Breasts

Describe the technique for inspect and palpation of the axillae

1. down the chest wall in a line from the middle of the axilla 2. along the anterior border of the axilla 3. along the posterior border 4. along the inner aspect of the upper arm

List breast cancer risks for women

>4.0: age 65+ 2.1-4.0: personal history of breast cancer; high endogenous estrogen or testosterone levels 1.1-2.0: alcohol consumption

What alterations of assessment data should you note for

Adolescents: begins 8-10 years old Pregnant women: vascular blue patterns may be visible over the breasts Lactating women: colostrum changes to milk production around the 3rd postpartum day Aging women: sagging

What are expected changes of the breast with aging?

After menopause, ovarian secretion of estrogen and progesterone decreases, causing breast glandular tissue to atrophy. It turns into fibrous connective tissue. The fat envelope atrophies also. Saggy breasts

When should women begin breast cancer screenings?

Annual screenings at 40 years of age

How would you teach breast self-examination?

Best time is right after the menstrual period (day 4 to 7 of the cycle) when the breasts are the smallest and least congested

How would you examine a male breast?

Inspect the chest wall for lumps or swelling. Palpate the nipple for lumps or tissue enlargement. It should feel even with no nodules. Palpate the axillary lymph nodes

What are the maneuvers to screen for retractions?

Lift arms: both breasts should move up symmetrically

If you identify a lump which characteristics do you need to note?

Location Size: width x length x thickness shape: oval round lobulated or indistinct consistency: soft, firm, or hard movable: freely movable or fixed? distinctness: is it solitary or multiple? nipple: is it displaced or retracted skin over the lump: erythematous, dimpled, or retracted? tenderness: a lump tender to palpation? lymphadenopathy: lymph nodes palpable

What should you visually assess?

Symmetry of size and shape. Left breast may be slightly larger than the left

Gynecomastia

a benign growth of male breast tissue, making it distinguishable from the other tissues in the chest wall. It feels like a smooth

Galactorrhea

a milky nipple discharge unrelated to the normal milk production of breast-feeding; isn't a disease but is a sign of an underlying problem

Supernumerary nipple

an extra nipple

Menarche

beginning of menstruation

Pregnant Woman development

breast changes are expected and normal. Assess the woman's knowledge and provide reassurance. Inverted nipples may need special care in prep for breastfeeding

Mastalgia

breast pain is either cyclical (associated with menstrual periods) or noncyclic. Occurs with trauma, inflammation, infection, and benign breast disease

Preadolescent breast development

developing breasts are a sign of puberty. Assess each girl's perception of her own development and provide teaching and reassurance as indicated

What are modifiable and unmodifiable risk factors for breast cancer?

obesity age race family history

Tanner Staging

the five stages of breast development follows this classic description of sexual maturity rating (boob size)

Colostrum

thick yellow fluid is the precursor for milk, containing same amount of protein and lactose but practically no fat (in pregnant women)

Describe the technique for palpation of the breast

use the pads of your first 3 fingers an make a gentle rotary motion on the breast vary pressure so you are palpating light, medium and deep tissue in each location