Common benign breast concerns for the primary care physician

Abstract

Women often visit their primary care physician because of breast concerns such as masses, pain, and nipple discharge. Most breast problems are benign, but it is important to know how to manage these and other breast problems and when to refer patients for further testing.

Prevalence, Impact, and Diagnostic Challenges of Benign Breast Disease: A Narrative Review

“…A key consideration with benign breast lesions is whether the biopsy findings on pathology align with findings from the examination and imaging, known as clinical- or radiologic-pathologic concordance. 1 Lesions that are not concordant should generally be surgically excised. 1 Two other factors that influence management are risk of upgrade to malignancy (risk of finding concurrent breast cancer) and future risk of breast cancer associated with a specific lesion type.…”

“… 1 Lesions that are not concordant should generally be surgically excised. 1 Two other factors that influence management are risk of upgrade to malignancy (risk of finding concurrent breast cancer) and future risk of breast cancer associated with a specific lesion type.…”

“…Benign breast lesions can be broadly grouped into nonproliferative lesions, proliferative lesions without atypia, and proliferative lesions with atypia. 1 , 2 These groups are separated by histologic appearance of the lesions and the associated risk that future breast cancer will develop in patients with these types of lesions. Nonproliferative lesions have minimal to no associated increased risk of breast cancer as well as minimal risk of upgrade, so routine observation is generally recommended.…”

“…Nonproliferative lesions have minimal to no associated increased risk of breast cancer as well as minimal risk of upgrade, so routine observation is generally recommended. 1 Simple cysts and nonproliferative fibrocystic change are common examples of nonproliferative lesions. 1 , 2 Individuals with proliferative lesions without atypia (including some fibroepithelial lesions, papillary lesions, radial scars) may have a slightly increased risk (relative risk of approximately 2.0) of future breast cancer.…”

“… 1 Simple cysts and nonproliferative fibrocystic change are common examples of nonproliferative lesions. 1 , 2 Individuals with proliferative lesions without atypia (including some fibroepithelial lesions, papillary lesions, radial scars) may have a slightly increased risk (relative risk of approximately 2.0) of future breast cancer. 1 Proliferative lesions with atypia have a higher associated risk of future breast cancer, so these lesions are considered clinically to be high risk.…”