Ch. 18 Breasts

Question 1

Which of the following statements is true regarding the internal structures of the breast?

a. Fibrous, glandular, and adipose tissues
b. Primarily muscle with very little fibrous tissue
c. Primarily milk ducts, known as lactiferous ducts
d. Glandular tissue, which supports the breast by attaching to the chest wall

Answer 1

ANS: A

The breast is made up of glandular, fibrous (including the suspensory ligaments), and adipose tissues.

Question 2

In performing a breast examination, the nurse knows that examining the upper outer quadrant of the breast is especially important.
What is the reason for this?
a. It is the largest quadrant of the breast.
b. It is the most common location of breast tumors.
c. It is where the majority of suspensory ligaments attach.
d. It is more prone to injury and calcifications than other locations in the breast.

Answer 2

ANS: B

The upper outer quadrant is the site of most breast tumors. In the upper outer quadrant, the nurse should notice the axillary tail of
Spence, the cone-shaped breast tissue that projects up into the axilla, close to the pectoral group of axillary lymph nodes. The other
options are incorrect.

Question 3

In performing an assessment of a woman’s axillary lymph system, the nurse should assess which of these nodes?

a. Central, axillary, lateral, and sternal
b. Pectoral, lateral, anterior, and sternal
c. Central, lateral, pectoral, and subscapular
d. Lateral, pectoral, axillary, and suprascapular

Answer 3

ANS: C

The breast has extensive lymphatic drainage, but there are no sternal or suprascapular lymph nodes. The four groups of axillary
nodes are the (1) central, (2) pectoral (anterior), (3) subscapular (posterior), and (4) lateral.

Question 4

If a patient reports a recent breast infection, then the nurse should expect to find what type of node enlargement?

a. Nonspecific
b. Ipsilateral axillary
c. Inguinal and cervical
d. Contralateral axillary

Answer 4

ANS: B

The breast has extensive lymphatic drainage. Most of the lymph, more than 75%, drains into the ipsilateral, or same side, axillary
nodes. If there was a recent breast infection, then the same side (ipsilateral) axillary nodes will likely be enlarged. A recent breast
infection would not cause enlargement of the inguinal or cervical lymph nodes or lymph nodes on the opposite (contralateral) side.
Instead, since the breast has extensive lymphatic drainage with most of the lymph (more than 75%) drains into the ipsilateral, or
same side, axillary nodes. If there was a recent breast infection, then the same side (ipsilateral) axillary nodes will likely be
enlarged.

Question 5

A woman is in the family planning clinic seeking birth control information. She states that her breasts “change all month long” and
that she is worried that this is unusual. What is the best response by the nurse?
a. “Continual changes in your breasts are unusual. The breasts of nonpregnant
women usually stay pretty much the same all month long.”
b. “Breast changes in response to stress are very common and you should assess
your life for stressful events.”
c. “Because of the changing hormones during the monthly menstrual cycle, cyclic
breast changes are common.”
d. “Breast changes normally occur only during pregnancy. You should get a
pregnancy test done as soon as possible.”

Answer 5

ANS: C

Breasts of the nonpregnant woman change with the ebb and flow of hormones during the monthly menstrual cycle. During the 3 to
4 days before menstruation, the breasts feel full, tight, heavy, and occasionally sore. The breast volume is smallest on days 4 to 7 of
the menstrual cycle.

Question 6

A woman has just learned that she is pregnant. What should the nurse teach this patient about changes in her breasts?
a. She can expect her areolae to become larger and darker in color.
b. Breasts may begin secreting milk after the fourth month of pregnancy.
c. She should inspect her breasts for visible veins and immediately report these.
d. During pregnancy, breast changes are fairly uncommon; most of the changes
occur after the birth.

Answer 6

ANS: A

The areolae become larger and grow a darker brown as pregnancy progresses, and the tubercles become more prominent. (The
brown color fades after lactation, but the areolae never return to their original color). A venous pattern is an expected finding and
prominent over the skin surface and does not need to be reported. After the fourth month of pregnancy, colostrum, a thick, yellow
fluid (precursor to milk), may be expressed from the breasts.

