Tag Archives: breast

Main Clinical Manifestations of Breast Cysts

Breast cysts are fluid-filled, epithelial-lined cavities that develop within terminal ducto-lobular units under hormonal influence. They may be solitary or multiple and are most prevalent in perimenopausal women. Symptom intensity correlates with cyst size, tension, and associated inflammation.

  1. Cyclic or non-cyclic mastalgia
    A well-localised, dull or throbbing pain that increases during the luteal phase; larger cysts produce constant discomfort unrelated to menses.
  2. Palpable, resilient mass
    A smooth, round, mobile lump with distinct borders that may feel fluctuant; tension within the cyst creates a firm “rubber-ball” consistency.
  3. Rapid variation in size
    Cysts may enlarge within days and regress spontaneously, distinguishing them from solid tumours that grow progressively.
  4. Transillumination
    A discrete, well-circumscribed area of light transmission is visible when examined in a darkened room; this sign is lost when cyst wall calcifies.
  5. Nipple discharge
    Clear, serous, or green-brown fluid may be expressed from a single duct; bloody aspirate mandates cytological evaluation to exclude intracystic papilloma or carcinoma.
  6. Tenderness to pressure
    Compression against the chest wall or during mammographic paddles elicits sharp pain; spontaneous relief often follows ultrasound-guided aspiration.
  7. Axillary discomfort
    Reactive, tender lymph nodes < 1 cm are common; firm or matted nodes require biopsy to exclude concurrent malignancy.
  8. Acute inflammatory episode
    Sudden increase in size with erythema and localised heat suggests secondary infection or hemorrhage into the cyst cavity.
Symptom / SignTypical Presentation
MastalgiaCyclic or constant, well-localised
Palpable massSmooth, round, mobile, fluctuant
Size variationRapid enlargement and regression
TransilluminationPositive in tense, thin-walled cysts
DischargeSerous/green; blood → cytology
Pressure tendernessSharp pain, relieved by aspiration
Axillary nodesTender, small; firm nodes need biopsy
InflammationSudden enlargement, erythema, heat

Related articles：

  1. Main Clinical Manifestations of Breast Fibroadenoma
  2. Main Clinical Manifestations of Breast Tumours
  3. Main Clinical Manifestations of Breast Hypoplasia
  4. Main Clinical Manifestations of Breast Cancer
  5. Main Clinical Manifestations of Mastitis
  6. Main Clinical Manifestations of Nipple Inversion

Main Clinical Manifestations of Breast Hypoplasia

Breast hypoplasia denotes under-development of glandular parenchyma beyond two standard deviations from age-specific norms. The condition may be unilateral or bilateral, isolated or associated with systemic syndromes. Recognition is based on quantitative and qualitative deviations from expected breast morphology rather than on isolated patient perception.

  1. Deficient breast volume
    A mammary projection that remains ≤ Tanner stage II after age 16 years, or a breast circumference difference ≥ 150 mL compared with the contralateral side, defines objective hypoplasia.
  2. Asymmetry
    Unilateral hypoplasia produces visible volume discrepancy, often accompanied by contralateral hypertrophy; the nipple-areolar complex is smaller and may lie more superiorly on the affected side.
  3. Tuberous configuration
    A narrow base with a constricted inframammary fold, enlarged areola, and herniation of glandular tissue through the areolar opening creates a “tube-like” shape; this variant is frequently bilateral.
  4. Absence of the inframammary fold
    A flat chest wall contour without the normal curved sub-mammary crease indicates insufficient lower-pole expansion and is typical of severe hypoplasia.
  5. Hypoplastic or absent nipple-areolar complex
    The areola may be < 2 cm in diameter, pale, or lightly pigmented; true anonychia (absent nipple) is rare and suggests ectodermal dysplasia or Poland sequence.
  6. Associated chest-wall deformities
    Pectus excavatum, carinatum, or rib abnormalities often coexist; rib hypoplasia and absence of the pectoralis major muscle point to Poland syndrome.
  7. Endocrine stigmata
    Delayed menarche, primary amenorrhoea, or sparse axillary/pubic hair suggests underlying hypogonadotropic hypogonadism; galactorrhoea may indicate hyperprolactinaemia.
  8. Psychosocial impact
    Significant distress, avoidance of tight clothing, and asymmetry-related postural changes are common; body-dysmorphic concerns may persist even after reconstructive surgery.
Symptom / SignTypical Presentation
Deficient volume≤ Tanner II after 16 yr, ≥ 150 mL side difference
AsymmetryUnilateral under-development, contralateral overgrowth
Tuberous shapeNarrow base, herniated areola, constricted fold
Absent IMFFlat chest wall, no sub-mammary crease
Small areola< 2 cm, pale, or truly absent (anonychia)
Chest-wall defectsPectus, rib gaps, Poland sequence
Endocrine signsDelayed menarche, amenorrhoea, sparse hair
PsychosocialDistress, clothing avoidance, posture changes

