Lesions may be painless or painful and occasionally accompanied by nipple discharge or skin changes.
The term “space-occupying lesions of the breast” is compared with the preferred nodes for a palpable independent area of ??any size. A lesion of the breast can be detected or during breast self-examination or the physician during routine physical examination at random by the patients. Lesions may be painless or painful and occasionally accompanied by nipple discharge or skin changes. Although the etiology of breast cancer is the most feared cause most (about 90%) are nodes of the non-malignant breast. The most common causes are: fibrocystic changes fibroadenomas fibrocystic changes (fibrocystic disease formerly called) is a broad term that refers to mastalgia, cysts chest and unrecognizable figure refers masses (usually in the upper outer part of the breast). These changes may occur individually or together. Breasts have a nodular and dense texture and are often sensitive when they are scanned. Fibrocystic changes cause most frequently reported symptoms of chest and have many causes. Breast disease is not associated with an increased risk of cancer. Repeated stimulation by estrogen and progesterone may contribute to fibrocystic changes associated with early menarche, late laboring woman (> 30 years) or nulliparous are more common in women. Fibroadenomas are usually smooth, rounded, mobile, painless masses; they can be mistaken for cancer. They develop normally in women during their reproductive years and may decrease over the years. Juvenile fibroadenoma are a variant that occurs in young people, and continue to grow, unlike fibroadenomas in older women with time. The risk of breast cancer does not appear to, and slightly increased by simple fibroadenomas with complex fibroadenomas. the breast (mastitis) infections cause pain, erythema and swelling; an abscess can cause a single mass. Infections outside the postpartum period or without connection with a penetrating trauma are rare. They can occur after breast surgery. Mastitis in childbirth, mostly caused by Staphylococcus aureus can cause a massive inflammatory reaction and severe pain of the breast and are sometimes complicated by an abscess. If there is an infection in other circumstances, the possibility of underlying malignancy should be excluded immediately. A galactocele is a round, easily movable milk filled cyst that occurs most often within the first 6-10 months after lactation. In rare cases such cysts can infect. Malignancies of different types can manifest as masses. In approximately 5% of patients experience pain. Clarification history During the medical history of the current disease should clarify how long the node is already present, if he comes and disappears or if it is painful. The earlier onset of lesions and the result of their investigation should be queried. During the review of the organ systems is examined whether nipple discharge exists and whether this is spontaneous or only in response to a manipulation of the breast occurs and whether this is clear, milky or bloody. It should be on symptoms of cancer at an advanced stage (eg. As weight loss, fatigue, bone pain) shall be respected. For history involves clarifying risk factors for breast cancer, including breast cancer diagnoses past, radiation therapy of the chest region before age 30 (eg. As in Hodgkin’s lymphoma). Family history of breast cancer cases in Verwanden first degree (mother, sister, daughter) be asked and clarified with a positive family history, whether the relatives of one of the two known breast cancer genes, BRCA1 or BRCA2, besitzt.Körperliche investigation focuses Physical examination the breast and the adjacent tissue. The chest is examined for changes in the skin above the mass and nipple discharge. Skin lesions embracing redness, rash, overemphasis on the normal skin structures and approaches of edema, sometimes referred to as peau d’orange (orange peel), respectively. The mass is in terms of size, painfulness, consistency (i. E. Hard or soft, smooth or irregular) and agility sampled (floating or fixed to the skin or chest wall). The axillary, supraclavicular and infraclavicular areas on masses and adenopathy untersucht.Warnzeichen Certain findings are particularly important: fixed to the skin or chest wall mass Rock hard, irregular mass denting the skin caked or fixed axillary lymph nodes Bloody or spontaneous nipple discharge thickens, reddened skin interpretation the findings painful, painful pressure, rubbery masses in women with similar changes in the history and in women of childbearing age suggest fibrocystic changes. Serious findings (warning signs) point to a carcinoma. However, the characteristics of benign and malignant lesions overlap considerably, including the presence or absence of risk factors. Therefore, and because the failure to recognize a cancer has serious consequences, most patients requesting examinations, breast cancer definitely ausschließen.Untersuchungen First, an attempt is made to differentiate solid from cystic masses because cysts are rarely cancerous. Usually, an ultrasound is performed. Sometimes cystic lesions appearing aspirated (z. B. if these symptoms cause) and solid masses using mammography and radiologically controlled biopsy clarified. Some doctors clarify masses from using needle aspiration; when no liquid is obtained or the aspiration does not eliminate the space requirement of a mammogram followed radiologically controlled biopsy is initiated. aspirated from a cyst fluid is examined by cytology only under the following circumstances: It is cloudy or grossly bloody. Minimum liquid is removed from a mass remains after aspiration. Patients will be examined again after 4-8 weeks. If the cyst is not palpable, it is considered benign. Takes the cyst again, it will again aspirated and any liquid derived returned regardless of appearance for cytologic diagnosis. A third recurrence or persistence of mass after initial aspiration (also with negative cytology) requires a biopsy. The therapy treatment depends on the particular cause. A fibroadenoma is usually removed when it is growing or causing symptoms. Fibroadenomas can usually be excised under local anesthesia, but often they also occur again. Patients with fibroadenomas, which must not be removed should be examined regularly for changes. Have in a patient multiple fibroadenomas proven histologically benign, they can opt for a re-emergence against excision. Since juvenile fibroadenomas tend to grow, they should be removed. Paracetamol, NSAIDs and sports bras (for injury reduction) can be used for symptom reduction in fibrocystic changes. Vitamin E and evening primrose oil can be effective. Summary Most lesions of the breast are not malignant. The clinical findings of benign and malignant diseases often overlap, so that an investigation should be carried out normally.