Management of palpable breast lumps - Consensus guideline for family physicians

OBJECTIVE To describe an approach to managing women who present with palpab le breast lumps. QUALITY OF EVIDENCE Databases were searched from 1990 to 1998 using the sea rch terms breast lumps, breast diseases, and breast cysts. Bibliographies o f the articles obtained were searched for further relevant titles. Most evi dence on management of breast cysts was obtained from cohort studies. Evide nce on family physicians' approach to managing breast lumps is based on a r eview of the 1998 Canadian consensus guidelines and a review of a 1998 cons ensus guideline by 12 University of Toronto surgical oncologists (U of T gu idelines). MAIN MESSAGE Family physicians can manage women presenting with breast lump s if they have skill in breast cyst aspiration. Most breast cysts can be cu red in minutes, thus avoiding unwarranted anxiety and eliminating unnecessa ry additional investigations and referrals. Women presenting with solid les ions 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 far referra l.