Physical Examination of the Breast Flashcards
There are several openings in the nipple
15-20
Mini-orifices
Breast
2nd-6th ribs
Sternal margin to midaxillary line
Secretes lipoid material that protects nipple during nursing
Glands of Montgomery
Provides support for the breast
Separate the lobules and is attached to the subcutaneous tissue and pectoralis fascia
Also called ‘suspensory ligament of the breast’
Cooper’s ligament
Physical Examination should include
Supraclavicular area
Breast
Axilla
Inspection
Size - variable Symmetry - one maybe slightly smaller Contourn- uninterrupted Skin color/texture - smooth Venous pattern - similar in both breast Lesions - no lesion
Contraction of fibrous tissue
Cooper’s ligament pulls the subcutaneous tissue
Dimpling
Edema of the breast
Blockage of dermal lymphatic
Advanced cancer
Lymphatic of the skin: absorbs interstitial fluid
Peau d’orange
Starts in areola
5 D’s related to the Nipple
Discharge Depression or inversion Discoloration: pregnancy Dermatologic: Paget's disease Deviation: compare opposite side
Nipple will be pulled where the breast cancer is located
Abnormal findings:
Retraction: inward pulling by inflammatory or malignant tissue
Deviation
Supernumerary nipple
This maneuver contracts the pectoralis major muscle
Fixation of mass denotes pectoral involvement
Seated with hands pressed against hips
Pushing palms together
- mass will be fixed, pulling the breast invading: invading the pec major
- if mass did not move before maneuver, tumor already invaded the chest wall
Every part of the breast is palpated
Systematic palpation
Start where you ended
vs. Haphazard
How to examine the Tail of Spence?
Seated position with arms raised
Pectoralis major included in the chest wall?
No
Firm transverse ridge of compressed breast tissue
Can be mistaken as mass
Inframammary ridge
