M10.08.02 Common Complaints of the Breasts and Axillae

Questions about a woman’s breasts can be included in the medical history or deferred to the physical examination. Properly inquiring about breast health is crucial for early detection and management of breast-related issues. This guide provides a structured approach to taking a breast health history.

Key Questions to Ask

Breast Self-Examination

• Self-Examination:
  • “Do you examine your breasts?”
  • “How often do you examine your breasts?”
  • For menstruating women: “When during your monthly cycle do you perform the examination?”

Breast Lumps, Pain, or Discomfort

• Lumps:
  • “Do you have any lumps in your breasts?”
• Pain or Discomfort:
  • “Do you experience any pain or discomfort in your breasts?”
• Common Findings:
  • Note that approximately 50% of women have palpable lumps or nodularity in their breasts. Premenstrual enlargement and tenderness are common.

Nipple Discharge

• Discharge:
  • “Have you noticed any discharge from your nipples?”
  • If yes, follow up with detailed questions:
    • “When does the discharge occur?”
    • “Is the discharge only present after squeezing the nipple, or does it appear spontaneously?”
    • “What is the color of the discharge?”
    • “What is the consistency of the discharge?”
    • “What is the quantity of the discharge?”
    • “Is the discharge unilateral or bilateral?”

Summary of Key Inquiries

• Self-Examination Frequency
• Timing During Menstrual Cycle
• Presence of Lumps
• Experience of Pain or Discomfort
• Discharge Characteristics:
  • Occurrence: Physiologic (after squeezing) vs. Spontaneous
  • Color
  • Consistency
  • Quantity
  • Laterality: Unilateral vs. Bilateral

Clinical Notes

• Physiologic Discharge: Discharge that occurs only after squeezing the nipple is generally considered physiologic.
• Spontaneous Discharge: Requires more detailed investigation, especially if seen on underwear or nightclothes without local stimulation.