Differential Diagnosis for Painful Breast Lump

• Single most likely diagnosis
  • Fibrocystic changes: This is the most common cause of painful breast lumps, characterized by lumpy or rope-like breast tissue. It is often associated with hormonal fluctuations during the menstrual cycle.
• Other Likely diagnoses
  • Breast cyst: A fluid-filled sac within the breast that can cause pain, especially if it becomes large or ruptures.
  • Fibroadenoma: A benign tumor that can cause a painful lump, especially in younger women.
  • Mastitis: An infection of the breast tissue, which can cause pain, swelling, and redness, often associated with breastfeeding.
  • Trauma: Injury to the breast can cause a painful lump, such as a hematoma.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Breast cancer: Although less common, breast cancer can present as a painful lump, and it is crucial to rule out this diagnosis, especially in older women or those with a family history.
  • Inflammatory breast cancer: A rare and aggressive form of breast cancer that can cause pain, swelling, and redness, often mistaken for an infection.
  • Abscess: A collection of pus in the breast tissue, which can cause severe pain and requires prompt drainage.
• Rare diagnoses
  • Phyllodes tumor: A rare tumor that can be benign, borderline, or malignant, often presenting as a rapidly growing lump.
  • Fat necrosis: A condition where fatty tissue in the breast dies, often due to trauma, and can cause a painful lump.
  • Granulomatous mastitis: A rare inflammatory condition that can cause painful lumps and is often associated with autoimmune disorders.