This document discusses the clinical presentation of breast cancer. It notes that breast cancer has a bimodal age distribution and that about 10% of cases have a family history that may explain the cause. The most common presenting symptom is a painless lump or thickening in the breast. On physical examination, inspection focuses on checking for asymmetry, changes to skin or nipple appearance. Palpation techniques are used to further examine any breast masses or enlarged lymph nodes found. Common signs include the presence of a breast mass, skin changes like peau d'orange, or nipple retraction.

1. Clinical Picture of
Breast Cancer
Dr. MohammedFathyBayomy
Lecturer of ClinicalOncology
ZagazigUniversity

2. History
Age
Bimodal age distribution at diagnosis for invasive
female breast cancer cases

3. History
Age (Cont.,)

4. History (Cont.,)
Breast Pathology

5. History (Cont.,)
Family history
For each 100 women with breast cancer in the UK:
About 10 will have a family history that may explain why they developed breast cancer.

6. History (Cont.,)
Family history (Cont.,)

7. History (Cont.,)
Menstrual history

8. History (Cont.,)
Menstrual history (Cont.,)

9. Presenting symptoms
Asymptomatic
Screening

10. Presenting symptoms (Cont.,)

11. Presenting symptoms (Cont.,)

12. Most common:
lump or
thickening in
breast. Often
painless
Change in color
or appearance
of areola
Redness or pitting
of skin over the
breast, like the
skin of an orange
Discharge
or
bleeding
Change in size
or contours of
breast
Presenting symptoms (Cont.,)

13. Presenting symptoms (Cont.,)

14. Presenting symptoms (Cont.,)
Breast Lump
Commonest
Painless

15. Presenting symptoms (Cont.,)
Painful breast
5%

16. Presenting symptoms (Cont.,)
Axillary Lymphadenopathy

17. Presenting symptoms (Cont.,)
Metastatic disease

18. Physical Examination
Inspection: Positions

19. Physical Examination
Inspection: Check for

20. Skin changes: Erythema
Physical Examination

21. Skin changes: Peau d’orange
Physical Examination

22. Skin changes: Puckering
Physical Examination

23. Skin changes: Ulceration & Fungation
Physical Examination

24. Symmetry: Asymmetry
Physical Examination

25. Contour: Breast Mass
Physical Examination

26. Nipple Changes: Retraction
NormalInverted
Retracted
Normal
Physical Examination

27. Nipple Changes: Discharge
Unilateral
Spontaneous
Bloody
Physical Examination

28. Inspection: Bilateral Breast Cancer
Physical Examination
Asymmetry
Peau d’orange
Nipple retraction

29. Physical Examination
Palpation: Position

30. Physical Examination
Palpation: Technique

31. Physical Examination (Cont.,)
Palpation: Technique (Cont.,)

32. Physical Examination (Cont.,)
Palpation: Pattern

33. Physical Examination (Cont.,)
Palpation: Breast Mass

34. Physical Examination (Cont.,)
Palpation: Lymph node

35. Signs
Breast Mass

36. Signs(Cont.,)
Forgue sign

37. Signs(Cont.,)
Skin Changes

38. Signs(Cont.,)
Nipple Changes
Retraction
Inversion
Scaling or Ulceration

39. Signs(Cont.,)
Inflammatory Breast Cancer

40. Signs(Cont.,)
Haagensen's Grave signs