Chapter 10: Breast Flashcards
Breast Anatomy
Subclavian lymph nodes
Pectoralis major
Nipple
Areola
Breast quadrants
Upper outer, lower outer, upper inner, lower inner.
Tail of Spence: axilla
Tissues of breast
Glandular tissue: glaands and ducts forms 15-20 septated lobes radiating around the nipple. Within each of these lobe are lobules. These drain in to milk-producing ducts and sinuses that open onto the surface of areola. Fibrous connective tissues provide structural support. Adipose tissue surrounds the breast
Nodularity
may increase prior to menses
milk line
one or more extra or supernumerary nipple. only small nipple and areola usually present-often mistaken for a common mole
lymph nodes
lymphatics from breast drain mostly toward axilla. of axillary nodes-central nodes are palpable most frequently. pectoral nodes, anterior-drain ant chest wall and much of the breast. sub scapular, posterior-drain the posterior chest wall and portion of arm. lateral nodes-along upper humerus-most of the arm. Lymph drains from the central nodes to the infraclavicular and supraclavicular nodes
cancer vs other masses
age: 30-90; most over 50
number: usu single but may exist with other nodules
SHape: irregular or stellate
consistency: firm or hard
delimitation: not clearly delineated from surrounding tissues
mobility: may be fixed to the skin or underlying tissues
tender-usually contender
retraction may be present
other signs of cancer
retraction sign: as breast cancer advances it causes scar tissues. shortening of this tissue causes dimpling, changes in contour, retraction or deviation of the nipple.
Edema of nipple: caused by lymphatic blockade-appears as thickened skin with enlarged pores-peau d orange sign.
Paget’s disease of nipple
Usually starts as a scaly eczemalike lesion that may weep, crust, or erode. breast mass may be present. Suspect pagets in any persisting dermatitis of the nipple or areola. Can present with invasive breast cancer or ductal carcinoma in situ
