Differential Diagnosis for a 35-Year-Old Female with a Breast Lump

Single Most Likely Diagnosis

• Fibroadenoma: This is a common benign breast tumor, especially in young women. It is usually a firm, mobile, and painless lump.

Other Likely Diagnoses

• Cyst: Breast cysts are fluid-filled sacs that can occur in the breast and are common in women of this age group. They can be tender and may fluctuate in size with the menstrual cycle.
• Lipoma: A benign tumor composed of fat tissue, which can occur in the breast and feels like a soft, movable lump.
• Breast Abscess: An infection of the breast tissue, which can cause a painful lump, especially in lactating women but can occur in non-lactating women as well.

Do Not Miss Diagnoses

• Breast Cancer: Although less common in younger women, breast cancer is a critical diagnosis not to miss. It can present as a lump, and early detection is crucial for treatment and prognosis.
• Phyllodes Tumor: A rare tumor of the breast that can be benign, borderline, or malignant. It tends to grow quickly and can become large.

Rare Diagnoses

• Hamartoma: A rare, benign breast tumor that is a mix of glandular, fibrous, and fatty tissues.
• Pseudoangiomatous Stromal Hyperplasia (PASH): A rare benign condition of the breast that can mimic cancer on imaging but is not malignant.
• Granular Cell Tumor: A rare tumor that can occur in the breast and is usually benign but can be malignant in rare cases.

Each of these diagnoses has distinct characteristics and implications for patient care, emphasizing the importance of thorough evaluation and diagnosis.