Breast examination - practical Flashcards
lymph nodes of breast
90% lymph drains into the ipsilateral axilla
10% goes into the internal thoracic lymph noed
where do malignancies in the breast begin
Malignancies generally originate in
either the glandular tissues that secrete milk
or in the ductal structures that transport it to
the nipple.
breast lumps
young infants both genders can have breast lumps from their mothers oestrogen.
Young girls often develop “breast
buds,” which appear just before the
beginning of puberty.
boys can have it to during puberty as hormonal changes occur
Fibrocystic changes
Fibrocystic changes are painful, lumpy breasts. Fibrocystic breast changes do not increase your risk of breast cancer. Symptoms are most often worse right before your menstrual period, and then improve after your period starts.
fibroadenoma
Is a non-cancerous benign lump that is found in breast tissue. When felt under the skin, the lump may feel rubbery and easily moveable within the breast tissue.
Fibroadenomas are commonly found in young women during their reproductive years
symptoms
nipples are inverted
asymetry
discharge of blood - (sign for malignancy)
“Orange Peel” like texture that’s caused by an
uncommon, aggressive, niflammatory malignancy
redness
how to palpate
use pads of 3 middle fingers
can use circular motions
use 3 levels of depth, superficial, medium and deep
dorn forget to test lymph nodes too ( axilla)
what indicates malignancy
if the mass moves with the pectoralis muscle
where do the majority of breast cancers develop
he majority of breast cancers develop in the upper outer quadrant so it’s essential this area is examined thoroughly
nipple discharge
Yellow / green discharge – suggestive of infection
Bloody discharge – more suspicious of malignancy – e.g. papilloma
division of mastitis
lactational infections - systemic signs
chronic subareolar infections
what is the treatment of solitary intraductal papilloma?
the treatment of solitary intraductal papillomas is excision through a circumareloar incision.
fibrocystic disease defintions
combination of localized breast fibrosis and cyst formation, occurs almost exclusively
between menarche and menopause.
- four major risk factors for breast cancer are accepted. what are they?
The major risk factors for breast cancer are : Gender, age, previous breast cancer, and family
history and genetic predisposition.
triple assessment of breast cancer
Triple assessment consists of clinical examination radiological assessment (mammography
usual particularly over age 35 years; ultrasound sometimes used under age 35 because
increased tissue density reduces the sensitivity and specificity of mammography) and
cytological assessment (fine needle aspiration cytology or occasionally, core needle biopsy)
regional spread
Regional spread of breast cancer is defined as …… to the axillary, internal mammary, and
supraclavicular nodes. The axillary nodes represent the most important site of regional
spread from breast cancer spread to axillary nodes is the most important prognostic
indicator of breast cancer.
what is the typical presentation in male breast cancer?
Cancer of the male breast is an uncommon disease. The typical presentation is a mass
beneath the nipple areola complex, with retraction of ulceration of the nipple.
Locally advanced breast cancer
Locally advanced breast cancer includes T3 and T4 tumors, those with extensive regional
nodal involvement (N2 AND N3) and inflammatory breast cancer and should be treated with
a combination of induction chemotherapy, surgery, and postoperative radiation therapy.
absolute contraindications for breast- conserving surgery in breast carcinoma
The absolute contraindications for breast- conserving surgery in breast carcinoma are:
-two or more primary tumors in separate quadrants of the breast,
- diffuse malignant- appearing microcalcifications,
- a history of prior therapeutic irradiation to the breast region that would result in re-
treatment to an excessively high radiation dose,
-pregnancy (pregnancy is an absolute contraindication to the use of breast irradiation)
peau d’orange (skin of the orange) is a typical feature of:
inflammatory breast cancer
tumour marker
CA1-53
MOST COMMON METASTSIS
a/the bones and the lungs
