Breast Tx Flashcards
CI’s for breast treatment
Infection (mastitis, post-surgical, etc)
Undiagnosed lump (on-site)
Abscess (on-site)
Forceful attempt to reduce implant-related contractures
Direct pressure on distorted implant
Submuscular implant with lateral breast and subscap pain
Indications for breast treatment
Congestion Edema Lymphedema Breast pain, discomfort "General drainage problems" PMS Post-surgical relief, scar treatment Trauma etc
Borders of breast tissue
Upper: lower edge of clavicle
Lower: 1” below breast contour, over upper fibres of rectus abdominis; 6th rib
Medial: sternal midline
Lateral: anterior lats; may continue into axilla
Central Nodes
Axillary lymph nodes
Lie along chest wall, high in axilla, midway between anterior and posterior axillary folds
Receive drainage from pectoral, subscapular and lateral nodes.
Drain into the infraclavicular and supraclavicular nodes
Much of the breast’s lymphatics drains into the:
Pectoral nodes
The only structural support for the breast
Coopers ligament
Direction of lymphatic draining from breasts
75% toward axilla
25% superiorly, towards other breast, downward (internal mammary chain, rectus abdominus lymphatics, subdiaphragmatic nodes to posterior paravertebral nodes)
Rotter’s Nodes
Lymph nodes that lie between the pec major and minor. Can be compromised by pec restriction
What organs refer pain to the breast?
Angina/heart pain
Gall bladder
Esophagus
Since lymph vessels are valveless, they are strongly affected by
Gravity
Retromammary space
In between deep fascia and the pec major. Channel of lymph drainage. Easily compressed.
Internal mammary nodes travel through which muscle
Pec major
Axillary Web Syndrome
Lymphatic cording
Common after breast cancer treatment
Interrupted lymphatics in axilla –> lymphatic thrombus –> painful limited movement in upper extremity.
Inflammatory breast cancer
No mass
Cancer cells block lymphatic vessels causing swelling, redness, rigid/dimpled skin
Considered Stage 3 (locally or regionally advanced)
Radical mastectomy
Breast Lymph nodes Chest fascia Maybe pecs Plus chemo and radiation
Modified radical mastectomy
Breast
Fascia
IL lymph
Chemo + radiation
Most common cause of gynomastia
Liver disease
Medication
(25% case each)
