Breast Care Cycle: 2. Conduct clinical breast exam
Abnormal clinical breast exam results include:
- Observable breast changes such as nipple or areolar scaliness, bloody or serous discharge
- Skin dimpling or nipple retraction
- Color or texture changes
Some abnormal breast findings such as skin dimpling, nipple retraction, scaliness or discoloration may be warning signs of cancer. Dimpling and nipple retraction, for example, may suggest an underlying tumor. Additional tests are needed to diagnose these abnormal findings.
The clinical breast exam might reveal a discrete, palpable mass. Most palpable breast masses discovered during a clinical breast exam are not malignant. The most common types of benign masses include:
- Cysts: fluid filled masses in the breast
- Fibroadenomas: movable, solid, rounded lumps made up of normal breast cells
In general, benign, palpable masses have distinct margins and a smooth surface; they are mobile, soft or rubbery; and they may be tender. Malignant palpable masses are usually distinct from benign masses. They have indistinct and irregular margins; are firm and fixed; usually the area is not tender.
Detailed procedures for how to follow up breast findings can be found in the Algorithms section of this site. When a clinical breast exam reveals abnormalities, Ladies First patients should be referred for additional imaging testing such as a diagnostic mammogram or ultrasound.
Refer for mammogram
Once the full Ladies First screening exam is completed (inclucing cervical and cardiovascular portions), your office provides the patient with the referral forms necessary to schedule her own mammogram, and any laboratioy tests not done in the office.
Click here for a complete listing of mammography facilities for Ladies First patients.
Screening vs. diagnostic mammograms
A screening mammogram is used to detect breast changes in women who have no signs or symptoms of breast cancer. A diagnostic mammogram is similar to a screening mammogram, but the technician takes additional or specialized x-ray views of the breast. Imaging techniques such as magnification or cone compression may be recommended to look more closely at an area of concern. These images can help evaluate unusual breast changes such as a lump, pain in conjunction with thickening, nipple discharge or change. A diagnostic mammogram is also performed on women with breast implants.
When a mammogram reveals abnormalities, Ladies First patients should be referred for additional imaging testing such as diagnostic mammogram, added mammographic views or ultrasound.
All of these procedures are covered by Ladies First.