- 80% of cancers are infiltrating ductal carcinomas
- Early menarche
- Late menopause
- Late age parity (> 35)
- Long term estrogen use
- One or more first degree relatives with breast cancer
- Ashkenazi Jewish heritage
- Thoracic radiation
- Family history BRCA mutation
- Early menopause (<40), multiparity, breast feeding > 3m might each be protective
- Increases in size over time (typically months)
- Typically painless
- Sometimes overlying skin changes, puckering, nipple inversion
- Nipple discharge, in particular bloody
- Sometimes noted by patient, other times by clinician
- Symptoms from mets if spread: SOB (lungs), back pain or weakness (if vertebral spread), headache or focal neuro deficits (brain)
- Firm and growing discrete mass
- Stuck to underlying tissues
- Sometimes overlying skin changes, including puckering or inflammation
- Nipple inversion
- Bloody nipple discharge
- Axillary adenopathy