Breast History

Question 1

Who is the breast screening programme for?

How often is it done?

Answer 1

50-70 years old females

3 yearly.

Question 2

Breast lump

1) slowly growing?
2) rapidly expanding and now hard?
3) changes occur with menstruation?
4) irregular lump?
5) rounded lump?
6) hard lump?
7) soft and then hard lump?
8) mobile lump?
9) fixed lump?

Answer 2

1) carcinoma
2) cyst
3) fibrocystic change
4) carcinoma
5) cyst
6) carcinoma
7) cyst (hard once filled with fluid)
8) cyst
9) carcinoma

Question 3

Name for breast pain?

1) chronic bilateral pain?
2) unilateral pain?
3) painless lump?
4) painful lump? (4)
5) if pain is related to menstruation? (2)
6) if pain started since breastfeeding?
7) if mild pain + relieved w/ NSAIDs?

Answer 3

Mastalgia

1) chronic mastalgia
2) mastitis
3) carcinoma
4) fibrocystic change, abscess, cysts or mastitis
5) benign cyclical mastalgia, fibrocystic change
6) lactational mastitis
7) nothing - reassurance

Question 4

Nipple Discharge

1) multicoloured, multiple ducts?
2) single duct?
3) bloodstained?
4) clear?
5) pus?
6) milky?

Answer 4

1) duct ectasia (green, yellow, brown discharge)
2) intraduct papilloma
3) intraduct papilloma, DCIS, invasive carcinoma, Paget’s
4) intraduct papilloma
5) infection - abscess
6) lactation

Question 5

Nipple Change

1) inversion?
2) in younger women - bilateral retraction?

Answer 5

1) sub-areolar carcinomas

2) duct ectasia

Question 6

Skin Change

1) bilateral skin change around nipple?
2) unilateral dimpling?
3) peau d’orange (skin around hair follicles is swollen)
4) peau d’orange with lump?
5) unilateral red, bleeding eczematous skin around nipple?

Answer 6

1) eczema or paget’s disease
2) carcinoma
3) lymphoedema
4) cancer
5) paget’s disease or intraductal carcinoma in 50% of pts)

Question 7

Other important questions for Breast cancer history

RF?

Answer 7

FHx
OCP
HRT
Alcohol
Menstrual Hx (early menarche and late menopause)
any previous lumps?
any breast infections/tattoos (for infective cause)