| Clinical feature | Potential significance |
| Characteristics of the mass |
| Duration | |
| Location | - Upper outer breast quadrants:
- Fibrocystic change
- Fibroadenoma
- Subareolar:
- Mammary duct ectasia
- Cysts of Montgomery
|
| Size/changes in size over time | - Fibroadenomas average 2 to 3 cm; size may increase during pregnancy
- Phyllodes tumors average 7 cm
- Enlarging solid masses may indicate malignancy
|
| Consistency (cystic versus solid) | - Cystic:
- Mammary duct ectasia
- Cysts of Montgomery
- Solid:
- Fibroadenoma
- Phyllodes tumors
- Fat necrosis
- Malignant breast tumors
|
| Mobility | - Fibroadenomas are usually mobile
- Malignant breast tumors are usually, but not always, fixed to underlying tissue
|
| Tenderness | - May be present before the onset of menses in adolescents with fibrocystic change and fibroadenoma
- May occur with infection or trauma
- Mammary duct ectasia with blocked ducts
|
| Overlying skin changes | - May occur in:
- Large fibroadenomas (prominent superficial veins)
- Infection (erythema, warmth)
- Phyllodes tumors (the skin is shiny and stretched from rapid growth)
- Breast cancer (peau d'orange, retraction)
|
| Associated findings |
| Nipple discharge | - Nonbloody green or brown: Fibrocystic disease
- Clear to brown: Cysts of Montgomery
- Multicolored, sticky: Mammary duct ectasia
- Bloody: Phyllodes tumor, breast cancer
- Purulent: Infection
|
| Appearance of the nipple | - Blue appearance or appearing to overlay a blue mass may occur in mammary duct ectasia
- Retraction may occur in breast cancer
|
| Fever | - May be present in:
- Breast infection
- Mammary duct ectasia with penetration of the duct wall
|
| Lymphadenopathy | - May be present in:
- Breast infection (axillary)
- Breast cancer (axillary, supraclavicular, or generalized)
|
| Hepatomegaly and/or splenomegaly | - May be an indication of metastatic cancer
|
| Additional history |
| Previous breast disease | |
| Previous or intercurrent malignancy or chest irradiation | - May be associated with metastatic cancer or secondary cancer
|
| Pregnancy history | - Fibroadenomas may increase in size during pregnancy
|
| Use of oral contraceptive pills | - May improve symptoms associated with fibrocystic change
|
| Family history of breast cancer | - Having a first-degree relative with breast cancer increases the risk of breast cancer
|