Question 7

A 65-year-old patient remarks that she just cannot believe that her breasts “sag so much.” She states it must be from a lack of
exercise. What explanation should the nurse offer her?
a. After menopause, only women with large breasts experience sagging.
b. After menopause, sagging is usually due to decreased muscle mass within the
breast.
c. After menopause, a diet that is high in protein will help maintain muscle mass,
which keeps the breasts from sagging.
d. After menopause, the glandular and fat tissue atrophies, causing breast size and
elasticity to diminish, resulting in breasts that sag

Answer 7

ANS: D

After menopause, the glandular tissue atrophies and is replaced with connective tissue. The fat envelope also atrophies, beginning
in the middle years and becoming significant in the eighth and ninth decades of life. These changes decrease breast size and
elasticity; consequently, the breasts droop and sag, looking flattened and flabby. There is no or little muscle mass in the breast, so
sagging is not due to decreased muscle mass and a diet high in protein will not help minimize sagging

Question 8

In examining a 70-year-old male patient, the nurse notices that he has bilateral gynecomastia. Which of the following describes the
nurse’s best course of action?
a. Recommend that he make an appointment with his physician for a mammogram.
b. Acknowledge it as benign breast enlargement which is not unusual in men.
c. Explain that this condition may be the result of hormonal changes, and
recommend that he see his physician.
d. Explain that gynecomastia in men is usually associated with prostate enlargement
and recommend that he be thoroughly screened

Answer 8

ANS: C

Gynecomastia may reappear in the aging man and may be attributable to a testosterone deficiency. The patient should see a
physician to determine the cause and possible treatment. This is not considered a normal finding and a patient should see a
physician to determine the cause and possible treatment. A mammogram is likely not necessary and it is not associated with
prostate enlargement.

Question 9

During a breast health interview, a patient states that she has noticed pain in her left breast. Which statement by the nurse is most
appropriate?
a. “Don’t worry about the pain; breast cancer is not painful.”
b. “I would like some more information about the pain in your left breast.”
c. “Oh, I had pain like that after my son was born; it turned out to be a blocked milk
duct.”
d. “Breast pain is almost always the result of benign breast disease.”

Answer 9

ANS: B

Although breast cancer usually occurs from trauma, inflammation, infection, or benign breast disease, rather than cancer, the nurse
should gather more information about the patient’s pain. The nurse should not belittle the patient’s feelings by using statements like
“don’t worry” or by sharing personal experiences.

Question 10

During a health history interview, a female patient states that she has noticed a few drops of clear discharge from her right nipple.
What should the nurse do next?
a. Ask her if she is possibly pregnant.
b. Immediately contact the physician to report the discharge.
c. Immediately obtain a sample for culture and sensitivity testing.
d. Ask the patient some additional questions about the medications she is taking

Answer 10

ANS: D

The use of some medications, such as oral contraceptives, phenothiazines, diuretics, digitalis, steroids, methyldopa, and calcium
channel blockers, may cause clear nipple discharge. Bloody or blood-tinged discharge from the nipple, not clear, is significant,
especially if a lump is also present. In the pregnant female, colostrum may be expressed after the fourth month of pregnancy, but
colostrum would be a thick, yellowish liquid, not clear. In the pregnant female, colostrum would be a thick, yellowish liquid, and it
would be normally expressed after the fourth month of pregnancy.

Question 11

During a physical examination, a 45-year-old woman states that she has had a crusty, itchy rash on her breast for approximately 2
weeks. In trying to find the cause of the rash, which question would be important for the nurse to ask?
a. “Is the rash raised and red?”
b. “Does it appear to be cyclic?”
c. “Where did the rash first appear—on the nipple, the areola, or the surrounding
skin?”
d. “What was she doing when she first noticed the rash, and do her actions make it
worse?”

