Breast and Axilla Flashcards
central nodes
most palpable;
lie along chest wall;
drain to infraclavicular and supraclavicular nodes
pectoral nodes
along pectoralis major
subscapular nodes
along the lateral border of scapula
lateral nodes
along the upper humerus
Galactorrhea
inappropriate discharge of milk containing fluid.
“abnormal if it occurs more 6 or more months after childbirth”
Fibroadenoma risks
15-20 years fine, round, mobile, nontender
Cysts risks
25-50 years
round,
mobile,
tender
Fibrocystic changes risks
25-50 years
round,
mobile,
tender
Cancer risks
25-50 possible
over 50, cancer until proven otherwise
Firm without clear borders
breast cancer risks of >4.0
Female 65+ Genes; BRCA1/BRCA2 2 or more first degree relatives with early age breast cancer previous breast cancer breast tissue density biopsy confirmed hyperplasia
breast cancer risks of 2.1-4.0
1 first degree relative with breast cancer
high dose chest radiation
high bone density (postmenopausal)
breast cancer risk of 1.1-2.0
30+ years at first full term pregnancy no pregnancy menarche before 12 menopause after 50 never breast fed recent oral contraceptive use recent long term hormone replacement use postmenopausal obesity
Risks for BRCA1/BRCA2 genes
first degree relative for one of these mutations
2 or more relatives with a diagnosis of breast cancer before 50 if one of the relatives is a first degree relative
3 relatives with breast cancer diagnosis if at least one was diagnosed before 50
2 or more relatives with ovarian cancer
1 relative with breast cancer and one with ovarian cancer
Breast density accounts for what percentage of risk for breast cancer
30%
Density of more 60-75% increase risks by how much
4 or 6 times greater risk
Mammography recommendations
40-50 years: every 1-2 years
50’s and up: annual screenings
Four views for breast inspection
arms at sides
arms overhead
hands pressed against hips
leaning forward
Recent flattening or retraction of nipple suggests
cancer
Rash or ulceration on breasts suggests
Paget’s disease
Redness on breasts suggests
local inflammation or inflammatory carcinoma
thickening, dimpling, or prominent pores suggests
cancer
Gynecomastia
enlarged breasts in men;
caused by estrogen/androgen imbalanc
tender cords suggest
possible mammary duct ectasia (benign but painful duct inflammation)
tender nodules suggest
could be a benign cyst or cancerous
acanthosis nigricans
dark velvety skin; possible internal malignancy
Enlarged axillary lymph nodes
could come from infection,
recent immunizations or skin tests in the arm,
or part of a generalized lymphadenopathy.
nodes that are large (more than 1 cm) and firm or hard, matted together, or fixed to the skin or to underlying tissues suggest malignant involvement.
nonpuerperal galactorrhea
milky discharge unrelated to pregnancy and lactation. causes include hypothyroidism,
pituitary prolactinoma,
and drugs that are dopamine agonists
Spontaneous unilateral bloody discharge from one or two ducts suggests
intraductal papilloma,
ductal carcinoma in situ,
or Paget’s disease of the breast.
peau d’orange suggests
lymphatic blockage that results in edema of the skin
Visibile signs of Paget’s disease in the nipple include
eczema like lesions tha weep, crust or erode.
