ABSTRACT: Breast-related symptoms are among the most common reasons women present to obstetrician–gynecologists. Obstetrician–gynecologists are in a favorable position to diagnose benign breast disease in their patients. The purpose of a thorough understanding of benign breast disease is threefold: 1) to alleviate, when possible, symptoms attributable to benign breast disease, 2) to distinguish benign from malignant breast disease, and 3) to identify patients with an increased risk of breast cancer so that increased surveillance or preventive therapy can be initiated. Obstetrician–gynecologists may perform diagnostic procedures when indicated or may make referrals to physicians who specialize in the diagnosis and treatment of breast disease. The purpose of this Practice Bulletin is to outline common benign breast disease symptoms in women who are not pregnant or lactating and discuss appropriate evaluation and management. The obstetrician–gynecologist’s role in the screening and management of breast cancer is beyond the scope of this document and is addressed in other publications of the American College of Obstetricians and Gynecologists 1 2 3.
- Jump to
- Search page
-
Resources
Resources Close
By reading this page you agree to ACOG's Terms and Conditions. Read terms
Nonmembers: Subscribe now to access exclusive ACOG Clinical content, including:
ACOG Clinical is designed for easy and convenient access to the latest clinical guidance for patient care. Developed with members’, physicians’, and women’s health care professionals’ needs in mind, user-friendly features include:
- Easy, advanced search function to find the most relevant guidance
- Enhanced document presentation
- Advanced features and functionality
You’ll find clinical content written and peer reviewed by experts and valuable information that spans guidance on the diagnosis and management of the full spectrum of obstetric and gynecological conditions and clinical management issues.
Note for Life Fellows: Annual membership dues are waived but there is a discounted annual subscription fee of $95 for access to publications such as the Green Journal, Practice Bulletins, and Committee Opinions. Individual subscriptions include print and online access. Subscribe today.
Subscribe![Fig. 1. Management of a palpable mass in women younger than 30 years. Abbreviations: BI-RADS, Breast Imaging Reporting and Data System; NCCN, National Comprehensive Cancer Network. *Physical examination every 3–6 months with or without diagnostic imaging every 6–12 months for 1–2 years. Follow-up interval may be varied depending on level of suspicion. † See BSCR-11 in National Comprehensive Cancer Network. Breast cancer screening and diagnosis. Version 1.2015. NCCN Clinical Practice Guidelines in Oncology [after login]. Fort Washington (PA): NCCN; 2015. Available at: http://www.nccn.org/professionals/physician_gls/pdf/breast-screening.pdf . Retrieved February 23, 2016. ‡ Follow-up interval may be varied depending on level of suspicion. § See BSCR-5 in National Comprehensive Cancer Network. Breast cancer screening and diagnosis. Version 1.2015. NCCN Clinical Practice Guidelines in Oncology [after login]. Fort Washington (PA): NCCN; 2015. Available at: http://www.nccn.org/professionals/physician_gls/pdf/breast-screening.pdf . Retrieved February 23, 2016. Modified from Pearlman MD, Griffin JL. Benign breast disease. Obstet Gynecol 2010;116:747–58 .](/-/media/project/acog/acogorg/clinical/images/practice-bulletin/articles/2016/06/diagnosis-and-management-of-benign-breast-disorders/pb164-20160600-fig1.png)
![Fig. 2. Management of a palpable mass in women aged 30 years and older. Abbreviations: BI-RADS, Breast Imaging Reporting and Data System; NCCN, National Comprehensive Cancer Network. *Physical examination every 3–6 months with or without diagnostic imaging every 6–12 months for 1–2 years. Follow-up interval may be varied depending on level of suspicion. † See BSCR-5 in National Comprehensive Cancer Network. Breast cancer screening and diagnosis. Version 1.2015. NCCN Clinical Practice Guidelines in Oncology [after login]. Fort Washington (PA): NCCN; 2015. Available at: http://www.nccn.org/professionals/physician_gls/pdf/breast-screening.pdf . Retrieved February 23, 2016. ‡ Follow-up interval may be varied depending on level of suspicion. Modified from Pearlman MD, Griffin JL. Benign breast disease. Obstet Gynecol 2010;116:747–58 .](/-/media/project/acog/acogorg/clinical/images/practice-bulletin/articles/2016/06/diagnosis-and-management-of-benign-breast-disorders/pb164-20160600-fig2.png)
![Fig. 3. Management of nipple discharge. Abbreviations: BI-RADS, Breast Imaging Reporting and Data System; hCG, human chorionic gonadotropin; TSH, thyroid-stimulating hormone. *See BSCR-4 and BSCR-10 in National Comprehensive Cancer Network. Breast cancer screening and diagnosis. Version 1.2015. NCCN Clinical Practice Guidelines in Oncology [after login]. Fort Washington (PA): NCCN; 2015. Available at: http://www.nccn.org/professionals/physician_gls/pdf/breast-screening.pdf . Retrieved February 23, 2016. † Either ductography or magnetic resonance imaging can be performed to guide the excision. Excision is indicated for abnormal discharge even if ductography is negative. The National Comprehensive Cancer Network algorithm also includes an option for surveillance with 6-month follow-up and imaging for 1–2 years. Modified from Pearlman MD, Griffin JL. Benign breast disease. Obstet Gynecol 2010;116:747–58 .](/-/media/project/acog/acogorg/clinical/images/practice-bulletin/articles/2016/06/diagnosis-and-management-of-benign-breast-disorders/pb164-20160600-fig3.png)