Answer 11

ANS: C

The location where the rash first appeared is important for the nurse to determine. Paget disease starts with a small crust on the
nipple apex and then spreads to the areola. Eczema or other dermatitis rarely starts at the nipple unless it is a result of
breastfeeding. It usually starts on the areola or surrounding skin and then spreads to the nipple.

Question 12

A patient is newly diagnosed with benign breast disease. The nurse recognizes which statement about benign breast disease to be
true?
a. It makes it more difficult to examine the breasts.
b. It is easily reduced with hormone replacement therapy.
c. It frequently turns into cancer in a woman’s later years.
d. It is usually diagnosed before a woman reaches childbearing age.

Answer 12

ANS: A

The presence of benign breast disease (formerly fibrocystic breast disease) makes it hard to examine the breasts; the general
lumpiness of the breast conceals a new lump. The other statements are not true. Benign breast disease is not treated with hormone
replacement therapy and it does not usually turn into cancer, although the nodularity associated with benign breast disease makes it
difficult to detect other cancerous lumps. It also is usually diagnosed between 30 and 55 years old (not before childbearing age).

Question 13

During an annual physical examination, a 43-year-old patient states that she does not perform monthly breast self-examinations
(BSEs). She tells the nurse that she believes that mammograms “do a much better job than I ever could to find a lump.” What
should the nurse include in his or her response to this patient?
a. BSEs may detect lumps that appear between mammograms.
b. She is correct—mammography is a good replacement for BSE.
c. The American Cancer Society recommends women over 40 years old perform a
monthly BSE.
d. She does not need to perform BSEs as long as a physician checks her breasts
annually.

Answer 13

ANS: A

Although the American Cancer Society no longer recommends a structured monthly BSE because many women with breast cancer
have detected their lumps by chance as when bathing or dressing, the goal of BSE is that a woman becomes familiar with the look
and feel of her breasts so she can detect any change and report it promptly. Intermittent BSEs along with clinical breast
examinations and mammograms are complementary screening measures. Mammography can reveal cancers too small to be
detected by the woman or by the most experienced examiner. However, interval lumps may become palpable between

Question 14

During an interview, a patient reveals that she is pregnant. She states that she is not sure whether she will breastfeed her baby and
asks for some information about this. Which of these statements by the nurse is accurate?
a. “Breastfed babies tend to be more colicky.”
b. “Breastfed babies eat more often than infants on formula.”
c. “Breastfeeding is second nature, and every woman can do it.”
d. “Breastfeeding provides the perfect food and antibodies for your baby.”

Answer 14

ANS: D

Exclusively breastfeeding for 6 months provides the perfect food and antibodies for the baby, decreases the risk for ear infections,
promotes bonding, and provides relaxation. The other statements are not accurate.

Question 15

The nurse is reviewing risk factors for breast cancer. Which of these women have risk factors that place them at a higher risk for
breast cancer?
a. 37-year-old who is slightly overweight
b. 42-year-old who has had ovarian cancer
c. 45-year-old who has never been pregnant
d. 66-year-old whose mother had breast cancer The nurse is reviewing risk factors for breast cancer. Which of these women have risk factors that place them at a higher risk for
breast cancer?
a. 37-year-old who is slightly overweight
b. 42-year-old who has had ovarian cancer
c. 45-year-old who has never been pregnant
d. 66-year-old whose mother had breast cancer

Answer 15

ANS: D

The woman at highest risk is the 66-year-old woman whose mother had breast cancer. This woman has two risk factors for breast
cancer with >4.0 relative risk, which are her age (≥65) and a first-degree relative (her mother) with breast cancer. The 37-year-old
woman who is slightly overweight does not have any risk factors for breast cancer. The 42-year-old woman who has had ovarian
cancer has one risk factor for breast cancer with a relative risk for 1.1 to 2.0 and that is her personal history of ovarian cancer. The
45-year-old woman who has never been pregnant has one risk factor for breast cancer with a relative risk for 1.1 to 2.0 and that is
having no full-term pregnancies.

