Diagnosis by team work: an approach to conservatism.
In the Nottingham Breast Clinic 5000 new cases are seen annually; 3000 are sent because the general practitioner believes that he/she has found a lump. It is the diagnosis and management of this common problem that is considered in this chapter. The traditional management of the palpable breast lump included excision to establish accurate diagnosis; indeed up until 20 years ago even simple cysts were excised. Now most surgeons accept that a woman with no residual palpable abnormality after aspiration of blood-free fluid from a cyst requires no further treatment. Most solid breast lumps are benign on histological examination; their routine removal a mistake in judgement. The challenge in the management of a palpable lesion is to correctly diagnose all the cancers without having to remove those which are benign, unless the patient wishes.
Department of Surgery, Nottingham City Hospital, UK.
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Galea
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Blamey
D000232:Adenofibroma / Q000473:pathology; D000328:Adult; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology; D003663:Decision Trees; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D010173:Palpation; D010348:Patient Care Team