Management of palpable breast lumps. Consensus guideline for family physicians.
OBJECTIVE
To describe an approach to managing women who present with palpable breast lumps.


METHODS
Databases were searched from 1990 to 1998 using the search terms breast lumps, breast diseases, and breast cysts. Bibliographies of the articles obtained were searched for further relevant titles. Most evidence on management of breast cysts was obtained from cohort studies. Evidence on family physicians' approach to managing breast lumps is based on a review of the 1998 Canadian consensus guidelines and a review of a 1998 consensus guideline by 12 University of Toronto surgical oncologists (U of T guidelines).


RESULTS
Family physicians can manage women presenting with breast lumps if they have skill in breast cyst aspiration. Most breast cysts can be cured in minutes, thus avoiding unwarranted anxiety and eliminating unnecessary additional investigations and referrals. Women presenting with solid lesions should be referred to a surgeon.


CONCLUSIONS
Breast cyst aspiration is a simple technique family physicians can use to either cure breast lumps or define appropriate cases for referral.
Heisey
R
R
Women's College Campus of Sunnybrook, Toronto, Ont.
Mahoney
L
L
Watson
B
B
D000465:Algorithms; D001707:Biopsy, Needle / Q000009:adverse effects / Q000379:methods*; D002170:Canada; D003663:Decision Trees; D019317:Evidence-Based Medicine; D005194:Family Practice / Q000379:methods*; D005260:Female; D005348:Fibrocystic Breast Disease / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D009819:Office Visits; D010173:Palpation / Q000379:methods*; D017410:Practice Guidelines as Topic; D012017:Referral and Consultation