Question 16

During an examination of a woman, the nurse notices that her left breast is slightly larger than her right breast. Which of these
statements is true about this finding?
a. Asymmetry of the breasts is unusual and the patient should be referred to
physician.
b. Asymmetry of the breasts is common, but the nurse should verify that this finding
is not new.
c. Asymmetry of breast size and shape is very unusual and means she may have an
inflammation or growth.
d. Asymmetry of breast size and shape is probably due to breastfeeding and is
nothing to worry about.

Answer 16

ANS: B

The nurse should notice symmetry of size and shape of the breasts. It is common to have a slight asymmetry in size; often the left
breast is slightly larger than the right. However, a sudden increase in the size of one breast signifies inflammation or new growth.
The nurse should verify that this asymmetry is not new.

Question 17

The nurse is assisting with a BSE clinic. Which of these women reflects abnormal findings during the inspection phase of breast
examination?
a. Woman whose nipples are in different planes (deviated)
b. Woman whose left breast is slightly larger than her right
c. Nonpregnant woman whose skin is marked with linear striae
d. Pregnant woman whose breasts have a fine blue network of veins visible under
the skin

Answer 17

ANS: A

The nipples should be symmetrically placed on the same plane on the two breasts. With deviation in pointing, an underlying cancer
may cause fibrosis in the mammary ducts, which pulls the nipple angle toward it. The other examples are normal findings. A
woman with a left breast that is slightly larger than her right, a nonpregnant woman whose skin is marked with linear striae, and a
pregnant woman whose breasts have a fine blue network of vein visible under the skin are all normal findings. However, a woman
whose nipples are in different planes, or deviate, is abnormal.

Question 18

During the physical examination, the nurse notices that a female patient has an inverted left nipple. Which statement regarding this
is most accurate?
a. Normal nipple inversion is usually bilateral.
b. Unilateral inversion of a nipple is always a serious sign.
c. Whether the inversion is a recent change should be determined.
d. Nipple inversion is not significant unless accompanied by an underlying palpable
mass

Answer 18

ANS: C

The nurse should distinguish between a recently retracted nipple from one that has been inverted for many years or since puberty.
Normal nipple inversion may be unilateral or bilateral and usually can be pulled out; that is, if it is not fixed. Recent nipple
retraction signifies acquired disease (see Table 17-3).

Question 19

The nurse is performing a breast examination. Which of these statements best describes the correct procedure to use when
screening for nipple and skin retraction during a breast examination?
a. Have the patient bend over and touch her toes.
b. Have the patient lie down on her left side and observe for any retraction.
c. Have the patient shift from a supine position to a standing position, and note any
lag or retraction.
d. Have the patient slowly lift her arms above her head, and note any retraction or
lag in movement

Answer 19

ANS: D

The woman should be directed to change position while checking the breasts for signs of skin retraction. Initially, she should be
asked to lift her arms slowly over her head. Both breasts should move up symmetrically. Retraction signs are due to fibrosis in the
breast tissue, usually caused by growing neoplasms. The nurse should notice whether movement of one breast is lagging.

Question 20

The nurse is palpating a female patient’s breasts during an examination. Which of these positions is most likely to make significant
lumps more distinct during breast palpation?
a. Supine with the arms raised over her head
b. Sitting with the arms relaxed at her sides
c. Supine with the arms relaxed at her sides
d. Sitting with the arms flexed and fingertips touching her shoulders

Answer 20

ANS: A

The nurse should help the woman to a supine position, tuck a small pad under the side to be palpated, and help the woman raise her
arm over her head. These maneuvers will flatten the breast tissue and medially displace it. Any significant lumps will then feel
more distinct.

Question 21

Which of these clinical situations would the nurse consider to be outside normal limits?
a. A patient has had one pregnancy and states that she believes she may be entering
menopause. Her breast examination reveals breasts that are soft and slightly
sagging.
b. A patient has never been pregnant. Her breast examination reveals large
pendulous breasts that have a firm, transverse ridge along the lower quadrant in
both breasts.
c. A patient has never been pregnant and reports that she should begin her period
tomorrow. Her breast examination reveals breast tissue that is nodular and
somewhat engorged. She states that the examination was slightly painful.
d. A patient has had two pregnancies, and she breastfed both of her children. Her
youngest child is now 10 years old. Her breast examination reveals breast tissue
that is somewhat soft, and she has a small amount of thick yellow discharge from
both nipples.

