Exam #3: Breast & Axillae Flashcards
What are the general breast cancer risk factors categories?
- Modifiable (cannot be changed)
- Non-modifiable ( can be changed)
- Uncertain, Controversial, or Unproven
Tanner Stages of Breast Development
1) Tanner I
2) Tanner II
3) Tanner III
4) Tanner IV
5) Tanner V
When does the onset of breast development occur?
- 1 year prior to the onset of pubic hair development
- 2 years prior to menarche
- Complete process usually occurs over a 4 year period
Tanner I
- Prepubertal
- Elevation of papilla only
Tanner II
- Breast Bud Stage
- Elevation of breast & papilla as a small mound
- Enlargement of the diameter of areola
Tanner III
Further enlargement of the breast and arerola with no separation of the contours
Tanner IV
Areola projected above level of breast as a secondary mound
Tanner V
- Mature Stage
- Recession of areola mount to the general contour of the breast
- Projection of papilla only
What are the 5 Dās related to nipples?
- Discharge
- Depression or Inversion
- Discoloration
- Dermatological changes
- Deviation (compare to the opposite side)
What are the red flags of a breast examination?
- Skin changes (Peau dāorange)
- Dimpling
- Hard & immobilize mass (pebble)
- Painless lump
- āOutie nipple transitioning to Innieā
What is the best method for a breast examination?
Vertical Method (like a lawn-mower)
Colostrum
clear or milky fluid that is expressed from the breast before milk production
Galactorrea
Lactation not associated with childbearing
Gynecomastia
Abnormal large mammary glands in the male; sometimes may excrete milk
Lactation
Production & secretion of milk from the breast
Mastitis
Inflammation of the breast
Mastodynia
Pain in the breast
Non-modifiable Risk Factors Breast Cancer
- Gender, 100x more likely in women
- Age, MOST IMPORTANT, 55>
- Genetic, BRCA1/2
- Family History, first degree increases 2x, 2x first degree= 5x
- Personal History
- Race
- Dense Breast Tissue
- Previous Chest Radiation
- DES (Diethylstilbesterol) Exposure
- Menstrual Periods
- Certain Benign Breast Conditions
- Lobular Carcinoma in situ
Modifiable Risk Factors for Breast Cancer
- Postmenopausal Obesity
- Exercise, lack of physical activity
- Alcohol
- Hormone Replacement
- Recent Oral Contraceptive Use
- Childbirth, breast feeding reduces risk of breast cancer
Outline the early detection plan.
1) Women >40, yearly mammogram if in good health
2) Clinical Breast Examination (20-39=Q3years, 40+=annual)
3) Breast Self-Examination (20+)
4) High Risk Women (MRI & Mammogram annually)
5) Moderate Risk Women (talk w/ provider about the benefits of MRI)
What are the signs & symptoms of a fibrocystic breast mass?
- 20-50 years
- Usually bilateral
- Multiple or single
- Round
- Soft to firm; usually elastic
- Mobile
- No retraction
- Often tender
- Well defined borders
- Variation w/ menses
What are the signs & symptoms of a Fibroedenoma?
- 15-25 years & 55+
- Usually bilateral
- Single; may be multiple
- Round, disc like, or lobular
- Usually firm, ruberry
- Very mobile
- No retraction
- Usually nontender
- Well defined border
- No variation with menses
What are the signs & symptoms of breast cancer?
- 30-90 years, most common
What are normal changes that occur with menstruation?
- Enlargement
- DO NOT examine breasts at this time
- Best time to evaluate is 5-7 days after the onset of menses
What are normal changes that occur with pregnancy?
- Fuller & more firm
- Nipple changes
- Colostrum in 3rd trimester
What are important PROS questions relating to breast complaints?
- Presence of a mass
- Breast pain
- Nipple discharge
- Recent trauma
Areola
pigmented area surrounding the nipple
Colostrum
a clear or milky fluid that is expressed from the breast before milk production
Cooper Ligaments
a band of subcutaneous fibrous tissue that provides support to the breast
Duct Ectasia
benign condition of the subareolar ducts that can cause a nipple discharge
Fibroadenoma
benign tumor of the breast
Fibrocystic Disease
benign condition that presents with fluid-filled cyst due to ductal enlargement that is usually seen bilaterally & multiple
Galactorrhea
lactation not associated with childbearing
Gynecomastia
- abnormally large mammary glands in the male
- sometimes may secrete milk
Intraductal papillomas
benign tumors of the subareolar ducts that produce a nipple discharge
Mastitis
inflammation of the breast
Mastodynia
pain in the breast
Montgomery follicles
tiny sebaceous glands that may appear on the areola
Paget Disease
skin manifestations that are indicative of ductal carcinoma
Peau dā orange
skin changes of the breast due to edema caused by blockage of the lymph drainage associated with inflammatory breast cancer
Tail of Spence
area where most malignancies of the breast tissue occur
Thelarche
beginning of female pubertal breast development
