Risk: increasing age (<2% of cases under age 30); previous
history of breast cancer (higher risk for patients who get first
breast cancer < age 40-45); positive family history (mother,
sister, daughter: 2-3 x increased risk with first degree relative),
higher risk if first degree relatives develop premenopausal or bilateral
breast cancer; personal history of fibrocystic disease (atypical
hyperplasia), noninvasive carcinoma in situ (ductal > lobular),
significant cellular atypia; Minor increased risk - early periods,
late menopause, overweight.
incidence, 1 of 10 adult women develop breast cancer.
Symptoms: asymptomatic, palpable breast
mass, mass in axilla, change in nipples (retraction, inversion,
irritation, dimpling), localized breast swelling, abnormal body
or bloody nipple discharge.
Screening: Self breast exam every month.
Annual breast exam by MD. Screening mammography - baseline exam
at age 35-39, at ages 40-49 every 1-2 years, and at age 50 or older
have annual mammograms. Increased risk factors necessitates earlier
and more careful surveillance (monthly self exam, annual MD exam,
basebaline mammogram by age 25 with subsequent mammograms every
2-3 years and annual mammograms after age 40 or diagnosis if earlier.)