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Working Diagnosis

Working Diagnosis. Breast mass probably malignant 2x2 enlarging mass, hard, non-tender, movable mass with irregular margins. Clinical Stage. Stage I (T1N0N0) T1-tumor 2 cm or less in greatest dimension N0-No regional lymph node metastasis M0-No distant metastasis.

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Working Diagnosis

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  1. Working Diagnosis Breast mass probably malignant • 2x2 enlarging mass, hard, non-tender, movable mass with irregular margins

  2. Clinical Stage • Stage I (T1N0N0) T1-tumor 2 cm or less in greatest dimension N0-No regional lymph node metastasis M0-No distant metastasis

  3. If there is a palpable 2x 2 cm hard supraclavicular lymph node, what would be the stage? • Stage IIIC (Any T N3 M0) N3c- Metastasis in ipsilateralsupraclavicularlymphnode

  4. Differential Diagnosis • Benign Breast mass 1. Fibroadenoma- careful ultrasound core needle biopsy will provide an accurate diagnosis 2. Cysts-diagnosed by FNAB 3. Sclerosingadenosis- may mimic canceron PE, mammography, and gross pathologic examination. Excisional biopsy and histologic exam for definitive diagnosis.

  5. Differential Diagnosis • Inflammatory 1. Hidradenitissuppurativa- chronic inflammatory condition of the nipple areola complex or axilla that originates within the accessory areolar glands of Montgomery. -may mimic invasive breast cancer -Antibiotic tx and with incision and drainage

  6. Work ups • Mammography -evaluate women with abnormal finding such as breast mass nipple discharge -Findings suggestive of a breast cancer: a. solid mass with or without stellate features b. assymetric thickening of breast tissue c. clustered microcalcifications d. fine stippled calcium in and around a suspicious lesion

  7. Work ups • FNAB -for clinically and mammographically suspicious mass, sensitivity and specificity approaches 100% -Definitive diagnosis

  8. Work ups • Ultasound -second only to mammography in frequency for breast imaging -important method for resolving equivocal mammography findings -Findings: a. Cystic lesions- well circumscribed, with smooth margins, and echo-free center b. Benign breast mass- smooth contours, round or oval shape, weak internal echoes, well defined anterior and posterior margins -Useful for guiding FNAB of non palpable mass

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