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Breast Assessment > Breast Assessment > Flashcards

Breast Assessment Flashcards

1
Q

What are appropriate history questions to ask re: the breast?

A

Pain, lumps, discharge, rashes

history of surgery, history of lumps or CA in other parts of body, birth control pills, sexual trauma, breastfeeding

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2
Q

What are normal findings for the breast in females who are…. Pre-pubescent

A

nipple, no breast tissue - Maturity Scale 1

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3
Q

What are normal findings for the breast in females who are…. Pubescent

A

maturity scale 2-5 – breast buds, to increased areola and breast (mound on mound) to mound with flattened areola and slight nipple to mature breast with nipple protruding – flat areola

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4
Q

What are normal findings for the breast in females who are…. Nulliparous, menstruating

A

“lumpy” or breast pain normal, enlarged/fluid retention normal, veins visible – some striae if weight gain

Clear nipple discharge may be normal with some meds, OCP, digoxin, antidepress.

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5
Q

What are normal findings for the breast in females who are…. Pregnant

A

enlarged, visible veins, striae normal – colostrum (yellow pre-milk discharge normal from 4 mos) Milk and breasts “harder” “full” from day 4 after delivery

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6
Q

What are normal findings for the breast in females who are…. Menopausal

A

sagging, drooping, less subq fat, less fibrous tissue, thinner, grainy in consistency

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7
Q

What should be taught re: self breast exam? What techniques should be used?

A

Prefer vertical lines up and down – push slightly into well of nipple, not squeeze nipple – do once month Look at self in mirror – arms up, down, pushing at hips

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8
Q

When should the woman check her breasts?

A

preferably first day of month if menopausal, pregnant, or not menstruating OR days 4-7 after period when breasts least sore.

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9
Q

What might indicate male breast cancer? How could it be detected?

A

Noticeable discharge from breasts, palpable mass esp if hard and irregular, gynecomastia – esp if assymetric, pucker or lump

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10
Q

What is a supernumerary nipple?

A

Extra nipple in the evolutionary line – just under the other nipples - no breast tissue

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11
Q

What are the symptoms/findings noted with the following conditions of the breast?

Fibrocystic breast disease

A

“water balloon” comes and goes with menstrual cycle, ache to breast, NON cancerous - common in ????

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12
Q

What are the symptoms/findings noted with the following conditions of the breast?

Fibroadenoma

A

hard, fast growing mass, often in younger women, NON cancerous – usually removed and biopsied

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13
Q

What are the symptoms/findings noted with the following conditions of the breast?

Acute mastitis

A

painful, red, hard area of breast – often related to infection from breastfeeding but can happen with nipple piercing, sexual trauma – often febrile

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14
Q

What are the symptoms/findings noted with the following conditions of the breast?

Cancer

A

hard, palpable mass – often irregular and fixed (not movable) or rash that is not going away – often starts in nipple and moves outward, bloody or change in discharge from nipple or ASYMMETRIC breasts

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15
Q

What are the symptoms/findings noted with the following conditions of the breast?

Paget’s disease

A

cancer inside that presents as diffuse rash or skin changes

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16
Q

When a mass is discovered, what characteristics should be documented?

A

location, consistency (hard or soft), mobile or fixed. Irregular or regular< size, clock location , pain

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17
Q

What lymph nodes are related to the breast?

A

Central (axillary) armpit
Brachial (lateral) arm between tricep and bicep
Pectoral or anterior axillary –
Subscapular or posterior axillary

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18
Q

What are two ways to reference anatomical position on a breast?

A
  • Clock

- divide into quadrants (upper outer, upper inner, lower outer, lower inner)

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19
Q

Where are most tumors in the breast/axilla found?

A

In the upper outer quadrant in the tail of spence (axilla)

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20
Q

When do breasts have a tendency to feel more nodular?

A

before menses

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21
Q

What is an extra nipple called and where do they usually fall?

A

Supernumerary nipples usually fall along the milk line

22
Q

Other than the tail of spence, where else do tumors have a tendency to grow?

A

behind the nipple

23
Q

Upon aging what causes breasts to sag?

A

loss of connective tissue

24
Q

In adolescence what is breast development called?

