Differential Diagnosis for 30-year-old Female with Breast Swelling and Pain
Single Most Likely Diagnosis
- Fibrocystic Changes: This condition is very common in women of reproductive age and can cause breast swelling and pain, especially if associated with hormonal fluctuations. The patient's history of galactorrhea suggests hormonal imbalance, which could contribute to fibrocystic changes.
Other Likely Diagnoses
- Hormonal Mastopathy: Given the patient's history of hypothyroidism and galactorrhea, hormonal imbalances could be contributing to breast symptoms. Thyroid disorders can affect breast tissue and lead to symptoms like swelling and pain.
- Breast Cyst: Breast cysts are common in women and can cause pain and swelling, especially if they become large or numerous. They are often related to the menstrual cycle but can occur at any time.
- Mastitis: Although less common in non-pregnant, non-breastfeeding women, mastitis could still be a consideration, especially if there's an underlying ductal issue or if the patient has a history of similar infections.
Do Not Miss Diagnoses
- Breast Cancer: Although less likely in a 30-year-old, breast cancer must always be considered, especially if there's a palpable mass or if the pain and swelling are localized and persistent. Early detection is crucial.
- Pituitary Tumor (e.g., Prolactinoma): The patient's galactorrhea could be indicative of a prolactinoma, a type of pituitary tumor that secretes prolactin, leading to hormonal imbalances and potentially affecting breast tissue.
- Thyroid-Related Breast Disease: Certain thyroid conditions can directly affect the breast, leading to symptoms like gynecomastia in men or mastalgia in women. Given the patient's hypothyroidism, this could be a contributing factor.
Rare Diagnoses
- Granulomatous Mastitis: A rare inflammatory condition that can cause breast pain, swelling, and sometimes nipple retraction. It's often associated with systemic diseases or can be idiopathic.
- Breast Abscess: Although more common in breastfeeding women, a breast abscess could occur in any woman and would present with localized pain, swelling, and possibly fever.
- Phyllodes Tumor: A rare type of breast tumor that can be benign, borderline, or malignant. These tumors can grow quickly and cause noticeable swelling and pain.