Benign breast disorders

Benign breast disorders (BBD) account for over 90% of referrals to rapid access breast clinics. Many women experiencing breast symptoms fear they may have breast cancer and GPs, because of the sensitivities around the diagnosis of breast cancer and the fear of a ‘delayed’ diagnosis have a low threshold for referral. It is also true that breast symptoms per se are poor discriminators of benign from malignant conditions and clinical signs of breast cancer in the era of very high ‘breast awareness’ are subtle. The assessment of women with BBD consumes a substantial proportion of breast outpatient resource yet most will only need a single multi-modality triple assessment. Although the exclusion of breast cancer is the primary concern of most women, they also seek an explanation of the aetiology of their breast symptoms and signs. A sound understanding of the anatomy, physiology, and function of the breast is needed to manage this anxious cohort of women. In order to better understand BBD it is helpful to consider the following headings: (i) congenital disorders; (ii) aberrations of normal development and involution (ANDI); (iii) other miscellaneous problems. This article follows this format but in practice the majority of women with BBD fall within the ANDI framework.