Breast Lump

Objectives

1. Given a well woman with concerns about breast disease, during a clinical encounter (annual or not):
   • Identify high-risk patients by assessing modifiable and nonmodifiable risk factors
   • Advise regarding screening (mammography, breast self-examination) and its limitations.
   • Advise concerning the woman’s role in preventing or detecting breast disease (breast self-examination, lifestyle changes).
2. Given a woman presenting with a breast lump (i.e., clinical features):
   • Use the history, features of the lump, and the patient’s age to determine (interpret) if aggressive work-up or watchful waiting is indicated.
   • Ensure adequate support throughout investigation of the breast lump by availability of a contact resource.
   • Use diagnostic tools (e.g., needle aspiration, imaging, core biopsy, referral) in an appropriate manner (i.e., avoid over- or under-investigation, misuse) for managing the breast lump.
3. In a woman who presents with a malignant breast lump and knows the diagnosis:
   • Recognize and manage immediate and long-term complications of breast cancer.
   • Consider and diagnose metastatic disease in the follow-up care of a breast cancer patient by appropriate history and investigation.
   • Appropriately direct (provide a link to) the patient to community resources able to provide adequate support (psychosocial support).