Breast History

Question 1

What 4 presenting complaints do you ask about?

Answer 1

Swelling or lump
Pain
Nipple discharge
Change in breast

Question 2

Swelling or lump:

• What should you ask? - 6 - same as you would ask about any other lump
• What else may you ask to see if it is hormonal?

Answer 2

Where?
When noticed?
Progression?
Size?
Tender?
Trauma? - maybe fat necrosis 

Does it change with the cycle?

Question 3

Breast pain:

• What is used?
• What else may you ask to see if it is hormonal?

Answer 3

SOCRATES

Does it change with the cycle?

Question 4

Nipple discharge:

- What should you ask? - 4

Answer 4

VCC

Uni/bilateral

Question 5

Change in breasts:

- What changes may they notice?

Answer 5

Size changes 
Shape changes 
Contour changes 
Nipple changes - inversion 
Skin changes

Question 6

What cancer symptoms do you ask about?

What about for mets?

Answer 6

Weight loss

SOB
Back pain
Abdo mass

Question 7

Past medical history:

You would ask about previous breast history!

What do you ask for a brief gynae/obs history? - 4

What previous breast investigation would you ask about?

Answer 7

Age of menarche
Date of LMP
Age of menopause
Brief pregnancy history (age of 1st, no of pregnancies, breastfeeding)

Mammogram

Question 8

Drug history:

What hormone therapies do you ask about?

Answer 8

OC/HRT

Question 9

Everything else the same

Answer 9

Everything else the same