Breast lumps history and symptoms

The important key to breast lumps diagnosis is history and physical exams. History must be complete and include all details regarding to age, parity, pregnancy, past history of breast diseases, familial history, and drug history. Common symptoms of breast lumps include breast pain, palpable mass, nipple discharge, galactorrhea.

By clinical history, the cancer risk can be evaluated:^[1]

• Age at menarche
• Menopausal status
• Number of pregnancies
• Previous history of radiation
• History of oral contraceptives or hormone replacement therapy
• Past history of breast cancer and age at time of diagnosis
• Familial history of breast cancer or ovarian cancer in first-degree relatives
• Other associated breast disease or possible biopsies

Symptoms of breast lump include:^[1][2]

• Breast Pain
  • Cyclic pain
    • Occurring at the late luteal phase of menstrual cycle, relieving at the onset of menstrual phase
  • Non- cyclic pain
    • Fat necrosis from trauma
    • Stretching cooper’s ligament
    • Mastitis (focal or periductal)
    • Cyst
    • Mondor’s disease
    • Hidradenitis suppurativa
  • Non-breast pain
    • Chest-wall pain
      • Tietz syndrome
    • Non chest-wall pain
      • Gallbladder disease
      • Ischemic heart disease
• Palpable breast mass
  • Usually unilateral
• Nipple discharge
  • Presence of galactorrhea
    • Hyperprolactinemia from pituitary tumor
    • Hyperthyroidism
    • Drugs
  • Absence of galactorrhea
    • From one duct
      • Intraductal papilloma
      • Ductal carcinoma in situ
      • Paget’s disease
    • From multiple ducts
      • Fibrocyctic changes
      • Ductal ectasia
• Malaise
• Body pain
• Weight loss

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