# Breast Lump or Mass - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - 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 date: 2026-08 ## Verified against - No dose - referral pathway, no medicine given in primary care - Breast Lump or Mass - disease-level clinical article (breast-lump-clinical.txt) ## Treatment metadata - No drug therapy in primary care (Referral & Advice) ## Complete treatment card ```text BREAST LUMP OR MASS 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 Review status: REVIEWED against No dose - referral pathway, no medicine given in primary care, Breast Lump or Mass - disease-level clinical article (breast-lump- clinical.txt) (2026-08) 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 Source StatPearls "New Palpable Breast Mass" - disease-level clinical article Status traced to the source above 1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE) [1st line] Adult 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 Peds Children follow the same pathway: recognise and refer. No primary-care medicine is implied. 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. Caution 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. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)