Concluded Case

Palpable non tender lump of 3×2 inches in upper quadrant of rt breast since 5_6 days. Painful,tender lump in lower quadrant between 6&9 o'clock since 7_8 days. All s/s of inflammation present in lower lump which is visible in pic. Pt is non diabetic, non lactating. What's the diagnosis dear curofians? Elaborate point vise.

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Concluded answer

Looks like breast abscess with retracted nipple . Should be investigated to rule out malignancy. Mamography usg breast FNAC. Start on antibiotics anti inflammatory.

All Answers

Size of the other breast is not mentioned , nor compared with the affected side. The swelling and the local signs inflammation are suggestive of abscess of the breast. But with the retracted nipple one should ruleout malignancy, by aspiration with a big bore needle.

Sir,size of the other breast is 40% less as compaired to rt one. Why have put this as nipple is retracted which won't be with abscess. And the lump in upper quadrant is non tender. I have done I&D today morning onlly of the abscess which one can see in the pic. There is no palpable lymph node. The only query is whether malignancy + abscess together??
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Looks like breast abscess with retracted nipple . Should be investigated to rule out malignancy. Mamography usg breast FNAC. Start on antibiotics anti inflammatory.

Thank you doctor
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Differentials will include 1.Multicentric carcinoma breast. 2.chronic granulomatous mastitis. Age is not mentioned so imaging studies most likely mammography to r/o impalpable lump in same and opposite breast. Followed by trucut biopsy of suspicious lump. If malignancy a Metastatic work up and opinion of medical oncologist. If chronic granulomatous mastitis physician reference to r/o contraindications for steriod. Start wysolone and taper it gradually.

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7-8days history in lower lump Enlarged size of breast 40% more than other side Painful tender lump All signs and symptoms of inflammation present MOST LIKELY DIAGNOSIS IS BREAST ABSCESS. Differential diagnosis is inflammatory breast carcinoma as nipple retraction is present ASPIRATION With a big bore needle . If Frank pus comes out Incision and drainage under Short G.A ..If aspirate is suspicious of malignancy accordingly treatment is required

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Non tender bresay lump ..and same tIle all s/s of inflammation present ... duration is 7 days. Unlikely a 3inch× 2 inch growth in 7 days. ..if it happens ..then it could be an abscess. Non tender swelling could be fibroma. But as view in picture ..venous engorgement seen. Chance of phylloides Timor of breast.

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Lump in right upper quadrant my have been unnoticed because it was non tender, may have been present for long, retracted nipple suggest malignancy and long duration of lump. Inflamed lower lump lead to its identification. USG and mammogram to be done of both breasts with lypmh node examination.

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Looks like inflammatory breast disease..more like breast abscess. But retracted nipple goes in favour of malignancy. Start antibiotics and anti inflammatory drugs meanwhil get her USG Breast; mammography and FNAC by large bore needle.

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Mam age of the pt..whether lactating or not Reddness painful mass mostly in favour of access not retractednipple.so malignancy to.be ruled out. Adv mammogram. FNAC with large boreneedle to rule out malignancy

Gopala I have already mentioned non lactating & non diabetic.
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May be Breast abscess Must investigate for inflammatory carcinoma as there is retraction of nipple present.Do biopsy, do Mammography and if required do CT and then plan out treatment

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mam it appears to b of inflammatory origin.start antibiotics n counsel d patients at d course of management. mammography has to b done as age is 35 n nipples retracted

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