation. Risks and side effects include uterine bleeding, predisposition to cancer, breast tenderness, hyperpigmentation, migraine headaches, hypertension, bloating, and mood changes.Noncontraceptive Estrogen and Progestins
  • Oral contraceptiveOral contraceptiveCompounds, usually hormonal, taken orally in order to block ovulation and prevent the occurrence of pregnancy. The hormones are generally estrogen or progesterone or both.Benign Liver Tumors pills (OCPs)
    • Can help with cyclicpainPainAn unpleasant sensation induced by noxious stimuli which are detected by nerve endings of nociceptive neurons.Pain: Types and Pathways
    • Producesnegative feedbackNegative feedbackHypothalamic and Pituitary Hormones for endogenousestrogenEstrogenCompounds that interact with estrogen receptors in target tissues to bring about the effects similar to those of estradiol. Estrogens stimulate the female reproductive organs, and the development of secondary female sex characteristics. Estrogenic chemicals include natural, synthetic, steroidal, or non-steroidal compounds.Ovaries: Anatomy production
    • May need to ↓estrogenEstrogenCompounds that interact with estrogen receptors in target tissues to bring about the effects similar to those of estradiol. Estrogens stimulate the female reproductive organs, and the development of secondary female sex characteristics. Estrogenic chemicals include natural, synthetic, steroidal, or non-steroidal compounds.Ovaries: Anatomy component in somepatientsPatientsIndividuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures.Clinician–Patient Relationship
• For severe symptoms (refractory mastalgia):
  • DanazolDanazolA synthetic steroid with antigonadotropic and anti-estrogenic activities that acts as an anterior pituitary suppressant by inhibiting the pituitary output of gonadotropins. It possesses some androgenic properties. Danazol has been used in the treatment of endometriosis and some benign breast disorders.Antiestrogens (androgen): reserve for refractory cases due to adverse effects.
  • TamoxifenTamoxifenOne of the selective estrogen receptor modulators with tissue-specific activities. Tamoxifen acts as an anti-estrogen (inhibiting agent) in the mammary tissue, but as an estrogen (stimulating agent) in cholesterol metabolism, bone density, and cell proliferation in the endometrium.Antiestrogens (estrogenEstrogenCompounds that interact with estrogen receptors in target tissues to bring about the effects similar to those of estradiol. Estrogens stimulate the female reproductive organs, and the development of secondary female sex characteristics. Estrogenic chemicals include natural, synthetic, steroidal, or non-steroidal compounds.Ovaries: AnatomyreceptorReceptorReceptors are proteins located either on the surface of or within a cell that can bind to signaling molecules known as ligands (e.g., hormones) and cause some type of response within the cell.Receptors antagonist): short course, off-label, counsel on risks
  • BromocriptineBromocriptineA semisynthetic ergotamine alkaloid that is a dopamine D2 agonist. It suppresses prolactin secretion.Parkinson’s Disease Drugs (dopamineDopamineOne of the catecholamine neurotransmitters in the brain. It is derived from tyrosine and is the precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement.Receptors and Neurotransmitters of the CNS agonist): generally not recommended due to adverse effects

