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All breast complaints are cancer until proven otherwise!!!

History

  • Increased risk of breast cancer
    • Family history of breast cancer (especially 1st degree)
    • Delayed childbearing (no children until after 30)
    • Age >50
  • Associated with menstrual cycle

Exam

  • Asymmetric appearance of breasts
  • Palpable mass
    • Red Flags
      • Non-mobile
      • Overlying skin changes
      • Lymphadenopathy
      • Located in upper/outer quadrant of breast

Differential Diagnoses

  • Red/inflamed/painful breast
    • Postpartum engorgement
      • Treat with warm compresses, continue breastfeeding/pumping, massage
    • Infection (“Mastitis”)
      • Treat with antibiotics and continue breastfeeding
    • Abscess
      • Treat with needle aspiration
      • Refer to breast surgeon
  • Non-inflamed breast pain
    • Fibrocystic changes
      • Associated with menses
      • Treat with supportive bra
  • Breast mass
    • Fibroadenoma
      • Slippery/mobile
    • Fibrocystic changes
  • Nipple discharge
    • Red flags
      • Unilateral discharge
      • Bloody discharge

Additional Reading

  • Breast Cancer Screening Guidelines (CDC)