Related articles：

  1. Main Clinical Manifestations of Breast Fibroadenoma
  2. Main Clinical Manifestations of Breast Tumours
  3. Main Clinical Manifestations of Breast Cancer
  4. Main Clinical Manifestations of Mastitis
  5. Main Clinical Manifestations of Mammary Hyperplasia
  6. Main Clinical Manifestations of Nipple Inversion

Main Clinical Manifestations of Nipple Inversion

Nipple inversion is the inward dimpling or retraction of the nipple-areolar complex, which may be congenital, physiologic, or pathologic. Symptoms range from cosmetic concern alone to indicators of underlying malignancy. Accurate classification (grades I–III) and recognition of associated features guide appropriate imaging and surgical management.

  1. Cosmetic deformity
    Visible inward folding that may be intermittent (grade I) or permanent (grades II–III), producing an umbilicated or slit-like appearance.
  2. Difficulty with lactation
    Inability to achieve effective latch; milk stasis and cracked epithelium increase the risk of mastitis and painful fissures.
  3. Nipple-areolar hygiene impairment
    Moisture trapping fosters maceration, malodour, and recurrent bacterial or candidal infection.
  4. Spontaneous or provoked discharge
    Serous, serosanguinous, or blood-stained secretion suggests duct ectasia, intraductal papilloma, or carcinoma; cytology is mandatory.
  5. Associated mass or skin changes
    Recent onset with palpable subareolar nodule, peau d’orange, or eczematous erosion mandates exclusion of Paget disease or invasive carcinoma.
  6. Pain or tethering
    Persistent pulling sensation or fixation to chest wall indicates fibrotic shortening of lactiferous ducts or malignant infiltration.
  7. Grading classification
    Grade I: nipple easily everted manually and maintains projection.
    Grade II: can be pulled out but promptly retracts.
    Grade III: cannot be everted; ducts are fibrotic and shortened.
  8. Sudden onset after 40 years
    New inversion, especially if unilateral and accompanied by bloody discharge, is considered malignant until proven otherwise and requires triple assessment.
Symptom / SignTypical Presentation
Cosmetic deformityUmbilicated or slit-like nipple
Lactation difficultyPoor latch, milk stasis, fissures
Hygiene issuesMaceration, malodour, infection
DischargeSerous, bloody → cytology mandatory
Associated massSubareolar nodule, skin changes
Pain/tetheringPulling sensation, chest-wall fixation
GradingI (evertable) → III (fixed inverted)
Sudden onset >40 yrUnilateral + bloody → exclude malignancy

Related articles：

  1. Main Clinical Manifestations of Mastitis
  2. Main Clinical Manifestations of Breast Fibroadenoma
  3. Main Clinical Manifestations of Mammary Hyperplasia
  4. Main Clinical Manifestations of Breast Tumours
  5. Main Clinical Manifestations of Breast Cancer
  6. Main Clinical Manifestations of Hepatic Rupture

Main Clinical Manifestations of Breast Tumours

Breast tumours comprise a spectrum ranging from benign fibro-epithelial lesions to invasive malignancies. Symptom expression reflects histological subtype, anatomical location, and biological behaviour. Early recognition allows accurate triage between conservative follow-up and definitive oncological therapy.

  1. Painless palpable mass
    Most tumours present as a discrete, firm nodule with variable mobility. Benign lesions (fibroadenoma) are smooth and slippery; malignant masses display irregular, spiculated borders and may fix to pectoral fascia or skin.
  2. Nipple-areolar changes
    Recent inversion, persistent eczema-like scaling, or spontaneous serosanguinous/bloody discharge suggests underlying malignancy. Ulceration and malodour indicate locally advanced disease.
  3. Skin alterations
    Dimpling along Cooper ligaments, peau d’orange from lymphatic obstruction, and diffuse erythematous induration (inflammatory carcinoma) are pathognomonic for malignancy. Benign tumours do not alter overlying skin.
  4. Axillary and supraclavicular lymphadenopathy
    Firm, matted, non-tender nodes ≥1 cm imply regional metastatic spread; fixation to deep structures signals extra-nodal extension.
  5. Cyclical vs. progressive pain
    Benign proliferations often produce cyclical mastalgia; persistent, progressive pain without relation to menses raises concern for malignancy or phyllodes tumour.
  6. Multifocality and bilateral disease
    Multiple synchronous masses may represent fibroadenomatosis or multifocal carcinoma; contralateral involvement suggests genetic predisposition (e.g., BRCA1/2).
  7. Rapid growth or sudden change
    Size increase >20 % within 6 weeks, new skin tethering, or appearance of satellite nodules mandates core biopsy to exclude high-grade malignancy or sarcomatoid transformation.
  8. Systemic and metastatic features
    Unintentional weight loss, persistent fatigue, bone pain, pleuritic cough, or neurological deficits indicate advanced malignant disease with distant organ involvement.
Symptom / SignTypical Presentation
Palpable massSmooth (benign) vs. irregular, fixed (malignant)
Nipple changesInversion, eczema, bloody discharge
Skin signsDimpling, peau d’orange, erythema (malignant)
Lymph nodesFirm, matted, ≥1 cm (metastatic)
PainCyclical (benign) vs. persistent (malignant)
MultifocalityMultiple synchronous or bilateral masses
Rapid change>20 %/6 weeks, tethering, satellites
SystemicWeight loss, bone pain, neurologic deficits

