Differential Diagnosis for Breast Lump

The following is a differential diagnosis for a breast lump, categorized for clarity and emphasis on critical diagnoses.

• Single Most Likely Diagnosis
  • Fibroadenoma: A common benign breast tumor, especially in young women. It is usually a firm, mobile, and painless lump.
• Other Likely Diagnoses
  • Cyst: A fluid-filled sac within the breast, often fluctuant and can be tender. Cysts are very common and tend to vary with the menstrual cycle.
  • Lipoma: A benign tumor composed of fat tissue, which can occur in the breast and is usually soft and mobile.
  • Breast Abscess: An infection of the breast tissue, which can cause a lump, pain, and fever. It's more common in lactating women but can occur in anyone.
  • Fibrocystic Changes: These are benign conditions where there are lumps, thickening, or nodular areas in the breast due to hormonal changes. They can cause discomfort and are very common.
• Do Not Miss Diagnoses
  • Breast Cancer: Although less common than benign conditions, breast cancer is a critical diagnosis to consider due to its potential severity and the importance of early detection. Risk factors include family history, genetic predisposition, and age.
  • Phyllodes Tumor: A rare tumor of the breast that can be benign, borderline, or malignant. It tends to grow quickly but is much less common than fibroadenomas.
  • Inflammatory Breast Cancer: A rare and aggressive form of breast cancer that causes the breast to look inflamed due to blockage of lymphatic vessels. It requires immediate medical attention.
• Rare Diagnoses
  • Hamartoma: A benign growth that can occur in the breast, composed of a mixture 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, usually benign but can be malignant in rare cases.

Each diagnosis has a unique set of characteristics, risk factors, and implications for patient care. A thorough clinical evaluation, imaging studies (such as mammography or ultrasound), and sometimes biopsy are necessary to determine the nature of a breast lump accurately.