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Dr. Huntley's

DIAGNOSIS CHECKLIST
for Breast symptoms

Questions Your Doctor May Ask - and Why!

During a consultation, your doctor will use various techniques in his assesment of the symptom: Breast symptoms. These may include a physical examination or other medical tests. Your doctor may ask several questions when assessing your condition. It is important to remember that your consultation is a two-way process and any extra information you can share with your doctor may help them with their diagnosis.

Some of the questions your doctor may ask are listed below:

  1. When did you first notice the breast symptoms?

    Why: to establish if acute or chronic.

  2. Are the breast symptoms in one or both breasts?

    Why: suggests benign mammary dysplasia or benign breast cysts.

  3. Is your menstrual period on time or overdue?

    Why: to assess possibility of pregnancy as cause of breast symptoms.

  4. Does breast tenderness and swelling increase before the menstrual period and settle after the menstrual period?

    Why: suggests benign mammary dysplasia.

  5. Have you noticed "lumpiness" in your breasts in the past?

    Why: suggests benign mammary dysplasia.

  6. Has the lumpy area been red or hot?

    Why: may suggest acute mastitis (most common) or inflammatory breast cancer.

  7. Age?

    Why: e.g. newborn babies of either sex can present with breast lump which lasts for 7-10 days due to the mother's hormones; a benign breast lump under the nipple can occur in boys in one or both breasts at about 12-14 years; cysts and benign mammary dysplasia unlikely after menopause, breast cancer rare in age 12-25 and uncommon in age 26-35.

  8. Sex?

    Why: if male, malignancy is rare. Gynecomastia (true enlargement of the male breasts) can occur in Klinefelter's syndrome, testicular failure, liver failure, estrogen secreting tumors and due to certain drugs.

  9. Are you breast feeding?

    Why: may suggest acute mastitis, breast abscess or Candida albicans infection (which causes severe breast pain, producing a feeling like "hot cords", especially during and after breast feeding).

  10. Assess risk factors for breast cancer e.g. increasing age ( over 40 years of age), pre-existing benign breast lumps, personal history of breast cancer, family history of first degree relative with breast cancer, childless until after age 30, late menopause ( after age 53), obesity and early age when first started menstruating
  11. Past history of breast problems?

    Why: e.g. cyclical breast pain, mastitis, nipple problems or breast cancer.

  12. Family history of breast cancer in first degree relative?

    Why: increases the risk threefold.

  13. Medications?

    Why: Hormone replacement therapy may increase the risk of breast cancer. Breast enlargement in men can occur with estrogen, digoxin, marijuana, spironolactone, cimetidine.

Questions your doctor may ask about related symptoms:

Sometimes, other symptoms may be present and may help your doctor analyse your condition. These may include:

  1. Breast mass

    Why: suggests mastitis, abscess, benign mammary dysplasia or advanced breast cancer. If tender masses in both breasts consider benign mammary dysplasia.

  2. Breast lump pain

    Why: a painful breast lump is most likely due to an infection (e.g. mastitis or abscess). Other possibilities are benign mammary dysplasia or advanced breast cancer. Note only 5% of breast cancers are associated with pain. The ache may extend down inner aspect of the upper arm in benign mammary dysplasia.

  3. Diffuse breast pain

    Why: may suggest pregnancy, benign mammary dysplasia or the effect of oral contraceptive pill or hormone replacement therapy.

  4. Nipple discharge

    Why: A bloody discharge from the breast suggests a benign breast cancer (intraduct papilloma), malignant breast cancer or sometimes benign mammary dysplasia. A pus-like discharge may suggest an abscess or mastitis. A watery discharge of various colors (clear to green-grey) suggests benign mammary dysplasia.

  5. Fever

    Why: would suggest acute mastitis or abscess.

  6. Symptoms of pregnancy E.g. lack of menstrual periods, nausea, urinary frequency

    Why: may suggest cause of breast pain.

  7. Has there been any change in your nipples e.g. nipple retraction suggests breast cancer. Nipple itching, burning or ulceration may suggest Paget's disease
  8. Symptoms suggestive of metastatic disease e.g. back pain, shortness of breath, weight loss, and headache

 » Next page: Types of Breast symptoms

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