19-7 Physical Exam Breast and Axilla Flashcards
what 7 things are used to describe the changes in a breast lump or mass
- location
- size
- shape
- consistency
- mobility
- borders
- retraction
how to describe the location of a breast lump
clock position and distance from nipple
how to describe the size of a breast mass or lump
in centimeters: length, width, thickness
how to describe the shape of a breast lump
- round
- discoid
- lobular
- stellate
- regular or irregular
how to describe the consistency of a breast mass or lump
- firm
- soft
- hard
how to describe the mobility of a lump or breast mass
- movable (in what direction)
- fixed
how to describe the borders of a breast mass or lump
- discrete
- poorly defined
how to describe retraction in breast mass or lump
- presence or absence of dimpling
- altered contour
- nipple discharge
- tender lymph nodes
- medication taken
what are nonmodifiable factors for breast cancer
- age
- gender risk factors
- personal history of breast cancer
- FMH of breast cancer
- previous breast biopsy
- race
- previous breast radiation
- early menarche
- late menopause
- breast density
- DES therapy
what are modifiable risk factors for breast cancer
- nullparity (late childbirth)
- hormone therapy
- alcohol
- obesity and high fat diets
- lack of physical activity
how many lobes are in each breast
15 to 20
how many lobules are in each lobe
20 to 40
what are the milk producing cells called
acini cells
what duct drains milk from each lobe onto the surface of the nipple
lactiferous ducts
what muscles forms the floor of the breast
- pectoralis major
- pectoralis minor
- serratus anterior
- latissimus dorsi
- subscapularis
- external oblique
- rectus abdominis
where in the breast is the greatest amount of glandular tissue
upper outer quadrant (tail of spence)
what equipment is needed to conduct a breast exam
- small pillow or folded towel
- ruler
- flashlight with transilluminator
Benign fluid-filled cyst formation caused by ductal enlargement
Fibrocystic changes
Benign tumors composed of stromal and epithelial elements that represents a hyperplastic or proliferative process in a single terminal ductal unit
Fibroadenoma
what condition accounts for the majority of breast tumors in young women
fibroadenoma
a firm, irregular mass, often appearing as an area of discoloration
fat necrosis
benign 2 to 3 cm tumors of the subareolar duct that occurs singly or multiples
Intraductal papillomas and papillomatosis
what is a common cause of bloody nipple discharge
Intraductal papillomas and papillomatosis
what mnemonic is used when assessing the nipples and areolar
5 D’s
- discharge
- discoloration
- deviation
- dermatologic changes
- depression
what ethnicity is more likely to have supernumerary nipples
black women
where are supernumerary nipples commonly located in black women
along the embryonic mammary ridge
which breast disorder is associated with the menstrual cycle and are usually multiple and bilateral fluid filled lesions
fibrocystic changes
what are some physical exam findings with breast cancer
- mass or thickening in the breast
- marked asymmetry
- prominent unilateral veins
- discoloration
- peau d’ orange
- ulceration
- dimpling
- puckering
- retraction of skin
- nipple inversion or deviation
a red scaling, crusty patch that forms on the nipple, areolar, and surrounding skin
paget disease
what are lesions that appear eczematous and usually unilateral
pagent disease
a smooth, firm, mobile, tender, disk of breast tissue located behind the areolar in males
gynecomastia
what is the cause of gynecomastia
- hormone imbalance
- liver failure
- antihypertensive meds
- testicular, pituitary, or hormone secreting tumors
inflammation of the sebaceous glands in the areolar
retention cysts
lactation not associated with childbearing
galactorrhea
what causes galactorrhea
- pituitary tumors
- cushing’s syndrome
- hypoglycemia
- drugs (antidepressants, estrogen, phenothiazine, tricyclics)
inflammation and infection of the breast tissue
mastitis
who is more likely to get mastitis
lactating women
what is the most common causative agent of mastitis
staph infection
what is the likely diagnosis of a woman who is currently breast feeding and complains of sudden onset of swelling, tenderness, erythema, and heat around her breast
mastitis
what population of women are more likely to have mammary duct ectasia
menopausal women
what breast conditioned is characterized as blocked subareolar duct with desquamating secretory epithelium, necrotic debris, and chronic inflammatory cells
mammary duct ectasia
