Conditions of the breast are common and cause a great deal of concern for many women.
Evaluation involves a thorough history and physical examination and often includes assessment with ultrasonography and mammography. MRI is occasionally used to further evaluate these disorders.
1. Breast pain/mastalgia
4. Breast implants
5. Breast masses
6. Nipple discharge
Breast pain can be related to the menstrual cycle – cyclic or noncyclic or extramammary (nonbreast)-
Noncyclic breast pain is often related to tumors, trauma, infection, cysts, history of surgery or many medications.
Non breast pain includes chest wall trauma, fibromyalgia, shoulder pain, neck disorders, herpes zoster(shingles) and even heart disease.
These are usually unilateral and the diagnosis is made on clinical exam. Infections are commonly associated with breast feeding and treatment involves the use of antibiotics.
If the infection does not respond to antibiotics and an abscess is not found INFLAMMATORY cancer should be considered.
This is more frequently with nipple piercing procedures. Other sources of breast trauma include sports trauma, accidents and physical abuse.
These may complicate evaluation of a breast mass or cancer screening. MRI is a useful adjunct in the evaluation of a woman with breast implants in whom mammography or ultrasound results are inconclusive.
All masses should be evaluated.
Even the most innocent appearing masses may in fact be cancerous!
Many factors exist which increase an individual’s risk of developing breast cancer.
Genetic disorders including the BRCA 1& 2 gene defects are always considered
This is usually a benign finding, but can indicate an endocrine dysfunction or cancer.
Underactive thyroid function is often related.
Evaluation by the health provider is important to rule out more serious causes.
We recommend annual screening beginning at age 40.
We do not support the use of thermography at Associated Gynecology.
The American College of Gynecology continues to support breast self exam because of the potential to detect palpable breast cancer.
Mammography is advised starting at age 25 in women with a strong family history of breast cancer and positive genetic studies( BRAC 1 & 2) The amount of radiation from a screening mammogram is minimal. The amount of radiation from a CT sacn of the abdomen is ~ 3,000 to 4000 millirads and from a screening mammogram is ~ 7 to 20 millirads.