Instructions
You are a medical student on placement in general practice. Your next patient is Lorraine Pettigrew, 56, an aged care worker, presenting with nipple discharge.
Examine the patient
Outline to the examiner:
- Your findings
- Your most likely diagnosis and differentials
- You do not need to take a further history or outline a management plan
- The breast examination is done on a model; please verbalise it, and findings will be provided on request
- The examiner will ask you one question at the end
History taken by the GP
Thick greenish-brown discharge from both nipples on and off for four months, found on her bra; never bloody. Left nipple slowly drawn in over the past year. No lump or pain. Periods stopped at 51; no hormone therapy or regular medicines. Smokes 20 a day. Screening mammogram two years ago normal.