A 46-year-old Caucasian woman presents to the clinic complaining of breast pain. The patient states the pain is intermittent, located in the right breast, and described as sharp with a burning sensation. She rates the pain as 7/10 at its worst. The pain sometimes interferes with her sexual activity. She has tried warm compresses, ibuprofen, and support bras with little improvement.

The patient is on oral birth control pills and takes a daily vitamin. She reports occasionally eating nutritious meals, but due to job and family obligations, she frequently consumes fast food. She is an assistant accountant at a local accounting firm, which adds to her stress, especially at the end of each month and during tax season. She exercises 1-2 times per week by walking around the block, but sometimes this increases her breast pain.

The patient drinks socially once or twice a month, consuming 1-2 glasses of wine each time. She smokes 2 packs per day and has been smoking for the last 22 years. She has tried to quit but has not been successful. Family history is non-contributory.

Objective Information:
- Height: 5'6"
- Weight: 155 lbs
- BMI: 25
- Blood Pressure: 140/78
- Heart Rate: 72/min

Examination Findings:
- HEENT: Normocephalic, no lumps or lesions
- Neck: Supple without adenopathy, no thyromegaly
- Lungs: Eupneic, CTA bilaterally
- Cardiovascular: Regular rate and rhythm, no murmurs, rubs, or extra sounds; 2+ peripheral pulses, no edema
- Breasts: Macromastia with soft, fibrocystic changes bilaterally noted without masses, dimpling, or discharge; no redness or inflammation

What other information do you need?

Additional information needed includes any signs of new lumps, persistent pain, changes in the breast or unusual symptoms, as well as lifestyle factors such as stress and smoking habits that could contribute to breast pain.

To provide a comprehensive assessment of the 46-year-old Caucasian woman presenting with intermittent breast pain, additional information is required. It is important to ask about any recent changes, such as a new lump in the breast, changes in breast size or shape, and any persistent pain that could be indicative of a more serious underlying condition. Furthermore, questioning about any unusual bleeding or discharge, thickening or lump elsewhere, indigestion or difficulty swallowing, changes in warts or moles, and any nagging cough or hoarseness is crucial.

The patient's lifestyle factors, including high stress levels and smoking habits, may also be contributing to her symptoms and should be addressed in her management plan. It's essential to differentiate whether the symptoms are related to benign fibrocystic changes, musculoskeletal inflammation, or whether there are signs suggesting potential malignancy or inflammatory processes.