What has to be kept in mind in regards the symptoms and stage of breast cancer?
Most commonly, individuals with breast cancer develop clinical symptoms in later stages of disease.
List clinical features of breast cancer in the early stages.
In early stages, affected individuals may notice a palpable mass with the following characteristics:
Typically single, nontender, and firm
Poorly defined margins
Where are palpable masses most commonly located (early stages)?
Most commonly located in the upper outer quadrant (∼ 55%
List clinical features of locally advanced disease.
Locally advanced disease is characterized by a number of changes affecting the appearance of the breast. These include:
Morphology: changes in size and/or shape → asymmetric breasts
Skin
Retractions or dimpling (due to fixation to the pectoral muscles, deep fascia, Cooper ligaments, and/or overlying skin)
Peau d'orange
Nipple
Inversion
Blood-tinged discharge
Local findings in breast cancer (picture).
List 3 features of progressive disease.
Ulcerations
Edema of the arm
Paget disease of the nipple
What are signs of lymphatic metastatic spread?
Lymphadenopathy
Nontender, firm, enlarged lymph nodes (> 1 cm in size), that are fixed to the skin or surrounding tissue
Most commonly the axillary nodes and, in later stages, the supraclavicular and/or infraclavicular nodes
List features of hematogenous spread (according to the organs involved).
Distant metastases of breast cancer can produce a number of heterogeneous symptoms.
Bone metastasis
Bone pain
Pathologic fractures
Spinal compression
Liver metastasis
Abdominal pain, distention
Nausea
Jaundice
Lung metastasis
Cough
Hemoptysis
Dyspnea
Chest pain
Brain metastasis
Headaches
Seizures
Cognitive deficits, focal neurological deficits
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