| Term | Definition |
| 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 |
