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Breast Assessment
Health Assessment
| Question | Answer |
|---|---|
| location of breast | anterior to pectorals major and serrates anterior muscles, which support and shape breasts between second and sixth ribs |
| function of breasts | to produce milk |
| axillary tail of spence | superior lateral corner of breast tissue, projects up and laterally into axilla **primary site of cancer** |
| breasts are primarily composed of | subcutaneous fatty tissue |
| composition of breast | glandular tissue; 15-20 lobes radiating from the nipple with acini cells(alveoli): produce milk suspensory(cooper's) ligaments, fibrous bands that support breast adipose tissue |
| areola | pigmented circle of wrinkled skin |
| Montgomery's glands (areolar glands) | tiny sebaceous glands on the areola |
| mammary ridge (milk line) | supernumerary nipples or breast tissue may be present along the ridge |
| which part of the breast is the most common site of cancer? | upper outer quadrant |
| different quadrants of the breast | upper inner, upper outer, lower inner, lower outer, tail of spence |
| Sites of breast cancer metastasis | brain, lymph nodes, skin, lung, liver, bone |
| chance of cancer in upper outer quadrant | 50% |
| chance of cancer in upper inner quadrant | 15% |
| chance of cancer in lower outer quadrant | 11% |
| chance of cancer in lower inner quadrant | 6% |
| chance of cancer in alveoli | 18% |
| when is breast cancer able to be seen on a mammogram? | about 8 years |
| when is breast cancer palpable? | about 10 years |
| breast lymphatic system | Empties the breast tissue of excessive fluid pathway between breasts and to liver which can lead to metastasis in these locations |
| nodes included in breast lymphatic system | central axillary nodes, pectoral nodes, subscapular nodes, lateral nodes, supraclavicular, sub clavicular |
| Tanner stages | scale for stages of sexual development in puberty |
| Thelarche | beginning of breast development in females, precedes onset of menarche by about 2yrs |
| Is breast asymmetry normal? | this can be normal in adolescence but may be an issue in older individuals if this is a new finding |
| tanners developmental stage | preadolescent stage (before age 10), nipple is small, slightly raised |
| tanners breast bud stage | after age 10 (8-9 for African Americans), nipple and breast form a small mound. areola enlarges. height spurt begins |
| tanners adolescent stage | 10-14 years, nipple is flush with breast shape. breast and areola enlarge. menses begins. height spurt peaks |
| tanners late adolescent stage | 14-17years, nipple and areola form a secondary mound over the breast. height spurt ends |
| tanners adult stage | nipple protrudes; areola is flush with breast shape |
| all lumps should be | further assessed and referred |
| when is breast pain common? | just before/during menstruation, possible sign of breast cancer |
| what is always referred immediately? | blood-tinged discharge |
| factors that lead to increased risk of breast cancer | 1. early menses before 12 2. delayed menopause after 52 3. never near birth 4. having first child after 30 5. high-fat diet 6. tobacco/alcohol use |
| client position for breast exam | sitting upright facing examiner (gown open to the front) |
| two main components of clinical breast exam | 1. inspection of breasts and axillae 2. palpation of breasts and axillae |
| positions for inspection | sitting upright with hands to the side, hands above head, hands on hips, leaning forward |
| position for pt. when palpating breasts | laying supine |
| how to assess the nipple | wear gloves and compress gently- look for discharge |
| strip method | lay supine with a small pillow under breast being examined, palpate every square inch and every layer of pressure to palpate up and down |
| breast self examination (BSE) | a self-care procedure for the early detection of breast cancer, can use strip method, spiral, or sorting in and working out |
| pendulous breast | Breast that hangs loosely, use bimanual method |
| how to check lymphatic drainage of the breast | inspect. and palpate the axillae, look for rash/infection, make sure no palpable nodes |
| central axillary node | reach with fingers not apex of axilla |
| anterior axillary (pectoral) node | palpate in anterior axillary fold |
| posterior axillary (sub scapular) node | palpate in posterior axillary fold |
| supra and sub clavicular node | above and below clavicle |
| lateral (brachial) node | upper inner aspect of arm |
| gynecomastia | development of breast tissue in males, smooth, firm, movable disc of glandular tissue, usually unilateral and temporary in puberty, may reappear in aging due to testosterone deficiency and obesity |
| witch's milk | fluid from the undeveloped mammary glands of newborn babies (male & female) |
| aging female breast | - decrease in size, firmness, axillary hair, and granular tissue post menopause (decrease in estrogen and progesterone) |
| how often should you do a BSE? | every month after 18 |
| when do clinical breast exams begin? | 20 (every 3 years), annually after 40 |
| best time to do a BSE | 10th day after the beginning of menstrual period |
| Peau d'orange | orange peel appearance of breast due to edema |
| Paget's disease of the breast | redness and flaking around nipple |
| retraction of nipple/dimpling | nipple starts raised but begins to pull inward |
| mastitis | inflammation of the breast, usually lactating mom with plugged duct red, swollen, tender, warm, headache, malaise, fever, chills, etc. |
| mastectomy | surgical removal of a breast don't take BP on a side of the body with a mastectomy |
| most common cancer among women | breast cancer |
| genetic risk factor of breast cancer | inherited mutation. of BRCA1 and BRCA2 genes |
| shape of breast cancer | irregular/ star shaped, borders poorly defined |
| consistency of breast cancer | firm-hard/ dense |
| mobility of breast cancer | may be fixed to underlying tissue/skin |
| Tenderness of breast cancer | usually not tender |
| gross cyst | 30-60 (decrease in number of menopause), round, mobile, tender, no erythema or retraction |
| Fibroadenoma | a round, firm, rubbery mass that arises from excess growth of glandular and connective tissue in the breast mostly 20-30 yrs women |
| carcinoma of the breast | Malignant tumor of breast tissue |
| fibrocystic breast disease | "lumpy breasts", fluctuates with hormonal changes throughout the month |
| percentage of men at risk for BRCA gene | 6% |
| how many men get breast cancer per year in the US? | 1500 and about 400 die |
Created by:
AV25
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