chronic

Breast Lump or Mass

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

Breast Cancer - StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK482286/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class GS26 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care

Verified against2 documents

No dose - referral pathway, no medicine given in primary care
Breast Lump or Mass - disease-level clinical article (breast-lump-clinical.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (6)

An acutely tender lump is more suggestive of an abscess or hematoma after trauma [abscess · hematoma · skin nodule]
Cancerous masses are rarely painful, though pain does not exclude malignancy
Recent pregnancy or breastfeeding raises suspicion for a lactation-related cause such as mastitis or galactocele
Associated weight loss, breathlessness, or bone pain raise concern for malignancy [bone pain · breathlessness · weight loss]
Nipple discharge or other nipple changes can point to certain less common breast tumors [nipple discharge]
Patients who do not self-examine may not notice a lump until it has grown considerably

Signs — what you find (5)

A breast mass exam records its site, size and shape, plus tenderness, fluctuance, mobility, texture, and any pulsatility [breast lump]
On inspection, clinicians check for skin change, nipple discharge, a visible mass, breast asymmetry, and skin tethering [nipple discharge]
Most palpable masses are found in the upper outer quadrant, where most breast tissue lies
Axillary and supraclavicular palpation may reveal enlarged, tender, or firm lymph nodes
In young women, a worrisome exam finding is a mass that is enlarged, fixed, hard, and unevenly textured

Tests (12)

BI-RADS scoring links the imaging appearance to the likelihood of malignancy and suggests a management approach
BI-RADS categories run from 0 to 6
On mammography a mass must be seen on two views, with convex outer borders, and be denser centrally
Circumscribed margins favor a benign lesion, while microlobulated, indistinct, or spiculated margins favor malignancy
In women 40 and older, mammography's sensitivity for identifying an abnormality is about 86% to 91%
Ultrasound picks up about 40% of benign palpable masses that mammography misses
Under age 30, a low-suspicion lump can simply be followed for 1 to 2 menstrual cycles before imaging
Ultrasound is favored under 30 because breast tissue is denser and cancer is less common at that age
MRI is not routinely used, given its high cost, false positives, and lower specificity
Core biopsy is generally favored over fine-needle aspiration for better tissue yield and accuracy
A cancer first found by fine-needle aspiration still needs core-needle confirmation before treatment starts
Male breasts are imaged with ultrasound rather than mammography

If not this — what else fits (5)

In women under 25, benign causes such as fibroadenoma, cysts, hamartoma, fat necrosis, or an abscess predominate
From age 25 onward, benign masses remain common but malignancy becomes more likely with increasing age
Considered causes include breast cyst, abscess, carcinoma, fibrocystic change, fibroadenoma, lactating adenoma, phlegmon, a prominent lactiferous sinus, traumatic fat necrosis, hematoma, and hamartoma
A central mass behind the nipple in a male may represent gynecomastia rather than a tumor
Gynecomastia can result from chromosomal disorders, liver failure, paraneoplastic syndromes, or drugs like spironolactone and calcium channel blockers

SourceStatPearls "New Palpable Breast Mass" - disease-level clinical article

Presentation findings are traced to the source above.

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line

Adult dose and duration

A breast lump needs clinical examination and imaging to distinguish benign findings (cyst, fibroadenoma) from cancer; the GP's role is prompt referral and clear advice, not empirical drug treatment. - Refer, with advice

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

A breast lump needs clinical examination and imaging to distinguish benign findings (cyst, fibroadenoma) from cancer; the GP's role is prompt referral and clear advice, not empirical drug treatment.

Cautions

No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.
RED FLAG - Suspicious physical examination characteristics of a mass include an enlarged, fixed, hard, and heterogeneous texture.
RED FLAG - Warning signs associated with a breast mass that require prompt evaluation include nipple discharge, skin changes, or rapid growth.
RED FLAG - A hard, fixed or irregular lump, skin dimpling, nipple retraction or ulceration, or an axillary lump: refer urgently.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.