Koo et al evaluated women with breast cancer for presenting signs and symptoms. The absence of a breast mass may result in a delay in diagnosis. The authors are from University College London, University of Exeter, NCRAS and University of Durham.
Patient selection: woman with breast cancer
The usual presentation of breast cancer is a lump or mass in the breast or axilla.
Atypical symptoms include:
(1) nipple abnormalities
(2) breast ulceration
(3) breast inflammation or infection
(4) swollen arm or axilla
(5) pain in axilla
(6) breast pain
(7) back pain
(8) weight loss
(9) abnormal breast shape
(10) other skin changes
Risk factors for a delay in diagnosis:
(1) absence of a breast lump
(2) negative for mammography
(3) low suspicion by clinician
(4) low suspicion by the patient
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