Mastalgia physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]

• Thorough breast exam

  • Best performed 7-9 days after onset of menses in premenopausal patients
  • Should be performed with patient in both lying and sitting positions

• Goals

  • Note any masses
  • Identify any localized areas of tenderness – correlation to patient symptoms
  • Identify any axillary or supraclavicular LAN
  • Detect skin changes, edema, erythema, or nipple discharge

• Fibrocystic changes

  • Lumpy or doughy consistency with no well-defined masses

• Fibroadenoma

  • Well-defined, mobile mass
  • May be multiple

• Suspicious characteristics of a palpable mass

  • Single lesion
  • Hard, immobile
  • Irregular border
  • Size > 2 cm