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Early Detection

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Personal Information

Are you experiencing any of the following?

Yes No
Is there a fixed (non-mobile) breast lump?
Bloody nipple discharge
Skin change (orange peel appearance)
Change in breast size
Dimpling or retraction of the breast
Have any imaging studies or external investigations been done?
Have any samples (biopsies) been taken?
Has the patient received any of the following treatments: radioactive iodine?
Has the patient received any of the following treatments: chemotherapy, radiotherapy or hormonal therapy
Has the patient undergone any surgeries related to malignant tumors?
Are there nipple crusts that do not respond to topical creams?
Is there a change in nipple direction (nipple retraction or deviation)?
Is there redness, inflammation, or increased warmth in the breast or nipple?

Family History

Yes No
Is there a family history of breast cancer from the mother, aunt, and cousin?