Benign breast disorders: A symptomatic approach

The argument over the standing of fibrocystic disease evokes the broader problem of treating breast-related symptoms. On the one hand, it is reassuring to know that the majority of women with nonproliferative changes in their breasts do not have an increased likelihood of developing malignancy. On the other hand, the physician does well to remember that every woman is at risk for breast cancer. Women have, overall, a 7% to 10% lifetime risk of developing the malignancy, and some women have a risk many times greater. A third of all breast cancers are found in women 35 to 50 years old, and 85% of women with breast cancer have no family history of the disease. Most women are well aware of the threat, so that virtually any breast symptom can generate anxiety, sometimes near panic. Consideration of the patient's distress must therefore underlie the planning of interventions for women with breast-related complaints, and reassurance and education are essential aspects of any treatment. A key responsibility is the prompt diagnosis and management of the problem.