Breast lesion

Causes

Appropriate Tests

 

Clinical assessment and diagnostic imaging directs investigation.

Breast biopsy (Fine needle aspiration biopsy, core biopsy and/or open biopsy) of breast lumps and mammographically detected impalpable lesions.

Cytology of nipple discharge or aspirated cyst fluid.

Breast neoplasm, including

 

  • Fibroadenoma

Tissue biopsy for histological examination.

  • Phylloides tumour

Tissue biopsy for histological examination.

  • Ductal papilloma

Tissue biopsy for histological examination.

  • Carcinoma

Breast biopsy ER and PR receptors, Immunohistochemistry, and/or Human epidermal growth factor receptor 2 (HER2) testing assists with the selection of therapy.

Serum Tumour markers are not useful for diagnosis or screening but may assist with monitoring disease progression - CA 15.3, MSA, CA 549 are of only limited value; carcinoembryonic antigen is occasionally useful.

  • Paget's disease (nipple)

See Paget's disease of the breast

Fibrocystic change/mammary dysplasia

Tissue biopsy for histological examination.

Simple cyst

Tissue biopsy for histological examination.

Other conditions

 

  • Mastitis

 

  • Breast abscess

See Abscess and Mastitis infectious

  • Fat necrosis

Tissue biopsy for histological examination.

  • Silicone leak from implant

There is no evidence that silicone levels or silicone antibodies are predictive of any complication of breast implants.