Exam 3- Breasts and regional lymphatics-MJ

Question 1

If a woman is not pregnant, are the glands that cause the milk to go in the ducts active?

Answer 1

No, only when a woman is pregnant

Question 2

What are the cooper ligaments?

Answer 2

Ligaments that support breast tissue

Question 3

What tissue is the bulk of the breast?

Answer 3

Adipose

Question 4

What age group can be palpated for abnormalities easier?

Answer 4

Older women

Question 5

Where is cancer normally found?

Answer 5

Upper outer quadrant

Question 6

In an adolescent, ____ stimulates breast changes

Answer 6

Estrogen

Question 7

What comes first: breast development or menarche?

Answer 7

Breast development

Question 8

What is gynecomastia?

Answer 8

Growth around the nipple area in boys (it goes away)

Question 9

What are the two developmental considerations of a pregnant woman?

Answer 9

Colostrum and lactation

Question 10

What is colostrum?

Answer 10

Clear, yellowish color
Also called “pre milk”
The milk produced right after birth
Loaded with antibodies, proteins, lactose, and very little fat

Question 11

What is lactation?

Answer 11

Producing the milk–more fat!!

Question 12

What is the second major cause of death from cancer in women?

Answer 12

Breast cancer

Question 13

What age women are at greater risk for breast cancer?

Answer 13

over 50

Question 14

__ in __ women will develop breast cancer at some point in their life

Answer 14

1 in 8

Question 15

What increases survival of breast cancer?

Answer 15

Early detection and improved treatment

Question 16

What is the 5 year survival rate percentage of breast cancer?

Answer 16

98%

Question 17

What can increase your risk of getting breast cancer?

Answer 17

Birth control and hormone replacement

Question 18

When should women get their first mammogram?

Answer 18

40

Question 19

What are the two areas to check for breast?

Answer 19

Breast 
Axilla (don't forget about checking here!)

Question 20

In a preadolescent girl there are noticed ____ changes

Answer 20

Breast

Question 21

Pregnant women may have ____, ____, and ____ breasts…as well as ___ nipples

Answer 21

Enlargement, tenderness, and tingling

Inverted nipples

Question 22

Lactating women may have engorgement and ____ or ___ nipples

Answer 22

Sore or cracked nipples

Patient education about how to breastfeed to avoid this!

Question 23

What are the changes in a menopausal women breast?

Answer 23

Change in breast contour, size, or firmness

Question 24

What are the two ways the patient may be during a breast exam?

Answer 24

Sitting facing examiner

Supine position

Question 25

What equipment should be brought for a breast exam?

Answer 25

Small pillow
Ruler marked in cm
Teaching aid for breast self-exams

Question 26

When should a women do a self-exam?

Answer 26

Monthly after period

Question 27

When should pregnant women, menopausal women, and men do breast self-exams?

Answer 27

Pick a day–still do it monthly!!

Question 28

What is the purpose of a self-exam?

Answer 28

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”

Question 29

What do you look for in general appearance of a breast exam?

Answer 29

Size
Shape
Symmetry

Question 30

How should you look for in skin during breast exam?

Answer 30

Redness, bulging, dimpling, lesions

Pregnancy: striae

Question 31

Why are there striae in pregnant women?

Answer 31

The vascular network increases and is visible

Question 32

What are the lymphatic drainage areas?

Answer 32

Axillary and supraclavicular regions

Look for bulging, discoloration, edema

Question 33

Breast exam: nipple

What should you look for?

Answer 33

Symmetry protrusion, fissure, discharge

Question 34

What are the 4 ways to screen for retraction during a breast exam?

Answer 34

Lift arm over head
Push hands onto hips
Push two palms together
Lead forward

Question 35

How do you inspect the axilla during breast exam?

Answer 35

Lift and support womans arm while palpating axilla

Move arm through ROM

Note enlarged or tender lymph nodes

Question 36

Abnormal findings: lumps

Benign breast disease

Answer 36

Little, tender masses

Question 37

Abnormal findings: lumps

Fibroadenoma

Answer 37

Benign tumor of fibrous mass
No lymph node movement
Moveable
*Nothing done about this unless larger than 5cm

Question 38

Abnormal findings: retraction and inflammation

What are 4 abnormalities here?

Answer 38

Dimpling
Fixation
Edema
Deviation of nipple pointing (one straight vs. one cock-eyed–>this needs to be explored)

Question 39

Abnormal findings: Abnormal nipple discharge

What are the 4 types?

Answer 39

Mammary duct ectasia
Carcinoma
Intraductal papilloma
Paget disease (inarticulate carcinoma)

Question 40

Abnormal findings: Abnormal nipple discharge: What is carcinoma?

Answer 40

Bloody nipple

Question 41

Abnormal findings: Abnormal nipple discharge: What is intraductal papilloma?
Benign or cancerous?

Answer 41

Raised duct

Benign

Question 42

Abnormal findings: Abnormal nipple discharge: Paget disease characteristics?
Benign or cancerous?

Answer 42

Early- unilateral, yellow, clear
Later- crust, redness, exzema after a while

Cancerous

Question 43

What are some disorders during lactation?

Answer 43

Plugged duct
Breast abscess
Mastitis (inflammation of breast, happens before a breast abscess)

Question 44

What type of people may see gynecomastia?

Answer 44

Teens
Aging men
If estrogen concentration exceeds testrogen

Question 45

__% of breast cancer is occurring in men

Answer 45

1%