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  1. Main Clinical Manifestations of Breast Fibroadenoma
  2. Main Clinical Manifestations of Breast Cancer
  3. Main Clinical Manifestations of Biliary Tract Tumours
  4. Main Clinical Manifestations of Mammary Hyperplasia
  5. Main Clinical Manifestations of Mastitis
  6. Main Clinical Manifestations of Cholangitis

Main Clinical Manifestations of Mammary Hyperplasia

Mammary hyperplasia (fibrocystic change or benign proliferative breast disease) encompasses a spectrum of hormonally responsive stromal and epithelial alterations. Symptoms fluctuate with the menstrual cycle and often regress spontaneously; however, pronounced changes require exclusion of malignancy.

  1. Cyclic mastalgia
    Bilateral, dull or heavy pain most prominent in the upper outer quadrants, beginning 3–7 days before menses and resolving with menstruation. Pain may radiate to the axilla or medial arm.
  2. Nodular or glandular thickening
    Multiple, small, mobile “lumps” with ill-defined borders create a cobble-stone or granular consistency that merges with surrounding tissue.
  3. Premenstrual breast swelling and heaviness
    Diffuse enlargement of one or both breasts, accompanied by tightness of brassiere and mild nipple hypersensitivity.
  4. Cystic fluctuation
    Large cysts produce discrete, well-circumscribed, resilient masses that may transilluminate; aspiration yields straw-coloured or greenish fluid.
  5. Nipple discharge
    Multiduct, serous or green-brown discharge is common; frank blood or persistent single-duct discharge mandates cytological evaluation.
  6. Axillary discomfort
    Tender, mobile lymph nodes < 1 cm accompany cyclic inflammation; firm or fixed nodes require biopsy.
  7. Post-menopausal regression
    Symptoms diminish spontaneously after ovarian failure; new palpable masses in post-menopausal women are considered malignant until proven otherwise.
  8. Psychological impact
    Fear of cancer amplifies symptom perception; reassurance following negative imaging and clinical follow-up often reduces pain scores.
Symptom / SignTypical Presentation
Cyclic mastalgiaBilateral, dull, premenstrual
Nodular thickeningMultiple, small, ill-defined lumps
SwellingDiffuse, heavy, premenstrual
Cystic massDiscrete, fluctuant, transilluminates
DischargeMultiduct, serous/green; blood → investigate
Axillary nodesTender, mobile < 1 cm
Post-menopauseSymptoms regress; new mass → biopsy
PsychologicalAnxiety-driven amplification

Related articles：

  1. Main Clinical Manifestations of Breast Fibroadenoma
  2. Main Clinical Manifestations of Mastitis
  3. Main Clinical Manifestations of Breast Cancer
  4. Main Clinical Manifestations of Hepatic Rupture
  5. Main Clinical Manifestations of Hepatic Abscess
  6. Main Clinical Manifestations of Congenital Biliary Malformations

Main Clinical Manifestations of Breast Fibroadenoma

Breast fibroadenoma is a benign biphasic tumour composed of proliferating glandular and stromal elements. It is the commonest solid breast mass in women under 30 years and is strongly hormone-responsive. Most lesions are solitary and indolent, but multiple or rapidly enlarging variants require exclusion of phyllodes tumour or carcinoma.

