### 44 years old lady presents to OPD with pain right breast since 15 days. On examination, a vague lump like hard induration can be felt which is of the size 6 cm X 5 cm approximately, not fixed to the skin, tender, no sinus present, no discharge present, no dimpling present and normal nipple. The hard induration is not discrete but vague. The right axilla is normal with no lymphadenopathy. Theft breast has also been compared which seems normal in all aspects. USG Both Breasts have been suggested. How to approach this case ??? What treatment should be given ???

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From clinical history seems Carcinoma is unlikely. However considering age of the patient one should go for USG and Mammography. If any suspicion for Carcinoma then confirm it with FNAC biopsy. At the same time also advice Blood for CBC and ask for fever and examine for local temperature. She might have Fibroadenoma or Abcess. Presumptively treat in the line of abcess with Broad spectrum antibiotic and pain killers until reports come.

Fibroadenosis needs follow up for malignant changes which is common
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It might be a mastitis as fibrosdenoma is not painful usually.check her complete blood count ,ask for fever ?take detail history. Give anti inflammatory and antibiotics if needed.do an bilateral usg breast to rule out any lump or abscess

Breast Abscess! Confirm by Needle Aspiration of pus , then proceed with Incidion Drainage! If needle aspiration is negative, a trucut needle biopsy will confirm the lesion whether its Fibroadenoma or Ca and treat accordingly!

With this clinical background one should go for USG , if indicated Mammogram & FNAC( if indicated further Biopsy & HP ) to reach at the diagnosis & treat accordingly

Do needle aspiration to rule out ABCESS. And f.n.a.c with mammography may be infected fibroadenoma or breast abcess

As its a painful swelling it might be a breast abscess or mastitis go for usg and FNAC to R/O malignancy

? Fibroadenoma Needle aspiration for pus culture. FNAC and mammography to rule out otherwise.

Thanks Dr Ramesh.
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CLINICOPATHOLOGICAL EVALUATION. FOR FURTHER MANAGEMENT.. MAMMOGRAPHY.. FNAC..

Tnx Dr Ramesh Kumar
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Aspirate under local.DO mammography. FNACTREAT ACCORDINGLY

Fibroadenoma or mastitis ... Confirm with Mammography

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