History

1. The precise location of the lump.

2. How it was first noted (by breast self-examination, or during a screening clinical breast examination or mammogram).

3. How long the patient has noted its presence.

4. Whether there is any accompanying nipple discharge.

5. Whether the lump waxes and wanes in size at particular times in the menstrual cycle. Benign cysts may be more prominent premenstrually and regress in size during the follicular phase.

B. A past history of breast cancer or breast biopsy and a history of risk factors for breast cancer (eg, age, family history of breast cancer, age of menarche, age at first pregnancy, age of menopause, alcohol use, and hormonal replacement therapy).

Risk Factors for Developing Breast Cancer

Risk factors

Low

High

Rela-

risk

risk

tive

risk

Deleterious

Nega-

Posi-

3-7

BRCA1/BRCA2

tive

tive

genes

2.6

Mother or sister with

No

Yes

breast cancer

18.0

Age

30 to

70 to

1.5

Age at menarche

34

74

1.9-

Age at first birth

>14

<12

3.5

Age at menopause

<20

>30

2.0

Use of contracep-

<45

>55

1.2

tive pills

Never

Past/c

urrent

1.4

Hormone replace-

Never

use

ment therapy

Cur

1.4

Alcohol

None

rent

1.8-6

Breast density on

0

2 to 5

mammography (%)

drinks/

2.7-

Bone density

Lowest

day

3.5

quartile

>75

History of a benign

No

1.7

breast biopsy

High-

History of atypical

No

est

3.7

hyperplasia on bi-

quartil

opsy

e

Yes

Yes

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