![]() ![]() Typical presenting symptoms such as pain, a palpable mass, and nipple discharge can be caused by a wide array of benign differential diagnoses ( table 1) and require targeted diagnostic imaging in addition to a comprehensive history and clinical examination ( e4). The management of benign breast changes includes clinical, radiological, and if necessary histological diagnostic investigations to rule out malignancy palliation of symptoms and counseling and monitoring of patients at increased risk of breast cancer. Benign breast changes are more common in women of child-bearing age, peaking between the ages of 30 and 50, whereas the incidence of breast cancer peaks during the postmenopause ( e2, e3). ![]() Although breast cancer is detected in only 3% to 6 % of women with clinical symptoms, and in most cases the cause of the symptoms is benign, no evidence-based recommendations for the management of benign disease have been produced because the focus has been on the diagnosis and treatment of breast cancer ( 1, 3) ( e1). ![]() For this reason, breast changes are a cause of anxiety in patients and require a carefully targeted diagnostic process ( 2). At around 70 000 new cases a year, breast cancer is the most common form of cancer in women in Germany, occurring in approximately one in eight women at some time during their lives. According to data from the Netherlands and the USA, around 3% of women’s consultations with their general practitioners (GPs) are about breast symptoms ( 1, e1). ![]()
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