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Symptoms » Breast lump » Diagnosis Checklist
 
Dr. Huntley's

DIAGNOSIS CHECKLIST
for Breast lump

Questions Your Doctor May Ask - and Why!

During a consultation, your doctor will use various techniques in his assesment of the symptom: Breast lump. 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 lump?

    Why: to establish if acute or chronic.

  2. Is it single or multiple, in one or two breasts?

    Why: suggests benign mammary dysplasia or benign breast cysts.

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

    Why: suggests benign mammary dysplasia.

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

    Why: suggests benign mammary dysplasia.

  5. Has the lumpy area been red or hot?

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

  6. 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.

  7. 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.

  8. Are you breast feeding?

    Why: may suggest acute mastitis or breast abscess.

  9. 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
  10. Past history of breast problems?

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

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

    Why: increases the risk threefold.

  12. 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 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.

  2. 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.

  3. Fever?

    Why: would suggest acute mastitis or abscess.

  4. Has there been any change in your nipples?

    Why: e.g. nipple retraction suggests breast cancer. Nipple itching, burning or ulceration may suggest Paget's disease.

  5. Symptoms suggestive of metastatic disease e.g. back pain, shortness of breath, weight loss, and headache
  6. Itching or burning of the nipple, with superficial erosion or ulceration

    Why: suggests Paget's disease of the breast.


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