Differential Diagnosis

• FibroadenomaFibroadenomaFibroadenomas are the most common benign tumor of the female breast and the most common breast tumor in adolescent and young women. The tumors are well-circumscribed, mobile, and unencapsulated, with a rubbery or firm consistency.Fibroadenoma: abenignBenignFibroadenoma, solid breastmassMassThree-dimensional lesion that occupies a space within the breastImaging of the Breast composed of fibrous and glandular tissue. This presents as a small, well-defined, mobilemassMassThree-dimensional lesion that occupies a space within the breastImaging of the Breast with a rubbery or firmconsistencyConsistencyDermatologic Examination. The exact etiology is unknown. Diagnosis is confirmed with a CNB. Management is either excision or observation.
• PhyllodestumorTumorInflammation: a fibroepithelialtumorTumorInflammation similar to fibroadenomas, usually characterized by rapid growth. They may behave likebenignBenignFibroadenoma fibroadenomas, or they may become malignant and metastasize. Phyllodes tumors are associated with Li-Fraumeni syndrome. Diagnosis is by CNB and management involves complete resection, withadjuvantAdjuvantSubstances that augment, stimulate, activate, potentiate, or modulate the immune response at either the cellular or humoral level. The classical agents (freund’s adjuvant, bcg, corynebacterium parvum, et al.) contain bacterial antigens. Some are endogenous (e.g., histamine, interferon, transfer factor, tuftsin, interleukin-1). Their mode of action is either non-specific, resulting in increased immune responsiveness to a wide variety of antigens, or antigen-specific, i.e., affecting a restricted type of immune response to a narrow group of antigens. The therapeutic efficacy of many biological response modifiers is related to their antigen-specific immunoadjuvanticity.VaccinationradiationRadiationEmission or propagation of acoustic waves (sound), electromagnetic energy waves (such as light; radio waves; gamma rays; or x-rays), or a stream of subatomic particles (such as electrons; neutrons; protons; or alpha particles).Osteosarcoma in malignant cases.
• GalactoceleGalactoceleBenign Breast Conditions:a cystic collection of fluid usually caused by an obstructed milk duct. They present as a palpable, firmmassMassThree-dimensional lesion that occupies a space within the breastImaging of the Breast in the subareolar region, and may show a classicfat-fluid levelFat-Fluid LevelImaging of the Mediastinum on imaging. Diagnosis is based on history and aspiration, yielding milky fluid. These lesions do not require excision, but this may be considered for significant discomfort.
• MastitisMastitisMastitis is inflammation of the breast tissue with or without infection. The most common form of mastitis is associated with lactation in the first few weeks after birth. Non-lactational mastitis includes periductal mastitis and idiopathic granulomatous mastitis (IGM).Mastitis orbreast abscessBreast AbscessBenign Breast Conditions:inflammationInflammationInflammation is a complex set of responses to infection and injury involving leukocytes as the principal cellular mediators in the body’s defense against pathogenic organisms. Inflammation is also seen as a response to tissue injury in the process of wound healing. The 5 cardinal signs of inflammation are pain, heat, redness, swelling, and loss of function.Inflammation of the breast tissue, most commonly due to infection withskinSkinThe skin, also referred to as the integumentary system, is the largest organ of the body. The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue.Skin: Structure and Functions or oral flora introduced duringbreastfeedingBreastfeedingBreastfeeding is often the primary source of nutrition for the newborn. During pregnancy, hormonal stimulation causes the number and size of mammary glands in the breast to significantly increase. After delivery, prolactin stimulates milk production, while oxytocin stimulates milk expulsion through the lactiferous ducts, where it is sucked out through the nipple by the infant.Breastfeeding. A purulentabscessAbscessAccumulation of purulent material in tissues, organs, or circumscribed spaces, usually associated with signs of infection.Chronic Granulomatous Disease may form. Occasionallynon-lactational mastitisNon-Lactational MastitisMastitis andabscessAbscessAccumulation of purulent material in tissues, organs, or circumscribed spaces, usually associated with signs of infection.Chronic Granulomatous Disease are also possible. Cases usually present with afeverFeverFever is defined as a measured body temperature of at least 38°C (100.4°F). Fever is caused by circulating endogenous and/or exogenous pyrogens that increase levels of prostaglandin E2 in the hypothalamus. Fever is commonly associated with chills, rigors, sweating, and flushing of the skin.Fever, breastpainPainAn unpleasant sensation induced by noxious stimuli which are detected by nerve endings of nociceptive neurons.Pain: Types and Pathways,erythemaErythemaRedness of the skin produced by congestion of the capillaries. This condition may result from a variety of disease processes.Chalazion,edemaEdemaEdema is a condition in which excess serous fluid accumulates in the body cavity or interstitial space of connective tissues. Edema is a symptom observed in several medical conditions. It can be categorized into 2 types, namely, peripheral (in the extremities) and internal (in an organ or body cavity).Edema, and a possible tender,fluctuantFluctuantDermatologic ExaminationabscessAbscessAccumulation of purulent material in tissues, organs, or circumscribed spaces, usually associated with signs of infection.Chronic Granulomatous Disease. The diagnosis is clinical. Management involves antibiotics, continued expression of breast milk if lactating, andincision and drainageIncision And DrainageChalazion of anabscessAbscessAccumulation of purulent material in tissues, organs, or circumscribed spaces, usually associated with signs of infection.Chronic Granulomatous Disease.
• FatnecrosisNecrosisThe death of cells in an organ or tissue due to disease, injury or failure of the blood supply.Ischemic Cell Damage of the breast:usually due to breast injury resulting inliquefactive necrosisLiquefactive NecrosisCell Injury and Death of theadipose tissueAdipose tissueAdipose tissue is a specialized type of connective tissue that has both structural and highly complex metabolic functions, including energy storage, glucose homeostasis, and a multitude of endocrine capabilities. There are three types of adipose tissue, white adipose tissue, brown adipose tissue, and beige or “brite” adipose tissue, which is a transitional form.Adipose Tissue: Histology. As the damaged breast tissue is repaired, there is progressive fibroblastic proliferation resulting inscarScarDermatologic Examination tissue. Calcifications may appear and can be difficult to distinguish from a malignantmassMassThree-dimensional lesion that occupies a space within the breastImaging of the Breast. Management involves supportive measures forpainPainAn unpleasant sensation induced by noxious stimuli which are detected by nerve endings of nociceptive neurons.Pain: Types and Pathways control, but this condition is usually self-limited and does require further treatment.
• Malignant breast lesions: the most common types ofbreast cancerBreast cancerBreast cancer is a disease characterized by malignant transformation of the epithelial cells of the breast. Breast cancer is the most common form of cancer and 2nd most common cause of cancer-related death among women.Breast Cancer are invasive ductal carcinoma and lobular carcinoma. MostpatientsPatientsIndividuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures.Clinician–Patient Relationship are asymptomatic, and a breastmassMassThree-dimensional lesion that occupies a space within the breastImaging of the Breast may be picked up on standard cancerscreeningScreeningPreoperative Care (mammographyMammographyRadiographic examination of the breast.Breast Cancer Screening). Diagnosis is made with a core needlebiopsyBiopsyRemoval and pathologic examination of specimens from the living body.Ewing Sarcoma. Management may involve surgery,chemotherapyChemotherapyOsteosarcoma,radiationRadiationEmission or propagation of acoustic waves (sound), electromagnetic energy waves (such as light; radio waves; gamma rays; or x-rays), or a stream of subatomic particles (such as electrons; neutrons; protons; or alpha particles).Osteosarcoma, and hormonal treatment.

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