Female breast cancer
Alerts and Notices
Synopsis
Risk factors associated with breast cancer include genetic predisposition (eg, BRCA1, BRCA2, PTEN, TP53 mutations; very large studies show that mutations in dozens of genes may be associated with increased breast cancer risk), increasing age, Northern European descent, obesity in postmenopausal women, family history of breast / ovarian / peritoneal cancer, and personal history of ovarian, breast, or peritoneal cancer.
In countries with established screening programs, the majority of breast cancers present due to abnormal mammogram findings. Despite this, almost 1 in 6 women who are diagnosed with breast cancer present with a breast mass not detected by mammogram, and a little under 1 in 3 will present with a mass that developed in the interval between mammograms.
Breast cancer typically presents as a painless, immobile breast lump or abnormality found on mammography. In more advanced cases, it can present with bloody nipple discharge, axillary lymphadenopathy, thickening and erythema of the skin (peau d'orange appearance), and metastatic disease commonly found in bone, liver, and lungs. Metastasis to the bone marrow may be associated with anemia. Ductal carcinoma in situ (DCIS) is considered a precursor lesion and is confined to breast ducts and lobules.
The diagnosis of breast cancer is made based on malignant-appearing cells found on biopsy. The treatment of breast cancer varies according to stage of disease as well as histologic and genetic subtype of the malignancy. Common histologic subtypes include infiltrating ductal carcinoma, infiltrating lobular carcinoma, and mixed ductal / lobular carcinoma. Tumor expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor 2 (HER2) is used to predict outcomes and guide treatment.
Related topic: cutaneous breast cancer
Codes
ICD10CM:C50.919 – Malignant neoplasm of unspecified site of unspecified female breast
SNOMEDCT:
254837009 – Malignant tumor of breast
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Breast cyst
- Fibroadenoma
- Fibrocystic tissue (see fibrocystic disease of the breast)
- Fat necrosis
- Galactocele
- Breast sarcoma
- Lymphoma
- Paget disease
- Phyllodes tumors
- Cutaneous breast cancer
- Ductal carcinoma in situ
- Microinvasive breast cancer
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:04/17/2019
Last Updated:03/21/2023
Last Updated:03/21/2023