Exam 3- Breasts and regional lymphatics-MJ Flashcards
If a woman is not pregnant, are the glands that cause the milk to go in the ducts active?
No, only when a woman is pregnant
What are the cooper ligaments?
Ligaments that support breast tissue
What tissue is the bulk of the breast?
Adipose
What age group can be palpated for abnormalities easier?
Older women
Where is cancer normally found?
Upper outer quadrant
In an adolescent, ____ stimulates breast changes
Estrogen
What comes first: breast development or menarche?
Breast development
What is gynecomastia?
Growth around the nipple area in boys (it goes away)
What are the two developmental considerations of a pregnant woman?
Colostrum and lactation
What is colostrum?
Clear, yellowish color
Also called “pre milk”
The milk produced right after birth
Loaded with antibodies, proteins, lactose, and very little fat
What is lactation?
Producing the milk–more fat!!
What is the second major cause of death from cancer in women?
Breast cancer
What age women are at greater risk for breast cancer?
over 50
__ in __ women will develop breast cancer at some point in their life
1 in 8
What increases survival of breast cancer?
Early detection and improved treatment
What is the 5 year survival rate percentage of breast cancer?
98%
What can increase your risk of getting breast cancer?
Birth control and hormone replacement
When should women get their first mammogram?
40
What are the two areas to check for breast?
Breast Axilla (don't forget about checking here!)
In a preadolescent girl there are noticed ____ changes
Breast
Pregnant women may have ____, ____, and ____ breasts…as well as ___ nipples
Enlargement, tenderness, and tingling
Inverted nipples
Lactating women may have engorgement and ____ or ___ nipples
Sore or cracked nipples
Patient education about how to breastfeed to avoid this!
What are the changes in a menopausal women breast?
Change in breast contour, size, or firmness
What are the two ways the patient may be during a breast exam?
Sitting facing examiner
Supine position
What equipment should be brought for a breast exam?
Small pillow
Ruler marked in cm
Teaching aid for breast self-exams
When should a women do a self-exam?
Monthly after period
When should pregnant women, menopausal women, and men do breast self-exams?
Pick a day–still do it monthly!!
What is the purpose of a self-exam?
So you know your breasts—that way if something comes up abnormal, you know “oh this isn’t how they usually feel..something must be wrong”
What do you look for in general appearance of a breast exam?
Size
Shape
Symmetry
How should you look for in skin during breast exam?
Redness, bulging, dimpling, lesions
Pregnancy: striae
Why are there striae in pregnant women?
The vascular network increases and is visible
What are the lymphatic drainage areas?
Axillary and supraclavicular regions
Look for bulging, discoloration, edema
Breast exam: nipple
What should you look for?
Symmetry protrusion, fissure, discharge
What are the 4 ways to screen for retraction during a breast exam?
Lift arm over head
Push hands onto hips
Push two palms together
Lead forward
How do you inspect the axilla during breast exam?
Lift and support womans arm while palpating axilla
Move arm through ROM
Note enlarged or tender lymph nodes
Abnormal findings: lumps
Benign breast disease
Little, tender masses
Abnormal findings: lumps
Fibroadenoma
Benign tumor of fibrous mass
No lymph node movement
Moveable
*Nothing done about this unless larger than 5cm
Abnormal findings: retraction and inflammation
What are 4 abnormalities here?
Dimpling
Fixation
Edema
Deviation of nipple pointing (one straight vs. one cock-eyed–>this needs to be explored)
Abnormal findings: Abnormal nipple discharge
What are the 4 types?
Mammary duct ectasia
Carcinoma
Intraductal papilloma
Paget disease (inarticulate carcinoma)
Abnormal findings: Abnormal nipple discharge: What is carcinoma?
Bloody nipple
Abnormal findings: Abnormal nipple discharge: What is intraductal papilloma?
Benign or cancerous?
Raised duct
Benign
Abnormal findings: Abnormal nipple discharge: Paget disease characteristics?
Benign or cancerous?
Early- unilateral, yellow, clear
Later- crust, redness, exzema after a while
Cancerous
What are some disorders during lactation?
Plugged duct
Breast abscess
Mastitis (inflammation of breast, happens before a breast abscess)
What type of people may see gynecomastia?
Teens
Aging men
If estrogen concentration exceeds testrogen
__% of breast cancer is occurring in men
1%