Answer 21

ANS: D

If any discharge appears, the nurse should note its color and consistency. Except in pregnancy and lactation, any discharge is
abnormal. In nulliparous women, normal breast tissue feels firm, smooth, and elastic; after pregnancy, the tissue feels soft and
loose. Premenstrual engorgement is normal, and consists of a slight enlargement, tenderness to palpation, and a generalized
nodularity. A firm, transverse ridge of compressed tissue in the lower quadrants, known as the inframammary ridge, is especially
noticeable in large breasts.

Question 22

A patient states during the interview that she noticed a new lump in the shower a few days ago. It was on her left breast near her

axilla. How should the nurse proceed?
a. Palpate the lump first.
b. Palpate the unaffected breast first.
c. Avoid palpating the lump because it could be a cyst, which might rupture.
d. Palpate the breast with the lump first but plan to palpate the axilla last.

Answer 22

ANS: B

If the woman mentions a breast lump she has discovered herself, then the nurse should examine the unaffected breast first to learn a
baseline of normal consistency for this individual.

Question 23

The nurse has palpated a lump in a female patient’s right breast. The nurse documents this as a small, round, firm, distinct, lump
located at 2 o’clock, 2 cm from the nipple. It is nontender and fixed. No associated retraction of the skin or nipple, no erythema,
and no axillary lymphadenopathy are observed. What information is missing from the documentation?
a. Size of the lump
b. Shape of the lump
c. Consistency of the lump
d. Whether the lump is solitary or multiple

Answer 23

ANS: A

If the nurse feels a lump or mass, then he or she should note these characteristics: (1) location, (2) size judge in centimeters in three
dimensions: width × length × thickness, (3) shape, (4) consistency, (5) motility, (6) distinctness, (7) nipple, (8) the skin over the
lump, (9) tenderness, and (10) lymphadenopathy.

Question 24

The nurse is conducting a class on BSE. Which of these statements indicates the proper BSE technique?
a. The best time to perform BSE is in the middle of the menstrual cycle.
b. A woman should perform BSEs bimonthly unless she has fibrocystic breast
tissue.
c. The best time to perform a BSE is 4 to 7 days after the first day of the menstrual
period.
d. If she suspects that she is pregnant, then the woman should not perform a BSE
until after her baby is born.

Answer 24

ANS: C

The best time to conduct a BSE is right after the menstrual period, or the fourth through seventh day of the menstrual cycle, when
the breasts are the smallest and least congested. The pregnant or menopausal woman who is not having menstrual periods should be
advised to select a familiar date to examine her breasts each month—for example, her birth date or the day the rent is due. Women
do not need to be advised to perform BSEs bimonthly

Question 25

A 55-year-old postmenopausal woman is being seen in the clinic for her annual examination. She is concerned about changes in her
breasts that she has noticed over the past 5 years. She states that her breasts have decreased in size and that the elasticity has
changed so that her breasts seem “flat and flabby.” Which is the best reply by the nurse?
a. “This change occurs most often because of long-term use of bras that do not
provide enough support to the breast tissues.”
b. “Decreases in hormones after menopause causes atrophy of the glandular tissue in
the breast and is a normal process of aging.”
c. “This is a normal change that occurs as women get older and is due to the
increased levels of progesterone during the aging process.”
d. “Postural changes in the spine make it appear that your breasts have changed in
shape. Exercises to strengthen the muscles of the upper back and chest wall will
help prevent the changes in elasticity and size.”

Answer 25

ANS: B

The hormonal changes of menopause cause the breast glandular tissue to atrophy, making the breasts more pendulous, flattened,
and sagging. This change in the breasts is not due to long-term use of unsupportive bras, increased levels of progesterone with
aging, or postural changes in the spine. Rather, the hormonal changes of menopause cause the breast glandular tissue to atrophy,
making the breasts more pendulous, flattened, and sagging.

