Diagnosis and evaluation

A. Clinical evaluation of a breast mass should assess duration of the lesion, associated pain, relationship to the menstrual cycle or exogenous hormone use, and change in size since discovery. The presence of nipple discharge and its character (bloody or tea-colored, unilateral or bilateral, spontaneous or expressed) should be assessed.

B. Menstrual history. The date of last menstrual period, age of menarche, age of menopause or surgical removal of the ovaries, previous pregnancies should be determined.

C. History of previous breast biopsies, cyst aspiration, dates and results of previous mammograms should be determined.

D. Family history should document breast cancer in relatives and the age at which family members were diagnosed.

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