The vast majority of women presenting with breast symptoms will have an underlying benign etiology. Only 1 in 10 of all women referred to a specialist breast clinic will have breast cancer. After establishing a firm diagnosis of benign disease, reassurance and an appropriate plan of management will need to be instituted. Benign disorders of the breast represent a large proportion of the workload at a specialist breast clinic; therefore, it is important to carefully distinguish these disorders from premalignant and malignant disease of the breast.

Understandably, they are a source of considerable anxiety for the patient and a potential source of medicolegal problems. A clear understanding of benign disease of the breast is therefore essential.

To ensure uniformity and consistency amongst all members of the specialist breast team, appropriate management protocols are advisable in clinical practice.

Our unit has developed management protocols based on available scientific evidence and has adopted a multidisciplinary approach in the management of patients involving surgeons, radiologists and pathologists.

The majority of patients with benign breast disease are premenopausal.

With the advent of hormone replacement therapy (HRT), an increasing number of postmenopausal women now present with a similar spectrum of disorders. The simplest approach to benign breast disease is to regard this group of disorders as an aberration of normal development and involution (ANDI).

This outlook facilitates an easier understanding of these disorders and consequently makes it easier to reassure patients and treat them appropriately.

A.D. Purushotham, P. Britton and L. Bobrow
A prospective study of benign breast disease and the risk of breast cancer. JAMA 2002