A

telarche

25
Q

What system measures breast development in adolescence?

A

tanner stages of breast development

26
Q

When is nipple discharge normal?

A

Colostrum in the third trimester of pregnancy

27
Q

What are some questions to ask for the ROS of breasts?

A
  • Do you have any discomfort or pain? (menses, medication)
  • Do you have any masses or lumps? (changes in a lump, symptoms)
  • Nipple discharge? (describe, bloody is bad)
  • Do you do SBE? How often?
28
Q

When is the ideal time to do a SBE?

A

5-7 days after onset of menses

29
Q

In what 4 positions do you want to inspect the breasts?

A
  • Arms at side
  • Arms overhead
  • Hands pressed against hips
  • Leaning forward
30
Q

What are you looking for in the breast exam when the patient is moving through different positions?

A
  • Shape
  • Symmetry
  • Texture
  • Dimpling
  • Refractions
31
Q

Is a nipple inversion, eversion, or retraction normal?

A

Only if it is a new finding

32
Q

What would be an abnormal finding during a breast exam?

A
  • Retractions
  • Dimpling
  • new nipple inversion
  • texture changes
33
Q

In what position do you palpate the breast?

A

supine

34
Q

What is the system for palpating the breast?

A
  • Palpate from the axillae downward using vertical lines up and down over the breast tissue (mowing a lawn).
  • When you push down, use small concentric circular pressure of light, medium, and deep pressure
  • never lift your fingers off the breast
35
Q

What are you examining the breast tissue for?

A
  • Consistency of tissue
  • Tenderness
  • Nodules
36
Q

If you find a nodule what things to you want to report?

A
  • Location
  • Size (cm)
  • Shape (round/single/matted)
  • Consistency (soft, firm, or hard)
  • Delimitation (well circumscribed or not)
  • Tenderness
  • Mobility (in relation to skin)
37
Q

What is the difference between a lymph node and a breast mass?

A
  • Lymph nodes are mobile and bean-like

- Tumors are hard, matted or fixed

38
Q

If a mass in the breast is very tender is it likely to be a tumor?

A

No, it’s more likely to be an inflamed lymph node

39
Q

What would be findings consistent with a malignancy?

A
  • Hard consistency
  • Irregular shape
  • Dimpling over skin
  • Retraction of nipple
  • non-tender
40
Q

When should women get clinical breast exams?

A
  • every 3 years from 20-40

- once a year after 40

41
Q

When are mammograms recommended?

A

Once a year after 40 (even though now they are recommending once a year after 50)

42
Q

What are risk factors of breast cancer?

A
  • Obesity
  • Hormone replacement therapy
  • Alcohol use
  • Sedentary lifestyle
  • Age
  • Family history (first degree)
  • Older age pregnancy
  • Early menarche
  • Late menopause
  • Breast density
  • Never breast fed
43
Q

What are the two gene markers to test for breast cancer?

A

BRCA1

BRCA2

44
Q

What would be considered an early age for menarche?

A

8, 9 or even 10

45
Q

What are the risks of breast cancer with someone who has breast implants?

A
  • Difficulty detecting lesions

- Decreases your chance of survival

46
Q

How do you palpate the breast of someone who has implants?

A

Press firmly inward at the edge of the implant to feel ribs beneath

47
Q

How do you do a breast exam on someone who has had a mastectomy?

A

Inspect the scar and axilla for possible return of malignancy

48
Q

What are two common side effects for someone who has had a mastectomy?

A
  • Scar soreness

- Lymphedema

49
Q

For males, what is the difference between breasts due to obesity and breasts of gynecomastia?

A
  • Obesity leads to soft, fatty enlargement

- Gynecomastia has a firm disc of glandular enlargement

50
Q

In what position do you want the patient when inspecting the axilla?

A

Sitting

51
Q

What is the method for palpating the axilla?

A
  • Cup together the fingers of your hand
  • Reach as high as possible into the apex of the axilla
  • Fingers directly behind pectoral muscle toward midclavicle
  • Press fingers toward chest wall and slide them downward
52
Q

When palpating the axilla, which nodes are you feeling for?

A

central nodes - one or more small (<1cm) nontender nodes is normal

Breast Assessment (1 decks)

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