Preliminary Breast Lump Inquiry Preliminary Breast Lump Info 1. When was the earliest you spotted the lump(s)? 2. What is the size of the lump(s)? 3. What is the hardness of the lumps? 4. Do any of the lumps hurt when pressed? No, none of them hurt when pressed. Yes, it hurts. Provide more details if necessary 5. Have you had any breast exams? No Yes, I had mammographs Yes, I had biopsies Provide more details if necessary 6. What is the latest diagnosis? There is no confirmed diagnosis. The diagnosis is 7. Has any treatment been suggested? Yes, the suggested treatment includes 8. Are you taking any medications? No, I am not on any drugs. I do not want to answer this. Yes, I am taking the following medications 9. Are you experiencing any financial hardships? No I do not want to answer this. Yes, my hardships are as follows: 10. Do you have any other comments? No Yes, here is some more info that might be helpful: Name (First, Last) * Phone # Email * Note If you are human, leave this field blank. Submit