Differential Diagnosis for a Painful Breast Mass
- Single most likely diagnosis
- Fibroadenoma: This is a common benign breast tumor, especially in young women. The mass is described as soft, mobile, and tender, which is consistent with a fibroadenoma. The fact that the mass remains palpable after aspiration of a cystic component suggests a solid component, which is typical of fibroadenomas.
- Other Likely diagnoses
- Breast cyst with a solid component: Although the ultrasound showed a thin-walled, fluid-filled cyst, the presence of a solid component cannot be ruled out. The fact that the mass is still palpable after aspiration suggests that there may be a solid component to the cyst.
- Phyllodes tumor: This is a rare tumor of the breast that can be benign, borderline, or malignant. It can present as a rapidly growing mass, but it can also be slow-growing and mobile, similar to the mass described in this patient.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Breast cancer: Although breast cancer is less common in young women, it is still a possibility and should not be missed. The fact that the mass is palpable and tender does not rule out cancer, and further evaluation with imaging and biopsy may be necessary.
- Inflammatory breast cancer: This is a rare and aggressive form of breast cancer that can present with a palpable mass, skin changes, and nipple discharge. Although the patient does not have skin changes or nipple discharge, inflammatory breast cancer should still be considered.
- Rare diagnoses
- Hamartoma: This is a rare benign breast tumor that can present as a palpable mass. It is usually asymptomatic, but it can cause pain and tenderness.
- Lipoma: This is a rare benign breast tumor that can present as a palpable mass. It is usually asymptomatic, but it can cause pain and tenderness.
- Pseudoangiomatous stromal hyperplasia (PASH): This is a rare benign breast lesion that can present as a palpable mass. It is usually asymptomatic, but it can cause pain and tenderness.