The physician should first
establish which risk factors, if any, are present in any individual patient.
More specific questions should be asked about symptoms of the breast pain, tenderness and nipple discharge.
The relationship of symptoms to the menstrual cycle is important.
Ø Breast lumps are
the presenting symptom in 85-90% of patient with carcinoma. Approximately 60%
of breast masses are discovered by patients on self- examination.
Ø Metastatic disease may also be the initial symptom, either to a distant organ or to the axillary nodes. In 2% of B.C. cases patients present with axillary node enlargement but no palpable primary breast tumor.
Ø Asymptomatic patients:
Patients may have no symptoms or signs of breast cancer but may be in a high risk category (i.e.: family or personal history of B.C. and should be followed closely with mammography and physical examination. They should also be advised to practice breast self-examination.