BREAST PAIN

Ask the following questions:

1. Is it unilateral or bilateral? Unilateral breast pain should make one think of an infectious process or advanced carcinoma. Bilateral breast pain should make one think of pregnancy. This may be a normal pregnancy or an ectopic pregnancy.
2. Is there an associated mass? A tender breast mass is most likely a mastitis or abscess, but advanced carcinoma can also produce a tender breast mass. If there are tender masses in both breasts, chronic cystic mastitis should be considered.
3. Is there a discharge? A bloody discharge associated with a tender breast should make one think of a carcinoma.
4. Is there fever? Fever associated with a tender breast or tender breast mass is most likely acute mastitis or abscess.

DIAGNOSTIC WORKUP

If there is a fever and discharge, a culture and sensitivity of the discharge should be done before beginning antibiotics. When there is a localized tender mass, referral to a general surgeon should be made. Patients with bilateral breast pain without any masses identified should have a pregnancy test. If this is negative and the pain is associated with the menstrual cycle, they should be treated as having premenstrual tension. A gynecologist may need to be consulted. If there is persistent bilateral breast pain in a young unmarried female, perhaps a psychiatrist should be consulted.

Book Source Details

• Book Title: Algorithmic Diagnosis of Symptoms and Signs
• Author(s): R. Douglas Collins
• Year of Publication: 2003
• Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.

Other Book Chapters Related to Breast pain

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Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2008 Williams & Wilkins.

More About Causes of Breast pain

• Back to symptom: Breast pain: Introduction (review 77 causes)
• Next Book Extract About Breast pain: Breast Pain & Discharge (In a Page: Signs and Symptoms)
• All Book Extracts: All Online Book Extracts for Breast pain

More About This Book: Title: Algorithmic Diagnosis of Symptoms and Signs Authors: R. Douglas Collins Publisher: Lippincott Williams & Wilkins Copyright: 2003 ISBN: 0-7817-3805-9

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