It may be difficult to clinically distinguish malignant from benign breast masses such as fibrous tumors (fibroadenomas), fatty collections, inflammatory masses, infections or cysts. In premenopausal patients, it is common for benign lesions to enlarge just before menstrual periods and then shrink.
It is often helpful for the physician to draw an exact diagram with a description of a newly detected mass. Mammography and/or biopsy may be useful, but if these are not done the mass should be re-examined one or two months later if there is any suspicion that it might be cancer. If the mass persists, mammography and biopsy should be considered.
Physical Examination
• Physical examination of the breast is conducted with the patient in various positions and with careful recording
of any suspicious masses or abnormal findings.
• This should be accompanied by a complete physical, including a pelvic examination and evaluation for signs of
cancer in other locations such as the skin, lymph nodes and liver.
Blood and Other Tests
• Blood counts and chemistry panel to determine organ function and detect metastases, including liver function
tests (alkaline phosphatase, LDH and SGOT).
• Tumor marker blood tests—including serum carcinoembryonic antigen (CEA) and CA 15-3—may be
performed to help determine prognosis and response to therapy.