Question 26

A 43-year-old woman is at the clinic for a routine examination. She reports that she has had a lump in her right breast for years.
Recently, it has begun to change in consistency and is becoming harder. She reports that 5 years ago her physician evaluated the
lump and determined that it was “nothing to worry about.” The nurse’s examination validates the presence of a mass in the right
upper outer quadrant at 1 o’clock, approximately 5 cm from the nipple. It is firm, mobile, and nontender, with borders that are not
well defined. What is the best response by the nurse?
a. “Because of the change in consistency of the lump, it should be further evaluated
by a physician.”
b. “The changes could be r/t your menstrual cycles. Keep track of the changes in the
mass each month.”
c. “The lump is probably nothing to worry about because it has been present for
years and was determined to be noncancerous 5 years ago.”
d. “Because you are experiencing no pain and the size has not changed, you should
continue to monitor the lump and return to the clinic in 3 months.”

Answer 26

ANS: A

A lump that has been present for years and is not exhibiting changes may not be serious but should still be explored. Any recent
change or a new lump should be evaluated. The other responses are not correct.

Question 27

While inspecting a patient’s breasts, the nurse finds that the left breast is slightly larger than the right with the bilateral presence of
Montgomery glands. How should the nurse proceed?
a. Palpate over the Montgomery glands, checking for drainage.
b. Consider these findings as normal, and proceed with the examination.
c. Ask extensive health history questions regarding the woman’s breast asymmetry.
d. Continue with the examination, and then refer the patient for further evaluation of
the Montgomery glands.

Answer 27

ANS: B

Normal findings of the breast include one breast (most often the left) slightly larger than the other and the presence of Montgomery
glands across the areola. These are normal findings so there is no need to palpate the Montgomery glands and checking for
drainage, asking extensive health history questions, or referring the patient for further evaluation of the Montgomery glands.

Question 28

During an examination, the nurse notes a supernumerary nipple just under the patient’s left breast. The patient tells the nurse that
she always thought it was a mole. Which statement about this finding is correct?
a. This variation is normal and not a significant finding.
b. This finding is significant and needs further investigation.
c. A supernumerary nipple also contains glandular tissue and may leak milk during
pregnancy and lactation.
d. The patient is correct—a supernumerary nipple is actually a mole that happens to
be located under the breast.

Answer 28

ANS: A

A supernumerary nipple looks like a mole, but close examination reveals a tiny nipple and areola; it is not a significant finding.
This is not a significant finding and does not need further investigation, will not leak milk during pregnancy and lactation, and is
not a mole. Although a supernumerary nipple looks like a mole, upon close examination a tiny nipple and areola are revealed.

Question 29

While examining a 75-year-old woman, the nurse notices that the skin over her right breast is thickened and the hair follicles are
exaggerated. What is this condition called?

Answer 29

ANS: C

This condition is known as peau d’orange. Lymphatic obstruction produces edema, which thickens the skin and exaggerates the
hair follicles. The skin has a pig-skin or orange-peel appearance. This condition suggests cancer. Dimpling, or a pucker, indicates
skin retraction. Retraction signs are caused by fibrosis in the breast tissue, usually caused by growing neoplasms. The fibrosis
shortens with time, causing contrasting signs with the normally loose breast tissue. Benign breast disease is multiple tender masses
that occur with numerous symptoms and physical findings such as swelling and tenderness, nodularity, dominant lumps, nipple
discharge, and infections or inflammation. The symptoms this patient has indicate peau d’orange. In peau d’orange, lymphatic
obstruction produces edema, which thickens the skin and exaggerates the hair follicles. The skin has a pig-skin or orange-peel
appearance. This condition suggests cancer.