  1. Painless, highly mobile nodule
    Typically 1–3 cm, firm, smooth, and well-circumscribed; the “slip sign”—easy displacement under the fingers—distinguishes it from malignant masses that adhere to surrounding tissue.
  2. Smooth, regular margins
    Palpation reveals an ovoid or gently lobulated contour with a distinct edge; deep lesions may feel discoid when compressed against the chest wall.
  3. Hormonal modulation
    Size and tenderness often increase during the luteal phase, pregnancy, or hormone-replacement therapy; spontaneous regression is common after menopause.
  4. Multiple or bilateral occurrence
    Up to 20 % of patients harbour two or more synchronously detectable masses; metachronous contralateral appearance supports a field effect rather than de-novo malignancy.
  5. Giant fibroadenoma (> 5 cm)
    Rapid enlargement can cause visible breast asymmetry, skin venous prominence, and rarely nipple deviation; core biopsy is mandatory to exclude juvenile phyllodes tumour.
  6. Absence of skin or nipple changes
    Erosion, retraction, peau d’orange, or spontaneous discharge are not features of classic fibroadenoma; their presence mandates malignancy work-up.
  7. Stability or slow growth
    Most lesions remain static for months to years; any new irregularity, fixation, or accelerated increase in size warrants imaging-guided core biopsy.
  8. Imaging characteristics
    Ultrasound: hypoechoic, oval mass with gentle posterior enhancement and no internal vascularity on Doppler. Mammography: circumscribed, dense nodule with occasional coarse “pop-corn” calcifications in involuting lesions.
Symptom / SignTypical Presentation
Painless mass1–3 cm, firm, highly mobile, well-circumscribed
Regular marginsSmooth, ovoid or gently lobulated
Hormonal changeEnlarges during luteal phase/pregnancy, regresses post-menopause
Multiple lesions20 % synchronous, bilateral possible
Giant variant> 5 cm, asymmetry, venous pattern, needs biopsy
Skin/nippleNo erosion, retraction, or discharge
Growth patternStable; sudden change → biopsy
ImagingHypoechoic oval on US, circumscribed on MG

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  1. Main Clinical Manifestations of Breast Cancer
  2. Main Clinical Manifestations of Mastitis
  3. Main Clinical Manifestations of Hepatic Abscess
  4. Main Clinical Manifestations of Hepatic Ascites
  5. Main Clinical Manifestations of Biliary Tract Tumours
  6. Main Clinical Manifestations of Portal Vein Thrombosis

Main Clinical Manifestations of Mastitis

Mastitis is an inflammatory condition of the breast parenchyma, most frequently infectious in the lactational period and non-infectious or duct-centric in non-lactational settings. Recognition of its characteristic features permits prompt antimicrobial therapy and prevents progression to abscess formation.

  1. Painful induration
    A localized, wedge-shaped area of firm, tender tissue develops rapidly, often in the upper outer quadrant. Pain is throbbing and exacerbated by movement or nursing.
  2. Erythema and oedema
    Brilliant erythema with irregular borders spreads centrifugally; peau d’orange change reflects dermal lymphatic obstruction and interstitial oedema.
  3. Pyrexia and systemic response
    Temperature ≥ 38.5 °C with chills, myalgia, and tachycardia indicates bacterial infection; rigors suggest bacteraemia.
  4. Nipple-areolar changes
    Fissures, erosions, or milk stasis plugs serve as bacterial entry portals; retraction or persistent erythema may signal underlying duct ectasia in non-lactational disease.
  5. Purulent nipple discharge
    Expressible, thick, yellow-green secretion from a single duct is typical of duct-centric or sub-areolar abscess; frank pus on aspiration confirms abscess formation.
  6. Axillary lymphadenopathy
    Tender, mobile nodes < 2 cm accompany acute infection; firm, matted nodes raise concern for granulomatous or underlying neoplastic processes.
  7. Abscess indicators
    Fluctuant mass, persistent fever > 48 h despite antibiotics, or leukocytosis > 15 × 10⁹ L⁻¹ signifies pus collection requiring image-guided drainage.
  8. Chronic or recurrent mastitis
    Intermittent pain, peri-areolar fistula, and thick nipple discharge point to squamous metaplasia of lactiferous ducts (SMOLD) or granulomatous mastitis; biopsy excludes malignancy.
Symptom / SignTypical Presentation
Painful indurationWedge-shaped, tender, firm area
Erythema/oedemaBrilliant red, peau d’orange
Pyrexia≥ 38.5 °C, chills, tachycardia
Nipple changesFissures, retraction, milk plugs
Purulent dischargeThick, yellow-green from single duct
Axillary nodesTender, mobile; firm if chronic
AbscessFluctuant mass, persistent fever
Chronic diseaseIntermittent pain, fistula, thick discharge

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  4. Main Clinical Manifestations of Biliary Tract Tumours
  5. Main Clinical Manifestations of Portal Vein Thrombosis
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