clinical presentation
Last reviewed 06/2023
Breast cancer may be asymptomatic, occurring as an impalpable lesion on screening mammogram. (Upto 70% of important mammographic lesions are impalpable)
In other cases, patients may present with:
- palpable breast lump:
- 40-50% in the upper outer quadrant
- 70-80% scirrhous i.e. hard and encapsulated
- may be tethered to superficial or deep structures
- does not fluctuate or transilluminate
- 15-40% multicentric
- bilateral in up to 30% of cases of lobular carcinoma
- frequently, patient detected
- skin changes:
- dimpling
- peau d'orange
- nipple "eczema" in Paget's
- visible lump
- surface ulceration; neglected carcinoma in elderly
- recent nipple inversion
- bloodstained nipple discharge - uncommon
- non-cyclic breast pain - usually, a late sign
- disseminated disease:
- bone pain, pathological fracture
- dyspnoea, pleural effusion
- hepatomegaly, jaundice