Age-related breast diagnosis

Of the three commonest symptoms found in 3294 patients referred to a specialty breast clinic--mass, nodularity and pain--only nodularity was age related. Only 30% of the patients had a clinically localized abnormality, and only 19% of these abnormalities were suggestive of carcinoma. The majority of suggestive lesions were in women over 55 years of age. Of the patients seen because of a breast lump, 46% were found to have a significant mass. Most abnormalities were found in patients presenting with a mass or nipple discharge, and the significance was age related. Symptoms associated with the lowest rate of positive biopsies were nodularity, pain and skin or nipple changes. The biopsy and cancer rates were significantly age related. The cancer rate in women 40 years of age and under was 0.8%, between 41 and 55 the rate was 5%, and in those over 55 it was 21%. The predominant finding in young women was a fibroadenoma. In the middle age range fibrocystic change was most common, and in postmenopausal women most of the lesions were malignant.