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CS1 Breasts

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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