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
- Mystalgia or mastodynia
- 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
- Second most common breast symptom
- 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
- Often normal when produced by manipulating the breast
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