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Breast cancer
Symptoms and signs

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	Breast Cancer
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Local symptoms

The left breast is involved more frequently than the right, and the most common locations of the disease are the upper outer quadrant and retroareolar region.

1. Asymptomatic: Increasing numbers of breast malignancies are being discovered in asymptomatic patients through the use of screening mammography.
2. Breast lumps are detectable in 80% of patients with breast cancer and constitute the most common sign on history and physical examination. The typical breast cancer mass has a dominant character and tends to be:
   • Unilateral
   • Solitary
   • Irregular
   • Solid
   • Hard
   • Nonmobile
   • Nontender
3. Breast pain is the presenting symptom in approximately 5% of patients.
4. Skin or nipple retraction in 5% of patients.
5. Spontaneous nipple discharge through a mammary duct is the presenting symptom in approximately 2% of patients.
6. Breast enlargement is seen in 1% of cases.
7. Nipple crusting or erosion: This can occur in Paget's disease and is the presenting symptom in 1% of the cases.

Memory aid: asymptomatic + 3 signs related to the nipple and 3 related to the whole breast.

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Metastasis

Lymph node metasasis

The most common regions that breast cancer may spread to in order of frequency are:

• Bone (80%)

• Lung (25%)

• Liver (20%)

• Brain (15%)

• Other organs which include the bone marrow, brain, ovaries, spinal cord, eye (20%).

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