{"id":591,"date":"2017-04-04T07:07:56","date_gmt":"2017-04-04T07:07:56","guid":{"rendered":"http:\/\/papergp.com\/?page_id=591"},"modified":"2023-01-24T11:25:26","modified_gmt":"2023-01-24T11:25:26","slug":"breast-lump","status":"publish","type":"page","link":"https:\/\/papergp.com\/index.php\/womens-health\/breast-lump\/","title":{"rendered":"Breast lump"},"content":{"rendered":"<div class=\"content-box-blue\">\n<h4>Data gathering<\/h4>\n<ul>\n<li>Red flags<\/li>\n<li>Others\n<ul>\n<li>lump &#8211; first noticed, changed in size, armpits<\/li>\n<li>breast &#8211; pain<\/li>\n<li>nipple &#8211; changes, discharge<\/li>\n<li>menstrual history<\/li>\n<li>FH<\/li>\n<li>Risk factors &#8211; never had a child, never breastfed, early menarche, late menopause, HRT, alcohol<\/li>\n<\/ul>\n<\/li>\n<li>Examine\n<ul>\n<li>Inspect &#8211; sitting, hands behind head<\/li>\n<li>breast symmetry<\/li>\n<li>nipple changes<\/li>\n<li>skin changes &#8211; dimpling, redness, oedema<\/li>\n<li>Palpation &#8211; hand above head<\/li>\n<li>breast &#8211; vertical strip method<\/li>\n<li>axilla<\/li>\n<li>supraclavicular and cervical LN<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Clinical management<\/h4>\n<ul>\n<li>the following should be referred via two week wait:\n<ul>\n<li>a discrete, hard lump with fixation, with or without skin tethering<\/li>\n<li>&gt;30 year old +\u00a0discrete lump that persists after their next period or presents after menopause<\/li>\n<li>persistent focal area of lumpiness or focal change in breast texture<\/li>\n<li>previous breast cancer, who present with a further lump or suspicious symptoms.<\/li>\n<li>Women with skin distortion or signs of oedema in the skin.<\/li>\n<li>Women with unilateral eczematous skin or nipple change that does not respond to topical treatment.<\/li>\n<li>Women with nipple distortion of recent onset.<\/li>\n<li>Women with spontaneous unilateral bloody nipple discharge.<\/li>\n<li>Women with persistent unexplained axillary swelling.<\/li>\n<li>Men aged 50 years and older with a unilateral, firm subareolar mass, with or without nipple distortion, or associated skin changes.<\/li>\n<li>Women aged younger than 30 years who present:\n<ul>\n<li>With a lump that enlarges.<\/li>\n<li>With a lump and other reasons for concern, such as family history.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li>The following should be referred and seen routinely:\n<ul>\n<li>Women aged younger than 30 years with a lump without sinister features or other concerns.<\/li>\n<li>Women under 50 years who have nipple discharge that is from multiple ducts or\n<p>is intermittent and is neither bloodstained nor troublesome<\/li>\n<li>Women with breast pain and no palpable abnormality, when initial treatment fails and\/or with unexplained persistent symptoms.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>NB: lump should be described by location, size, mobility, texture<\/p>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Breast cancer family history<\/h4>\n<ul>\n<li>Red flags\n<ul>\n<li>Family tree<\/li>\n<li>Age of diagnosis<\/li>\n<li>Bilateral<\/li>\n<li>Male<\/li>\n<li>Ovarian, prostate cancer<\/li>\n<li>Ashkenazi Jew<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Treatment\n<ul>\n<li>Breast aware &#8211; self checks, attending screening<\/li>\n<li>Lifestyle &#8211; weight loss, exercise, reduce alcohol and smoking<\/li>\n<li>Medications &#8211; stop COCP, HRT<\/li>\n<\/ul>\n<\/li>\n<li>Follow-up \/ Safety-net\n<ul>\n<li>Refer to genetics clinic for counselling &#8211; if moderate risk<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Data gathering Red flags Others lump &#8211; first noticed, changed in size, armpits breast &#8211; pain nipple &#8211; changes, discharge menstrual history FH Risk factors &#8211; never had a child, never breastfed, early menarche, late menopause, HRT, alcohol Examine Inspect &#8211; sitting, hands behind head breast symmetry nipple changes skin changes &#8211; dimpling, redness, oedema &hellip; <a href=\"https:\/\/papergp.com\/index.php\/womens-health\/breast-lump\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Breast lump<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":122,"menu_order":113,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-591","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/591","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/comments?post=591"}],"version-history":[{"count":7,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/591\/revisions"}],"predecessor-version":[{"id":1969,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/591\/revisions\/1969"}],"up":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/122"}],"wp:attachment":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/media?parent=591"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}