|
History and Risk Factors for Breast Disease
The examiner should take a focused history of breast problems
and risk factors for breast cancer befroe performing the clinical
breast examination. The assessment of breast problems should
include duration and onset of signs and symptoms (such as lump,
skin changes, spontaneous nipple discharge, or breast pain),
menstrual and reproductive history, hormone use, and dietary
habits. The examiner should ask about factors that increase
the risk of breast cancer including the following (American
College of Obstetricians and Gynecologists):
- Increased age
- Previous history of breast cancer
- Nulliparity
- Delayed childbearing (over age 30)
- Early menarche (before age 12)
- Late menopause (after age 53)
- Family history of breast cancer (primarily in first-degree
relatives)
- Biopsy-proven ductal or lobular hyperplasia
- Higher socioeconomic status
- Obesity
Approximately 80% of women found to have breast cancer have no
identifiable risk factors. The history should also include details
of previous imaging studies (mammography, ultrasonography, magnetic
resonance imaging, etc.) and previous breast aspirations, biopsies,
and surgeries. During the history is an excellent time to teach
patients how to perform breast self-examination
and reinforce its importance.
Contraindications to
Breast Examination
There are no clear contraindications to clinical breast examination.
However, if a woman refuses the examination, the examiner should
stress its importance and try to understand her reasons for refusing.
If the examiner is male, he should offer to have a female nurse
act as chaperone during the examination.
|
Send
to a friend
Printer
friendly page
Get
PDF
