[Symptoms and diagnostic work-up in breast cancer]

Symptoms from the breast leading to suspicion of breast cancer are very common. The present review gives guidelines for a rational diagnostic strategy for women with breast symptoms. The triple assessment based on clinical examination, imaging by mammography and ultra sonography, and biopsy is central to the diagnostic work-up. The triple assessment should be performed in the integrated diagnostic system to ensure fast diagnosis and a low rate of inconclusive results. The principles of the triple-test can be deviated from in women under 25 years since breast cancer is extremely rare in this age group. Imaging is not mandatory among older women with clinically obvious cancer verified with biopsy. Breast lumps in men is rarely cancer, and imaging does not contribute to diagnostics.