Benign breast disease.

This article describes 25 years of clinical experience in the setting of a Breast Health Center devoted to benign and malignant disease of the breast. During this period, more than 100,000 patients have been evaluated and treated for a wide variety of breast problems. This experience has provided an extraordinary opportunity to evaluate the natural history of benign breast disease and the frequent observation that the relevant medical literature does not reflect the entire spectrum of these conditions or the appropriate treatment. Most textbooks on breast disease emphasize breast cancer and the late manifestations of benign breast disease that often require surgical treatment. More than 180,000 cases of breast cancer occur each year in the United States. The number of women with benign breast disease is far greater and can be counted in the millions. For these patients, the well-trained primary care physician can provide appropriate evaluation and treatment, including appropriate recommendations for referral. For most patients with breast symptomatology, the goal is relief of symptoms and resolution of the problem. To accomplish this requires a contemporary knowledgebase combined with adequate time spent with the patient.