My Clinical Notes

• The most common symptoms reported by women are pain, nipple discharge or a palpable mass
• Pain
  • Mystalgia or mastodynia
  • Most common breast symptom, may be cyclical
  • Other causes, ruptured cysts, infection
  • About 10% of breast cancers present with pain
• Discrete palpable mass
  • Second most common breast symptom
  • Requires to be distinguished from normal breast nodularity
  • Breast mass usually has to reach 2cm in diameter before it becomes palpable
  • More common before the menopause
  • In 10% of premenopausal women, lumps were cancerous
  • In 60% of women over 50, lumps were cancerous
  • Other causes of breast lumps, fibroadenomas, cysts
  • 50% of carcinomas arise in the upper outer quadrant, 20% occur in the central region
• Nipple discharge
  • Often normal when produced by manipulating the breast
  • A milky discharge (galactorrhea) is associated with increased production of prolactin. Hypothyroidism or endocrine anovulatory syndromes
  • Can also occur due to medications, contraceptive pill, tricyclic antidepressants, methyldopa, phenothiazine
  • Milky discharge is not associated with malignancy
  • Bloody discharge can be associated with pregnancy and the formation of new lobules
  • Risk of malignancy with discharge increases with age
  • Most common causes of nipple discharge are papillomas, cysts or carcinomas

This entry was posted on Sunday, September 30th, 2007 at 10:04 am and is filed under Female Breast. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.