[Diagnostic evaluation of breast nodules]

Nowadays many women see a gynaecologist because of breast problems; in fact in the last years the frequency and the women's capacities to perform a breast self examination are increased. The prognosis efficacy and the improvement to detect breast nodules thanks to the mammary self palpation nowadays are still difficult to evaluate. Therefore it is important that the family doctor begin with anamnestic data, goes on with an accurate medical examination and, if necessary, sends the patients to perform assessments, clinical and instrumental ones. At the first ambulatory examination we can accurately diagnose the 90% of breast masses thanks to a diagnostic triad, consisting of: bilateral clinical evaluation; bilateral mammography (performed in antero-posterior and in latero-lateral scanning); fine needle aspiration cytology. In fact a careful mammography certainly has reduced mortality due to breast cancer. An useful approach to diagnose breast cancer in all women, especially under thirty years old, is fine needle aspiration cytology, that allows us to avoid surgical treatment in case of benign pathology. If by these approaches a mammary nodule is not definitely diagnosed (impalpable lesion but suspicious by mammography) it needs surgical excision biopsy, in any case, at any age. Another diagnostic possibility is surely ultrasound examination, that is useful to diagnose inflammatory disease and to differentiate cystic or solid lesions. Other diagnostic procedures are thermography, diaphanoscopy and galactography. Because of the multiple and increasing frequency of benign or malignant breast disease, the role of the family doctor is very important.(ABSTRACT TRUNCATED AT 250 WORDS)