Breast problems
- Breast problems must be carefully assessed to find cause
- Use the 'triple test' approach
- History and clinical examination
- Imaging — breast ultrasound and mammogram
- Biopsy — tissue diagnosis
- Most women with breast problems do not have breast cancer
- Women of any age may present with breast problems
- Pregnancy and breastfeeding can cause lumps in breast
Ask
- Symptoms
- Lump OR change in shape or size of breast
- Change to nipple — crusting, ulcer, redness, inversion
- Nipple discharge
- Change in skin — redness, dimpling, puckering
- Unusual persistent pain, especially if only in 1 breast
- When first noted
- Constant or changing
- Related to periods
- Medicines especially contraceptive pills, MRT
- Menopause — when periods stopped
- Pregnant
- Breastfeeding
- Number of children and breastfeeding history
- Previous breast problems and tests
- Family history of breast cancer or other cancer (eg ovary, endometrial)
- Smoking and alcohol intake
Check
- Ask woman to show you problem area/s
- Do breast examination
- Check lump/s
- Position
- Size, shape
- Consistency (hard or soft)
- Mobility, whether joined to skin or muscle
- Tenderness
Do
- Medical consult about any woman with breast problem
- If young woman with breast tenderness, lumps, thickening before period — check again
after period to see if problem has gone. If problem still present — medical consult again
Follow-up
- Most women with breast problem need
- Diagnostic mammogram (breast x-ray) at hospital or radiology service (not BreastScreen
Australia)
- AND breast ultrasound
- AND biopsy (tissue diagnosis) - may be done by radiologist at time of ultrasound or by
surgeon
- On pathology request form
- Describe breast abnormality and position
- Request mammogram, ultrasound and biopsy
- Priority recall for medical consult after radiology appointment