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CS1 Breasts
| Question | Answer |
|---|---|
| Why might a woman have one breast larger than another? | Pectoral muscle enlargement on the a dominant side. |
| What nodes are present in the upper outer quadrent and where do they drain? | 1.Scapular. 2.Brachial. 3.Intermediate. **They drain into axillary nodes. |
| What is Thelarche? when does it occur? | The begging of breast development, (Tanner 0). It occurs 1-2yrs before menarche around 9.8 yrs old. **Breast buds can sometimes be confused with cancerous lumps in MEN and women. |
| Changes to the breast in Pregnancy | 1.Increased Duct size & number (lactation). 2.Vascular Engorgement. 3.Tissue becomes softer and looser. **Increase in cup size may lead to shoulder/back pain. |
| Changes to the breast Post-Menopause | 1.Glandular tissue atrophies and thins. 2.Fat replaces parenchyma/ duct tissue. 3.less support. **All of these lead to a sagging of the breast |
| Nipple Abnormalities | 1.Inversion (difficulty breast feeding). 2.Retraction & Dimpling (Pathological, tightening of suspensory ligaments. Look at breasts from different angles). 3.Flattening. 4.Deviation. 5.Discharge/galactorrhea. |
| Normal variants of breast/nipples | 1.Color. 2.Shape (Conus, Convex, Pendelous). |
| 3 causes of axillary Lymphadenopathy | 1.Infection. 2.Systemic disease. 3.Breast cancer (mammary neoplasm). |
| Are breast masses always cancerous? | NO |
| Mastitis | Infection that leads to an inflammation of the breast. **Often from a backup of milk during feeding. |
| Fat Necrosis | painless, benign breast lump that occurs as an inflammatory response to trauma/ local injury. **Will see the nipple inverted with bruising. |
| Gynecomastia | Breast enlargement in males. **Most often seen in adolescent boys due to smoking weed and eating. |
| Most common breast mass? | Benign Cyst. **There will be no dimpling or retraction, the mass will be freely mobile with premenstral tenderness. |
| Firboadenoma | Benign, solid round mass. Feels rubbery or firm and is freely mobile. NONTENDER with no retraction or fixation. |
| Breast cancer Risk Factors | 1.Age > 40 (mammogram 2X yr).** 2.Gender. 3.Personal history (previous cancer). 4.Family hx of breast cancer. 5.Early (<12) menarche or late (>55) menapause. 6.Nulliparity or 1st child after 30yrs. 7.Hormone replacement therapy. |
| Does risk of breast cancer increase with age after 40? | YES |
| Cancerous tumors | Irregular contoured mass. Firm/hard consistancy that is difficult to delineate from surrounding tissue (non-mobile). NONTENDER with dimpling/retraction/fixation of the nipple. |
| Is breast cancer usually bilateral? | NO, only one sided. |
| What is Mastalgia? | Breast pain/tenderness. |
| Breast Cancer Inspection | EYES ONLY!! look for: 1.retraction, 2.dimpling, 3.peau d' orange, 4.Unilateral venous engorgment. **Remember to inspect at all 4 positions |
| Breast Cancer Inspection positions | 1.Low (arms at side). 2.High (arms raised). 3.Hips (hands pushing on hips). 4.Fly (leaning forward with Dr holding arms). |
| Breast Cancer palpation | Palpating light to deep with pads of the fingers: 1.All 4 quadrants (vertical strip method while supine). 2.nipple and areola. 3.Tail of spence (extension of breast tissue into the axilla). |
| Additional tests for Breast Cancer | 1.Mammogram. 2.Observation of mass. 3.ultrasound. 4.biopsy. |
Created by:
WeeG
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