WH - The Female Breast Flashcards
Where is the breast located?
It lies against the anterior thoracic wall, extending from the clavicle and second rib down to the sixth rib. It extends from the sternum across to the mid axillary line
Describe the shape of the breast
The breast is more rectangular than round and has an axillary tail of breast tissue that extends toward the axilla
Describe the middle part of the breast
The areola is a pigmented area surrounding the nipple
Describe what the breast is made of
The breast is made of adipose tissue with milk glands
Describe what is found in the axillary tail and what it does
Lymph glands are found in the axillary tail and are part of the lymphatic system which collects excess fluid in body tissue and returns it to the blood stream and makes immune cells
List the concerning findings during a breast exam
Breast lumps, change in shape, nipple discharge, discoloration, change in texture, breast pain, enlarged lymph nodes
Describe the most common palpable mass found in the breast of a 15-25 year old
Fibroadenoma; usually fine, round, mobile, tender
Describe the most common palpable masses found in the breast of 25-50 year olds
Cysts - Usually soft to firm, round, mobile, often tender;
Fibrocystic changes - nodular, ropelike;
Cancer - Irregular, firm, not clearly delineated from surrounding tissue
Describe the most common palpable masses found in the breast of women over the age of 50
Cancer until proven otherwise
Describe the most common palpable masses found in the breasts of pregnant/breastfeeding women
Fibroadenomas, cysts, mastitis, cancer
Describe a fibroadenoma
A benign tumor made of epithelial cells
Describe a cyst
A closed sac that contains fluid or can have solid quantities; only fluid means simple cyst, fluid and solid qualities mean complex cyst
Describe fibrocystic disease
Condition marked by palpable lumps in the breast usually associated with pain and tenderness; fluctuates with menstrual cycle and is worse pre-menstrually
Describe the proper inspection of the breast
4 things: Asymmetry, Skin changes, Contour changes, Retraction;
4 different positions: Arms at sides, Arms overhead, Arms at hips, Leaning forward
What should be asked if nipple retraction/indentation is observed?
Has it always been that way?
What does atypical fullness/puckering indicate?
Potential pathology underneath
What is the best position for breast palpation?
Supine position
What fingers should be used to palpate the breasts?
Finger pads of 2,3,4
Describe how palpation should be done
- Be systematic
- Can be done in a circular manner or up and down
- Nipple should be palpated as well (discharge)
- Remember to palpate the tail of breast and axilla
How should physical findings of the breast be described?
The breast is divided into four quadrants based on horizontal and vertical lines which intersect at the nipple. Findings can be localized as the time on the face of a clock. Document size.
Give an example of how to document a breast finding
Marble-sized lump in upper outer quadrant about 1 inch from the nipple
Describe the quadrants of the breast and the percentage of area they make up
Upper outer quadrant - 50%
Upper inner quadrant - 15%
Lower outer quadrant - 11%
Lower inner quadrant - 6%
Nipple and areola - 18%
What is a mammogram?
An x-ray of the breasts
Describe how a mammogram works
Breasts are compressed between two plates to flatten the breast tissue
