Breast Flashcards
The Breasts
- sensorary reproductive organs between the 2nd and 6th ribs
- anterior to the pectoralis major and serratus anterior
- The nippple is just below the center of each breast and sourrounded by the areola
- the areaola- surrounds the nipple for 1-2 cm radius. contains the montgomery glands which secrete a protective liquid during lactation
- The tail of spense is located in the upper outer quadrant laterally into the axila–spot where most breast murmurs occur
The breast is composed of
granular tissue
* 15-20 lobes that radiate from the from the nipple & consist of lobules. Each lobe empties into the laciferous duct that carries milk into the laciferous sinus, which stores milk behind the nipple
fibrous tissue
* includes the copper ligamnet that supports the breast tissue
adipose tissue
* houses the lobes and provides most of the bulk of the breast
The lymphatic system of the Breast
- occurs primarily through four groups of axillary nodes, with most of the draining occuring in the ipsilateral axillary nodes
developmental changes of the breast
birth
* lactiferous ducts within the nipple present
8-10 years old
* breast development occurs, varies by race, ethnicity, and body mass
* girls with earlier maturation are at a greater risk of low self-esteem and depression
Puberty
* estrogen stimulates breast changes; the breast enlarges & the duct system grows & masses of small, solid cells develop at the duct endings
Tanner stages
1.preadolescent
* there is only a small elevated nipple
2.breast bud stage
* small amount of breast and nipple develoips; the areola widens
- enlargement of breast
* the nipple is flush with the breast surface - aerola stage
* forms from a secondary mound over the breast
6.mature breast stage
* only the nipple protrudes; the areola is flush with the breast contour
breast development during pregnancy
- begins in the second month with the expansion of the ductal system & supporting fatty system & the development of the true secetory alveoli
- areolae becomes larger and dark brown, tubercles more prominent, nipples are larger, darker and more erectile
- during lactation–> 4th month, colostrum may occur (thick, yellow fluid which is a precursor for milk) lactation occurs 1-3 days after delivery
- post-lactation–> mature sagging breast tissue with enlarged nipples
breast devleopment: Menopause
- ovation secretion of estrogen and progesterone decreases which causes glandular and fatty tissue to atrophy
=droopy, saggy breast
Male breast
- consists of a thin disk of undevloped tissue underlying the nipple
- during adolescence the breast tissue may enlarge to form gynecomastia which is usually temporary
Breast cancer
- Death rates from breast cancer have decreased significantly due to treatments that target expression of the estrogen receptor and HER2, the cell-surface receptor. Also, cancer-specific mutations in DNA can be measured if family history suggests increased risk
- Lifestyle factors relate to breast cancer risk, with alcohol drinking associated with a risk in a dose-dependent measure.
- Additionally, a diet rich in fruits and vegetables may lower the risk of breast cancer. Smoking increases the risk of breast cancer
. - BRACA1 and BRACA2–> tumor supressor gene, if matuated have a higher risk of breast or ovarian cancer
- screening–> can discover small, curable breast cancers, recommended in ages 40-44
objective//subjective data assessment of the breast and regional lymphatics
subjective data
- ask questions regarding breast pain, lumps or discharge; swelling trauma; history of breast disease; surgery or radiation on the breast; medications & the frequency of self-breast exams
- Additionally, ask questions inquiring about any tenderness, lump, swelling, or rash in the underarm area
objective data
* inspect the breast as the woman sit
* note the apperance and symmetry of the breast including the size, shape and color and texture
breast assessment
- ask the woman to raise her arms overhead,
followed by asking her to push her hands on her hips, leaning forward. This tests for retraction. - Inspect and palpate the axillae and regional lymph nodes.
- Then with the woman supine and her arm raised over her head, systematically palpate all four quadrants of the breasts, including the tail of Spence, the nipples, and the areolae.
- If you feel a lump or mass, note its location, size, shape, consistency, mobility, and distinctness. Also notice any related nipple changes, skin changes, tenderness, or lymphadenopathy.
- After your assessment is completed, teach breast self-examination. Besides reviewing the appropriate technique, cover additional points
breast assessment through the lifespan
- In the neonate, the breasts may be enlarged and visible from maternal estrogen crossing the placenta.
- In the child, the nipples are flat and symmetric with the areolae having a darker pigment.
- With maturing adolescents, palpate the breasts as with the adult. The breasts should feel firm and uniform.
- In the pregnant woman, a blue vascular pattern is observed over the breasts. The breasts and nipple enlarge and striae may be visible. In lactating women, the breasts are engorged, red, and warm to the touch.
- In the older woman, the breasts appear pendulous, flattened, and sagging. The nipples may be retracted. Upon palpation, the breasts feel granular and the terminal ducts around the nipples feel stringy
self breast examination
- potenial harm–> false postitive
- best time is day 4-7 day of cycle
abnormal findings of the breast
- gynecomastia—> enlargement of the male breast due to estrogen//testosterone imbalanace
- Galactorrhea–> milky nipple discharge that is unrelated to the norm
- supernumerary nipple–> extra nipple
- mastitis–> uncommon, inflammatory mass before abscess formation
- bibrocystic breast disease–>multiple tender masses that occur with nurmerous symptoms and physical findings
