Medical Council of Canada

Medical expert

Breast Masses and Enlargement - 10-1

Rationale

While breast masses are common and considering the prevalence of breast cancer in women, it is important to note that not all breast masses are cancerous. Breast cancer screening is an important tool for the detection of the disease in its early stages. Breast enlargement may be due to physiological causes or an underlying mass effect .

Causal Conditions

(list not exhaustive)
  1. Malignant breast masses
  2. Non-malignant breast masses
    1. Fibrocystic change
    2. Breast infections
    3. Associated with lactation
  3. Gynecomastia
    1. Physiological (newborn, adolescence, elderly)
    2. Pathological (e.g., testosterone deficiency or increased estrogen production, medications)

Key Objectives

Given a patient with a breast mass or gynecomastia, the candidate will diagnose the cause, severity and urgency, and will initiate an appropriate management plan.

Enabling Objectives

Given a patient with a breast mass or gynecomastia, the candidate will

  1. list and interpret critical clinical findings, including
    1. results of an appropriate history and physical examination (e.g., drug use);
    2. identified risk factors for malignancy;
  2. list and interpret critical investigations (e.g., imaging, biopsy);
  3. construct an effective management and prevention plan, including
    1. screening;
    2. treatment;
    3. referral, if necessary;
    4. follow-up assessment and support (e.g., genetic testing).
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