Breast Complaints

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)