Breasts Flashcards
Breast function
milk production and sexual pleasure
Four quadrants
upper inner Q, upper outer Q, lower inner Q, lower outer Q and tail of spence
5 Lymphatic drainage nodes/chains
Central (midaxillary) Pectoral (anterior) Subscapular (posterior) Brachial (lateral) Infraclavicular
Breast development
Stimulated by estrogen release during puberty
Usually begins at 8 to 10 years of age
Common chief complaints
Breast mass
Tenderness
Discharge
Breast- Health history
Medical history-Breast specific
Surgical history- Breast specific
Breast- Family history
Breast cancer
Benign breast disease
Breast cancer
45% of all breast cancers occur in upper, outer quadrant
Inspection positions
Arms at side
Arms overhead- accentuates retractions
Hands pressed against hips- accentuates retractions
Leaning forward
Inspect breasts
color, Striae, Vascularity, Thickening or edema,ize and symmetry, Lesions or masses
Inspecting breast contour
Retractions, dimpling or puckering
Other areas of inspection
Axillae
Areolar areas
Nipple inspection
Symmetry/ level
Inversion/retraction
Discharge
Beginning of palpation
Sequential manner
Sitting with arms at side, arms raised
Axillary and infraclavicular nodes
Patient in supine position
spread the tissue across chest
Palpate using the palmar surface of fingers
Palpate all breast tissue, including the tail of Spence
Palpation methods
Wedge
Concentric circles
Horizontal parallel lines
Vertical parallel lines
Palpate areola
Compress the nipple-Note any discharge
First 6 Evaluation of breast mass
Location Size Shape Number Consistency Definition
Second 5 evaluation of breast mass
Mobility Tenderness Erythema Dimpling or retraction Lymphadenopathy
Common Breast masses
Cyst
Fibroadenoma
Carcinoma
Normal breast color findings
Breast and axillae are flesh colored
Areolar areas and nipples are darker in pigmentation (increases with pregnancy)
Moles and nevi are normal variants
Normal breast findings
Symmetrical and diffuse vascular patterns
No thickening or edema
Normal breast size findings
Minor size variation in the breasts and areolar areas
Breast on dominant side usually is larger
Normal nipple findings
Nipples should point upward and laterally or outward and downward
No discharge from nipples in nonpregnant, nonlactating female
Normal symmetry findings
Breasts, areolar areas, nipples should be symmetrical
Normal contour findings
Breasts are convex, without flattening, retractions, or dimpling
Free from masses, tumors, primary or secondary lesions
Normal lymph node findings
Palpable lymph nodes less than 1 cm in diameter usually are clinically insignificant
Nodes usually are not palpable
Non-modifiable risk factors
Female, Age > 50
Personal or family history of breast cancer
Prior thoracic radiation
Menarche at an early age, Firstborn after age thirty, Late onset of menopause
Ethnicity
Dense breast tissue
High postmenopausal bone density
Personal history of endometrial, ovarian, or colon cancer
Modifiable risk factors
Alcohol intake > 3 servings per day Obesity Physical inactivity Cigarette smoking Postmenopausal hormonal therapy Childbearing history Oral contraceptive use Breastfeeding history
Simple Mastectomy
only the breast tissue is removed
Modified radical mastectomy
the breast and lymph nodes from the axilla are removed
Radical masectomy
the breast, lymph nodes from the axilla, and the pectoral muscles are removed
Subcutaneous mastectomy
the skin and nipple are left intact, but underlying breast tissue and lymph nodes are removed. Rarely performed
Diagnostic Techniques
Mammography Ultrasonography Needle aspiration Biopsy Thermography Ductal lavage
needle aspiration
withdrawal of fluid or tissue from a cavity
biopsy
process of removing tissue from a suspicious area of examination
ductal lavage
method of rinsing the milk duct to obtain cells for analysis of atypia
Self-Breast examination
Performed once a month on a fixed date each month, or 8 days after menses
Avoid completing during menstruation or ovulation
