0/3The complaint
- Presenting problems: lump or change in texture or contour, pain, nipple discharge, nipple changes (retraction, scaling, ulceration), skin changes (rash, redness, dimpling), axillary or supraclavicular lump.
- Characterize“How and when was it found? Has it changed, grown or progressed? One side or both? Constant or intermittent? How long? Any change with your periods? Any tests so far? Any fever or other symptoms?”
- Discharge“Does it come on its own or only when squeezed? What colour? How often? Has it happened before?”Only truly spontaneous, unilateral, single-duct bloody, serosanguinous or clear discharge is concerning.
0/4Risk
- Past breast history: high-risk benign pathology (atypical hyperplasia), prior screening over 50, breast density if known.
- Reproductive history: menarche, menopause, cycle pattern, pregnancies and age at first term delivery, breastfeeding and duration, hormonal therapy and duration (contraception, infertility, HRT).
- Alcohol, smoking, chest wall or neck irradiation; previous non-breast malignancy, especially ovarian.
- Family history: siblings and ages, mother's age or age at death, breast, ovarian and early prostate cancer on either side with ages at diagnosis; ethnicity and country of origin.
7 steps left in this station.