Action Against Cancer HISHAM HAMED Consultant Oncoplastic Breast Surgeon Honorary Senior Lecturer Guy’s & St Thomas’ Hospital University Hospital Lewisham

Breast Cancer Presentation Breast lump Nipple: eczema, ulcer, inversion, discharge Skin: dimpling, lump, ulcer, redness, skin oedema (peau d’orange) Lump in axilla Lymphoedema Screen detected

Significant Risk Factors Gender Age Benign histology (e.g Lobular neoplasia (LCIS), Atypia) Strong FH (Moderate / High risk) Previous irradiation for lymphoma Genetic mutations (BRCA1&2, P53 and others)

Diagnostic Pitfalls Nipple: inversion, eczema, itching Skin: redness, prominent pores, texture changes, infected lesions Lumpy breasts in a young woman Breast lump following a trauma Axillary breast tissue Medical problems (cardiac failure, intra-thoracic disease

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