Breast Cancer

Your Path

  • Breast Cancer


  • 80% of cancers are infiltrating ductal carcinomas

Risk Factors

  • Early menarche
  • Late menopause
  • Never pregnant
  • Age > 50
  • 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)

Physical Exam Findings

  • Firm and growing discrete mass
  • Stuck to underlying tissues
  • Sometimes overlying skin changes, including puckering or inflammation
  • Nipple inversion
  • Bloody nipple discharge
  • Axillary adenopathy