Breasts

Question 1

Breast function

Answer 1

milk production and sexual pleasure

Question 2

Four quadrants

Answer 2

upper inner Q, upper outer Q, lower inner Q, lower outer Q and tail of spence

Question 3

5 Lymphatic drainage nodes/chains

Answer 3

Central (midaxillary)
Pectoral (anterior)
Subscapular (posterior)
Brachial (lateral)
Infraclavicular

Question 4

Breast development

Answer 4

Stimulated by estrogen release during puberty

Usually begins at 8 to 10 years of age

Question 5

Common chief complaints

Answer 5

Breast mass
Tenderness
Discharge

Question 6

Breast- Health history

Answer 6

Medical history-Breast specific

Surgical history- Breast specific

Question 7

Breast- Family history

Answer 7

Breast cancer

Benign breast disease

Question 8

Breast cancer

Answer 8

45% of all breast cancers occur in upper, outer quadrant

Question 9

Inspection positions

Answer 9

Arms at side
Arms overhead- accentuates retractions
Hands pressed against hips- accentuates retractions
Leaning forward

Question 10

Inspect breasts

Answer 10

color, Striae, Vascularity, Thickening or edema,ize and symmetry, Lesions or masses

Question 11

Inspecting breast contour

Answer 11

Retractions, dimpling or puckering

Question 12

Other areas of inspection

Answer 12

Axillae

Areolar areas

Question 13

Nipple inspection

Answer 13

Symmetry/ level
Inversion/retraction
Discharge

Question 14

Beginning of palpation

Answer 14

Sequential manner
Sitting with arms at side, arms raised
Axillary and infraclavicular nodes

Question 15

Patient in supine position

Answer 15

spread the tissue across chest
Palpate using the palmar surface of fingers
Palpate all breast tissue, including the tail of Spence

Question 16

Palpation methods

Answer 16

Wedge
Concentric circles
Horizontal parallel lines
Vertical parallel lines

Question 17

Palpate areola

Answer 17

Compress the nipple-Note any discharge

Question 18

First 6 Evaluation of breast mass

Answer 18

Location
Size
Shape
Number
Consistency
Definition

Question 19

Second 5 evaluation of breast mass

Answer 19

Mobility
Tenderness
Erythema
Dimpling or retraction
Lymphadenopathy

Question 20

Common Breast masses

Answer 20

Cyst
Fibroadenoma
Carcinoma

Question 21

Normal breast color findings

Answer 21

Breast and axillae are flesh colored
Areolar areas and nipples are darker in pigmentation (increases with pregnancy)
Moles and nevi are normal variants

Question 22

Normal breast findings

Answer 22

Symmetrical and diffuse vascular patterns

No thickening or edema

Question 23

Normal breast size findings

Answer 23

Minor size variation in the breasts and areolar areas

Breast on dominant side usually is larger

Question 24

Normal nipple findings

Answer 24

Nipples should point upward and laterally or outward and downward
No discharge from nipples in nonpregnant, nonlactating female

Question 25

Normal symmetry findings

Answer 25

Breasts, areolar areas, nipples should be symmetrical

Question 26

Normal contour findings

Answer 26

Breasts are convex, without flattening, retractions, or dimpling Free from masses, tumors, primary or secondary lesions

Question 27

Normal lymph node findings

Answer 27

Palpable lymph nodes less than 1 cm in diameter usually are clinically insignificant Nodes usually are not palpable

Question 28

Non-modifiable risk factors

Answer 28

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

Question 29

Modifiable risk factors

Answer 29

``` Alcohol intake > 3 servings per day Obesity Physical inactivity Cigarette smoking Postmenopausal hormonal therapy Childbearing history Oral contraceptive use Breastfeeding history ```

Question 30

Simple Mastectomy

Answer 30

only the breast tissue is removed

Question 31

Modified radical mastectomy

Answer 31

the breast and lymph nodes from the axilla are removed

Question 32

Radical masectomy

Answer 32

the breast, lymph nodes from the axilla, and the pectoral muscles are removed

Question 33

Subcutaneous mastectomy

Answer 33

the skin and nipple are left intact, but underlying breast tissue and lymph nodes are removed. Rarely performed

Question 34

Diagnostic Techniques

Answer 34

``` Mammography Ultrasonography Needle aspiration Biopsy Thermography Ductal lavage ```

Question 35

needle aspiration

Answer 35

withdrawal of fluid or tissue from a cavity

Question 36

biopsy

Answer 36

process of removing tissue from a suspicious area of examination

Question 37

ductal lavage

Answer 37

method of rinsing the milk duct to obtain cells for analysis of atypia

Question 38

Self-Breast examination

Answer 38

Performed once a month on a fixed date each month, or 8 days after menses Avoid completing during menstruation or ovulation