Mass or Swelling

During self-examination, a patient may discover a breast mass. Ask the following questions: ''When did you first notice the lump?''

''Have you noticed that the mass changes in size during your menstrual periods?'' ''Is the mass tender?''

''Have you ever noticed a mass in your breast before?'' ''Have you noticed any skin changes on the breast?''

''Have you had any recent injury to the breast?''

''Is there any nipple discharge? nipple retraction?''

''Do you have breast implants?'' If yes, ' 'What are they made of?''

If the lump enlarges during the premenstrual and menstrual stages of the cycle, it is likely that the woman is detecting only physiologic nodularity. The association of nipple discharge, nipple inversion, or skin changes overlying the mass is strongly suggestive of neoplasm. Figure 16-6 shows a large breast mass found on self-examination.

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