Differential Diagnosis for an 18-year-old Female with a Painful Lump on the Right Breast
- Single most likely diagnosis:
- Fibroadenoma: This is a common benign breast tumor, especially in young women. The fact that the lump is painful and has been present for 2 months, with the patient noticing an increase in size, aligns with the typical presentation of a fibroadenoma, which can grow and sometimes cause discomfort.
- Other Likely diagnoses:
- Breast cyst: These are fluid-filled sacs that can develop in the breast and are common in women of reproductive age. They can be painful and may fluctuate in size.
- Phyllodes tumor: Although less common than fibroadenomas, phyllodes tumors can occur in young women and may present as a rapidly growing, sometimes painful mass.
- Infection or abscess: Given the painful nature of the lump, an infectious process such as mastitis or a breast abscess should be considered, especially if there are signs of inflammation like redness, warmth, or fever.
- Do Not Miss diagnoses:
- Breast cancer: Although breast cancer is rare in young women, a family history of breast cancer (especially at a young age, like the patient's mother being diagnosed at 35) increases the risk. It's crucial to not miss this diagnosis, despite its lower likelihood.
- Sarcoma: Extremely rare, but sarcomas can occur in the breast and present as a rapidly growing mass. Given the potential for aggressive behavior, missing this diagnosis could have severe consequences.
- Rare diagnoses:
- Granulomatous mastitis: A rare inflammatory condition that can mimic breast cancer or other tumors, presenting with a painful mass.
- Hamartoma: A benign tumor-like growth that can occur in the breast, although it's much less common than fibroadenomas.
- Pseudoangiomatous stromal hyperplasia (PASH): A rare benign condition that can form a mass in the breast, more commonly seen in young women.