Breast disease in young women. When is biopsy indicated?

The low incidence of breast cancer among women under the age of 25 years may not justify the routine excision biopsy of breast lumps in this age group. A policy of conservative management has been tested in 70 women between the ages of 17 and 25 years. Excision biopsy was eventually performed in 23 women - fewer than half of those with a palpable mass. No cancerous lesions were found; a high proportion of lumps removed were fibroadenomas. The accuracy of clinical diagnosis was high and, of 31 breast lumps diagnosed as benign mammary dysplasia, more than three-quarters resolved without surgical intervention. Indications for surgery are defined. Because breast cancer does occasionally occur in this age group, accurate clinical diagnosis and review are essential components of conservative management.