Breast Problems, Common

[2013 update]

Introduction to this self-study CME activity


Little scientific information is available on evaluation and management of women who present to their primary care physicians with breast problems.  While most disorders are benign, the possibility of breast cancer is always a concern.  This CME activity helps clinicians improve their knowledge and clinical strategies for the diagnosis and treatment of four common breast problems: 

  • Palpable mass
  • Breast pain with a negative exam
  • Nipple discharge without abnormal findings
  • Assessment and management of women at high risk for breast cancer. 

New to this updated guideline are:

  • Somewhat simpler algorithms for palpable mass and for nipple discharge
  • Initial evaluation of galactorrhea:
    • Rule out medical illnesses (e.g., hypothryoidism, prolactinoma) and medications as a cause
    • Manage and reassure patient. 
  • Special populations:
    • Pregnant women with breast complaints
    • Men with breast problems, pain, enlargment, mass
    • The augmented breast, special problems and considerations


Participants in this CME activity will understand and be able to implement evidence-based cost-effective clinical strategies for the diagnosis and treatment of common breast problems in non-pregnant adults.


This self-study activity is appropriate for adult primary care clinicians and other health care providers involved in the diagnosis and treatment of breast problems in adults.


Team Leaders

  • Monica M. Dimagno, MD
    General Internal Medicine

Team Members

  • R Van Harrison, PhD
    Medical Education
  • Lisa A. Newman, MD
    Surgical Oncology
  • Ebony C. Parker-Featherstone MD
    Family Medicine
  • Mark Pearlman, MD
    Obstetrics & Gynecology
  • Mark Helvie, MD
    Radiology/Breast Imaging

Author Disclosures

No member of the Breast Problems Guideline Team has relationships with commercial companies whose products are discussed in this guideline.

Other Acknowledgements

UMHS Guidelines Oversight Team

  • Grant Greenberg, MD, MA, MHSA
  • R. Van Harrison, PhD

Literature Search Services

  • Taubman Medical Library

Production of Internet Format and Website Maintenance

  • Ellen Patrick-Dunlavey, MA

CME Accreditation and Credit Designation

The University of Michigan Medical School is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Michigan Medical School designates this enduring material for a maximum of 1 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This CME activity was released in June 2013 with credit available through May 2016. The activity was reviewed for currency of content in June 2016 and availability of credit extended through June 2019. Continuation of credit from that date depends on a thorough review of the content currency and accuracy.

Method of Participation

  1. View the web pages. You may print the self-study text to read off-line.
  2. Complete the on-line learning assessment test with a score of 70% or higher.  After you initially take the test, the test will be immediately electronically scored. 
    If fewer than 70% of the questions are answered correctly, the questions that were not answered correctly will be noted in red.  Review the CME content related to those topics and retake the test.
    If 70% or more of the questions are answered correctly, the correct and incorrect answers for all questions will be shown along with explanations of the basis for the correct answer.  The link to register and receive credit is shown at the end of the items and explanations. 
  3. Complete the electronic credit request and activity evaluation.  An electronic certificate of participation will be provided immediately.
  4. Print the certificate of participation for your personal records.