Breast lumps are common. They may pose a diagnostic dilemma, particularly as they may be malignant.
A woman has a 1 in 8 chances of developing Breast Cancer at some point in her life. The incidence has been increasing over the last several year. This incidence is only in part related to early detection.
Despite advances and improvements in diagnosis and treatment, the mortality rate has not changed significantly in the last several decades.
Breast Cancer is a leading cause of morbidity and mortality for that reason we think this topic is important and we made a revision about it.


INITIAL ASSESSMENT

It is useful for physicians to be aware of those factors which increase the risk that a woman might develop breast cancer.


A personal history of :

Ø Chronic cystic mastitis with atypical hyperplasia results in a 3 to 6 times higher risk of B.C.
Ø A previous incidence of contralateral B.C carries a relatively high risk of B.C. occurring in the unaffected breast.
Ø A previous adenocarcinoma increases the risk 2 times.
Ø For a preceding lobular carcinoma, the likelihood of developing carcinoma in the other breast is 25-50%.

A family history of:

Ø A first degree relative (such as a patient's mother, maternal grandmother, maternal aunts and sisters) of a patient with premenopausal B.C. has a 3 times higher risk.
Ø A first degree relative of a patient with bilateral B.C. has a 5 times higher risk.
Ø A first degree relative of a patient with bilateral premenopausal B.C. has an 8 times higher risk.


Estrogen compounds have a variable effect on the development of B.C. in animals. However, an association does exist between estrogen an endometrial carcinoma. It is prudent to withhold exogenous estrogen from patients who have had B.C. and from those in high risk groups because estrogens can support the growth of an already established cancer. That's why a long time of fertile life has a higher risk.
The next steps in routine clinical practice are the taking of the history and the performance of the physical examination.