Breast: History

History in Breast Lump

1.     Age

2.     History of lump

·        Duration

·        Initial size

·        Progression(Rate of growth, any history of rapid growth)

·        Pain (Duration, Site, Character, Relation with the swelling, Relation with menstrual cycle)

·        Ulcer

·        Associated symptoms (fever, retraction of nipple)

·        Presence of other lumps

3.     History of Nipple discharge

·        color

·        amount

·        type of discharge: serous/blood/milky

·        from one duct opening or multiple openings

·        foul smell

4.     Personal history

·        menstrual history

·        marital status

·        age of marriage

·        age of birth of first child

·        Breast feeding

·        history of oral contraceptives/HRT

·        smoking

·        age of menarche and menopause

·        history of chest irradiation

5.     Family history

·        Similar illness or any history of GI or ovarian malignancy in 2–3 generations

·        any history of breast carcinoma or gastrointestinal or ovarian malignancy in sibling and cousins( first and second degree relatives)

·        Draw a pedigree if positive family history

6.     Ask for Metastatic symptoms

·        Anorexia

·        weight loss

·        bone pain

·        hemoptysis

·        jaundice