Breast lump

Key points:

• History needs to include her mentrual and reproductive history, and any known risk factors for breast cancer 
• Approach is clinical examination, U/S and FNA. If all came back negative, then you can re-assure patient. If equivocal, refer to breast surgeon
• Risk factors for breast cancer
• Family history of breast and ovarian cancer
• increasing age
• late childbearing (after the age of 30 years)
• Nulliparity (no children)
• Early menarche (<12 age="" li="" of="" years="">
• Late menopause
• Use of hormone replacement therapy
• Ashkenazi jewish ethnicity
• Obesity (post-menopausal women)
• Lifestyle factors (e.g. high alcohol consumption, high-fat diet)
• Tamoxifen
• it is prescribed to treat early stage oestrogen receptor - positive breast cancer in premenopausal and postmenopausal women
• Tamoxifen is usually taken for up to five years 
• As tamoxifen is an anti oestrogen drug, the common side effects are hot flushes, night sweats and vaginal dryness. Less commonly, tamoxifen increases the risk of blood clots, stroke, cataracts, endometrial cancer, mood swings, depression and loss of libido
• Only about 5% of women have breast cancer due to a genetic predisposition or inherited gene mutation, such as BRCA1 and BRCA2.