Final answer:
When assessing a breast lump, questions and exams should be thorough, covering the lump's history, associated symptoms, personal and family medical history, and lifestyle factors, with additional considerations for older women. A clinical breast examination and, based on risk factors, potentially imaging studies and biopsies, will be part of the assessment. Age influences the risk profile and screening recommendations, such as routine mammograms for those aged 50 and above.
Step-by-step explanation:
When assessing a patient with a breast lump, irrespective of age, a systematic approach is essential. However, the age of the patient may influence the risk profile and subsequent questions and examinations.
Questions to Both Age Groups
- History of the lump: When did you first notice it? Has it changed in size or feel?
- Symptomatology: Are there any associated symptoms such as pain, nipple discharge, or skin changes?
- Personal and family history of breast cancer or other cancers.
- Menstrual and reproductive history, which may influence risk factors.
- Lifestyle factors: smoking, alcohol intake, and exercise habits.
Additional Questions for Older Women
- History of hormone replacement therapy or past contraceptive use.
- Previous mammogram results and any past breast procedures.
For physical examination, both age groups would have a clinical breast examination, assessing the lump's size, texture, and mobility. In a 50-year-old patient, mammograms are more routinely used due to the higher incidence of breast cancer, as indicated by routine screening recommendations. However, for a 30-year-old patient, if there are significant risk factors or findings, a mammogram or ultrasound might be recommended. A biopsy may be considered if the lump is suspicious.
Understanding what is normal for one's breasts is important, which is why women are encouraged to perform monthly breast self-exams. This helps in identifying any new changes promptly. Girls and younger women are also advised to perform self-exams, even though breast cancer is rare at a young age, to familiarize themselves with their normal breast anatomy and to promote early detection should any changes occur.