Clinical assessment of a breast mass: a case study

The estimated 180,300 new cases of breast cancer that were diagnosed in the United States during 1998 represent only a small percentage of the breast masses discovered by women and their healthcare providers during the same year. Almost half of women who have regular menstrual cycles will experience a breast mass during their reproductive years; and from 50% to 90% of all women will encounter fibrocystic breast changes. Imaging (ultrasound and mammography) and manual palpation have been demonstrated to be the most useful methods of breast mass detection and evaluation. A woman's age and reproductive status are factors to be considered in the selection of a protocol for the clinical assessment of a breast mass. While a suspicious lesion warrants immediate physician referral, nurse practitioners have important roles to play in the identification, documentation, and appropriate follow-up of breast masses.