Carcinoma of the breast

Question 1

Incidence

Answer 1

Breast carcinoma is uncommon <30 yrs

Steadily increases to a max. at ~60 yrs.

• ⅓ of women are premenopausal
• ⅔ postmenopausal.

Question 2

Clinical features

Answer 2

Painless lump (10% associated pain)

Hard and irregular lump

Other symptoms include;

• breast pain
• nipple discharge (bloody or serous)
• nipple retraction or distortion
• skin dimpling
• skin oedema (peau d’orange)

Rarely cancer can present with Paget sign (red scaly rash around nipple)

Rarely it can present with bony secondaries (e.g. back pain, dyspnoea, weight loss, headache)

Question 3

Management

Answer 3

Immediate referral to an expert surgeon on suspicion or proof of breast cancer is essential.

Any doubtful breast lump should be removed.