Bring all prescription drugs, herbs, and supplements you are taking with you to your doctor’s visit. Be honest with your doctor if you use street drugs like amphetamines that aggravate breast tissue. Your doctor may consult with a pharmacist to find out if your benign breast disease could be the result of a drug interaction.
Be prepared to answer these questions when the doctor takes your history:
- When did you first notice the abnormality in your breast?
- Is there any discharge, and if so, what color and consistency?
- Have you gained or lost any hair on your chest, underarms or face?
- Do you also have enlarged breasts?
- Does your breast size vary or remain the same?
- At what age did you first start menstruating?
- Do you have children? If yes, how old were you when your first child was born?
- Is there tenderness or pain in your groin, breasts or pelvis?
- Have you ever had your nipples or genitals pierced, and if so, were there complications?
- Do you regularly use prescription or street drugs?
- Do you use herbs or body-building preparations?
Following the history, your doctor performs a physical examination of your breasts and sex organs. You may recline on the examination couch, or the doctor may ask you to reach your hands over your head, or to lean forward with your hands braced on your hips. He or she will specifically look for dimpling, rashes, ulcers, color changes, and asymmetry in your breasts. Your doctor will suspect breast cancer if there is: Breast growth on one side only (unilateral); nipple inversion or flattening; discharge that is not milk (watery, bloody, or pus-streaked); “orange peel” skin; heat or redness; an itching or burning sensation.
Your doctor will feel (palpate) for a mass in your pelvis to find fibroids, cancerous tumors, lesions, discharge, and venereal disease. Your doctor must rule out pregnancy, which turns the cervix blue. If you have not had a pap smear in the past year, the doctor scrapes your cervix with a wooden Popsicle stick, smears the sample on a slide, and sends it to the Pathology Lab for expert examination.
Sexually active females give a urine sample or a ßhCG blood test as a routine precaution to ensure they are not pregnant before beginning hormone therapy. This is a standard legal precaution, and is especially important if your periods are irregular.
You may be sent to the Diagnostic Imaging Department for chest and skull x-rays or a mammogram. You may be asked to get a CT, MRI or PET scan, or a biopsy. The usual preliminary blood tests for benign breast disease include:
| PROFILE | TEST | NORMAL ADULT – NON-PREGNANT VALUE – FEMALE |
|---|---|---|
| Thyroid | T3 | 110 to 230 ng/dL |
| T4 | 5 to 10 μg/dL | |
| TSH | 1 to 4 μU/mL | |
| Liver | AST | 5 to 40 IU/L |
| ALT | 5 to 35 IU/L | |
| ALP | 30 to 85 ImU/mL | |
| Bilirubin | 0.1 to 1.0 mg/dL | |
| Cholesterol | 150 to 250 mg/dL | |
| Kidney | Creatinine | 0.7 to 1.5 mg/dL |
| BUN | 7 to 20 mg/dL | |
| Adrenals | Cortisol | 2 to 28 μg/dL depending on time of day |
| ACTH | 15 to 100 pg/mL | |
| Hormones | GH | 0 to 8 ng/mL |
| FSH | 3 to 20 mIU/mL | |
| LH | 7 mIU/mL | |
| HCG | Negative unless pregnant | |
| Progesterone | 2 ng/mL before ovulation 5 ng/mL after ovulation |
|
| Estradol | Varies from 25 pg/mL on Day 3 to 200 pg/mL at ovulation | |
| Prolactin | 24 ng/mL | |
| Testosterone | 6 to 86 ng/dL | |
| SHBG | 18 to 114 nmol/L |
These are guidelines only. Children, pregnant women and men have different normal values. Your laboratory adjusts its normal values for the local population it serves. It may use different units of measure. To find out more about diagnostic tests, visit Lab Tests Online:
http://www.labtestsonline.org/understanding/index.html