Question 30

A new mother calls the clinic to report that part of her left breast is red, swollen, tender, very hot, and hard. She has a fever of 38.3°
C. She also has had symptoms of influenza, such as chills, sweating, and feeling tired. The nurse notices that she has been
breastfeeding for 1 month. From her description, what condition does the nurse suspect?
a. Mastitis
b. Paget disease
c. Plugged milk duct
d. Mammary duct ectasia

Answer 30

ANS: A

The symptoms describe mastitis, which stems from an infection or stasis caused by a plugged duct. A plugged duct does not have
infection present. Paget disease starts with a small crust on the nipple apex and then spreads to the areola. A plugged milk duct
often presents as a tender lump that may be reddened and warm to touch but no infection is present. Mammary duct ectasia is
caused by stagnation of cellular debris and secretions in the ducts, leading to obstruction, inflammation and infection. Itching,
burning, or drawing pain occurs around the nipple with a sticky, purulent discharge that may be cream, green, or bloody. The
symptoms this patient has described mastitis, which stems from an infection or stasis caused by a plugged duct. A plugged duct
does not have infection present but a plugged duct with infection is mastitis.

Question 31

During a breast examination on a female patient, the nurse notices that the nipple is flat, broad, and fixed. The patient states it
“started doing that a few months ago.” What does this finding suggest?
a. Dimpling
b. Retracted nipple
c. Nipple inversion
d. Deviation in nipple pointing

Answer 31

ANS: A

The retracted nipple looks flatter and broader, similar to an underlying crater. A recent retraction suggests cancer, which causes
fibrosis of the whole duct system and pulls in the nipple. It also may occur with benign lesions such as ectasia of the ducts. The
nurse should not confuse retraction with the normal long-standing type of nipple inversion, which has no broadening and is not
fixed.

Question 32

A 54-year-old man comes to the clinic with a “horrible problem.” He tells the nurse that he has just discovered a lump on his breast
and is fearful of cancer. The nurse knows which statement about breast cancer in men is true?
a. Breast cancer in men rarely spreads to the lymph nodes.
b. Less than one percent of all breast cancers occurs in men.
c. Most breast masses in men are diagnosed as gynecomastia.
d. Breast masses in men are difficult to detect because of minimal breast tissue.

Answer 32

ANS: A

Less than one percent of all breast cancers occur in men. The early spreading to axillary lymph nodes is attributable to minimal
breast tissue. Breast cancer in men often spreads to the axillary lymph nodes because of the minimal breast tissue in men. Breast
masses in men are not typically diagnosed as gynecomastia or more difficult to detect, but they are diagnosed 10 years later than
women because of lack of screening and general awareness. The correct option is that less than one percent of all breast cancers
occur in men.

Question 33

The nurse is assessing the breasts of a 68-year-old woman and discovers a mass in the upper outer quadrant of the left breast. When
assessing this mass, the nurse is aware that characteristics of a cancerous mass include which of the following? (Select all that
apply.)
a. Nontender mass
b. Regular border
c. Hard, dense, and immobile
d. Rubbery texture and mobile
e. Dull, heavy pain on palpation
f. Irregular, poorly delineated border

Answer 33

ANS: A, F

Cancerous breast masses are solitary, unilateral, and nontender. They are solid, hard, dense, and fixed to underlying tissues or skin
as cancer becomes invasive. Their borders are irregular and poorly delineated. They are often painless, although the person may
experience pain. They are most common in the upper outer quadrant. A dull, heavy pain on palpation and a mass with a rubbery
texture and a regular border are characteristics of benign breast disease.

Question 34

The nurse is examining a 62-year-old man and notes that he has bilateral gynecomastia. The nurse should explore his health history
for which related conditions? (Select all that apply.)
a. Malnutrition
b. Liver disease
c. Hyperthyroidism
d. Type 2 diabetes mellitus
e. History of alcohol abuse

Answer 34

ANS: B, C, E

Gynecomastia occurs with Cushing syndrome, liver cirrhosis, adrenal disease, hyperthyroidism, and numerous drugs, such as
alcohol and marijuana use, estrogen treatment for prostate cancer, antibiotics (metronidazole, isoniazid), digoxin,
angiotensin-converting enzyme (ACE) inhibitors, diazepam, and tricyclic antidepressants.