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M6 13-005

Exam 8: Reproductive System; Benign Disorders of the Female Reproductive Tract

Normal Breast: External Components Skin, Areola, Nipple
Normal Breast: Internal Components Mammary Glands, Lobes (15-20), Adipose tissue determines breasts size, Milk production is called lactation, Axillary & internal mammary lymph nodes
Breast Nodes: 15-20 Lobules contain milk-producing cells Lactiferous ducts empty into the nipple
Breasts response Respond to the hormonal cycle associated with ovulation, menstruation, and pregnancy.
Breast response: Hormones Prolactin, Progesterone, Estrogen
Breast Assessment Triad Breast Self Exam (BSE) Clinical Breast Exam (CBE) Mammography
Breast Self Exam (BSE) A regular (monthly) systematic examination starting at the age of 20 Regularity is the Key! Usually 7 to 8 days after menses 90% of lumps are found by women during BSE
Regular Breast Examination: Rationale The majority of lumps found are not cancerous. Cancerous breast lesions are treatable.
Techniques for teaching BSE Inspection Palpation Timing of BSE
Types of Breast Changes to Report Changes in skin texture. Retraction or indentation of nipple. Discharge from nipple. Atypical fullness and/or puckering Breast Dermatitis Mastitis Paget's Disease Inflammatory Breast Cancer
Timing of BSE's: Menstruating Menstruating women- 3-8 days after end of mensus
Timing of BSE's: Post-menopausal Women First day of the month or on any special day that is remembered
Mammograms A low dose x-ray of the breast in combination with a physical exam. Detects tumors not detectable with palpation. Detects tumors as small as 0.5 cm, Annual screenings beginning at 40 years of age.
Established risk factors for breast cancer Age over 50 Family history Defective gene BRCA 1 and BRCA Chronic alcohol use Ethnicity Nulliparity Age of first full term pregnancy
50% of women diagnosed with breast cancer demonstrated none of the identified risk factors except for age
Benign Growths Fibrocystic Breast Condition Fibroadenoma Acute Mastitis Chronic Mastitis
Fibrocystic Breast Disease Or Benign Breast Disorders Also called chronic cystic mastitis or mammary dysplasia Cause is unknown but related to response of breast tissue to cyclic hormone changes Most common benign breast lesion
Fibrocystic Breast Disease Or Benign Breast Disorders Results from hormonal changes during the menstrual cycle
Fibrocystic Breast Disease Or Benign Breast Disorders: Symptoms Premenstrual pain or breast tenderness Diffuse tender cysts Usually occur bilaterally Mobile lumps - if close to skin surface Deeper ones from carcinoma Surgical biopsy for definitive diagnosis
Fibrocystic Breast Disease Or Benign Breast Disorders: Characterisitcs Most common benign breast lesion Affects premenopausal women usually ages 30 – 50  Aspiration biopsy may be required for definitive diagnosis
Fibrocystic Breast Disease Or Benign Breast Disorders: Interventions Padded bra/good supportive bra Analgesics / diuretics Dietary measures Danocrine/Danazol Hormonal contraceptives
Fibroadenoma Solid benign mass of connective tissue & glandular tissue Usually occurs in late adolescence or early adulthood Cause unknown but related to hormonal changes
Fibroadenoma: Characteristics grows during pregnancy shrinks after menopause grows slowly: -usually single nodule -not related to menstrual cycle -not considered pre-cancerous
Fibroadenoma: Assessment Finding Painless, non-tender lump Encapsulated, mobile firm If large, breast size asymetric
Fibroadenoma: Diagnosis and Treatment US more accurate than mammogram Excisional biopsy as needed
Fibroadenoma: Nursing Management Teach how to perform BSE's Wound care if excision is necessary Follow-up care
Acute Mastitis Bacterial infection usually caused by S. aureus or streptococci Occurs mostly during lactation Caused by poor hygiene or infant infection Tender/inflammed breasts obstructing milk flow Use of warm packs, well fitting bra, ABX helpful
Chronic Mastitis Women between ages of 30-50 Common in obese women Multiparous Have had difficulty nursing Inverted or cracked nipples Traumatic injury to breasts Increased fibrosis of tissue
Created by: jtzuetrong