Breast Clinical Assessment (History + Examination)

Question 1

What are you looking for in the presenting complaint regarding breast pathology?

Answer 1

Presence of lump + characteristics

Question 2

Characteristics of breast lumps to ask about in a breast history?

Answer 2

Site
Size
Duration
Onset
Change in symptoms
Pain
Skin changes

Question 3

Associated symptoms (with breast lump) to ask about in a breast history?

Answer 3

• Relationship to last menstrual period and symptoms
• Pain
• Nipple symptoms: discharge (amount, colour, consistency), bleeding, inversion
• Skin changes
• FLAWS
• Back pain or breathlessness
• Any other lumps or gland swellings

Question 4

Breast cancer risk factors to ask about?

Answer 4

Previous pregnancies
- number
- age at 1st one
- breast-feeding?
Age of menarche/menopause 
- date of last menstrual period
Drug history
- oral contraceptive pill, hormone replacement therapy
PMHx of breast disease or malignancy
FHx of breast/ovarian cancer

Question 5

Process to assessing breast lumps?

Answer 5

She Cuts The Fish

• Site, size, skin, single?
• Colour, contour, consistency, compressibility?
• Tenderness, temperature, trans-illuminable?
• Fluctuance, fixity (tethering), free to move?