Breast examination Flashcards
What are the 3 main components of the breast?
milk glands
ducts
fat
How do breasts extend into the axilla?
Via the tail of Spence
Which muscles are the breast attached to?
Pectoralis major and serraus anterior
Rationale for performing breast examination
Lump
“looks different”
mastalgia
nipple discharge
Risk factors for breast disease include
Previous breast disease Family history Age Pregnancy (increased if a woman has never given birth) HRT Menstrual history
What are the 8 steps to be taken before the examination starts?
Introduce yourself to the patient
Ask permission to perform the examination
Assure privacy
Ask for chaperone to be present
Explain what you want to do
Expose the patient adequately
Position the patient correctly
If sores or discharge visible wear gloves
When the patient is sitting up, resting their hands in their lap what are you looking for?
symmetry
visible masses
skin changes
When the patient’s arms are behind the head, what are you looking for?
Change in mass’s relative position
Nipple or skin tethering
When the patient’s hands are on their hips, what are you looking for?
- Dimpling
- Fixation
What position is the patient in for palpation?
Supine, flat on the bed
what is the technique for palpating the lymph nodes?
Palpate the axilla using the “between fingers and thumb” technique and support the patient’s arm
When documenting the findings, what 11 things need to be reported?
Size - cm and shape
Site - position (o’clock) and distance from nipple
Overlying skin (?colour, ?discharge)
Shape
Consistency/Texture - rubbery, stony, hard, fluctuant
Surface (craggy/smooth)
Temperature
Mobility - attached to skin and/or underlying structures
Tenderness
Regularity - (regular/irregular)
Discharge
what is the consistency of a benign mass?
firm or rubbery
what is the consistency of a malignant mass?
hard
Are benign masses painful or painless?
painful, malignant masses are painless 90% of the time
margins of malignant masses are
irregular
margins of benign masses are
smooth/regular
do benign masses move?
yes, they are mobile and not fixed
do malignant masses move?
no, they are fixed to skin or chest wall
what is skin dimpling a sign of?
malignant mass
bloody and unilateral discharge indicates
malignancy
bilateral discharge that is green or yellow indicates
benign mass
nipple retraction is a sign of
malignancy
