Common Breast Problems.

Area of Science:

• Radiology
• Oncology
• Endocrinology

Background:

• Breast symptoms like masses, pain (mastalgia), and discharge are frequent in outpatient settings, causing patient distress.
• Initial evaluation involves clinical history and physical examination, with imaging and biopsy crucial for suspicious breast masses.

Purpose of the Study:

• To provide a diagnostic framework for evaluating common breast symptoms.
• To guide the appropriate use of imaging and biopsy for breast masses.
• To outline the diagnostic pathways for mastalgia and nipple discharge.

Main Methods:

• Clinical history and physical examination.
• Diagnostic mammography and ultrasonography, with ultrasonography favored for women under 30.
• Core needle biopsy with imaging guidance for suspicious masses.
• Classification of nipple discharge (pathologic vs. physiologic) and targeted imaging.

Main Results:

• Mammography is standard, but ultrasonography is more sensitive in younger women.
• Biopsy is indicated for suspicious findings on imaging or physical exam.
• Mastalgia is rarely malignant; topical NSAIDs are a first-line treatment.
• Pathologic nipple discharge requires imaging; galactorrhea is typically physiologic and linked to endocrinopathies or medications.

Conclusions:

• A systematic approach to breast symptoms ensures timely diagnosis and appropriate management.
• Imaging modalities and biopsy are essential for evaluating breast masses.
• Mastalgia and nipple discharge require specific diagnostic pathways to differentiate benign from potentially serious conditions.