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  • The accredited CME learning activity based on this article is offered under the auspices of the CE department of the University of Toronto. Participating physicians are entitled to one (1) MAINPRO-M1 credit by completing this program, found online at

    Nehmat Houssami, MBBS, MPH, MEd, FASBP, FAFPHM, PhD, Screening & Test Evaluation Program, School of Public Health, University of Sydney, Sydney, Australia.
    J. Michael Dixon, MBChB,MD, FRCS, FRCSEd, FRCP, Edinburgh Breast Unit,Western General Hospital, Edinburgh, Scotland.

    The incidence of breast cancer increases with advancing age, and the relative frequency of benign breast disease (BBD) decreases. Therefore, all breast symptoms or abnormalities should be assessed with triple testing (clinical examination, imaging, +/-percutaneous needle biopsy if a localized lesion is identified) to establish a diagnosis.The spectrum of BBD changes substantially from about age 45 onwards.We review some of the benign conditions that occur in older women, such as cysts and duct ectasia, and describe clinical features and management.We also discuss specific BBDs that may be encountered more frequently and in a much older population of women than was previously identified, a consequence of both increased incidence of BBD due to past use of hormone replacement therapy and improved detection.
    Key words: benign breast disease, triple test, breast neoplasms, breast cyst, duct ectasia.