Chapter 17-Breast and Regional Lymphatics
What type? how was it dx? when? treated?
-Family hx of breast disease? What ages?
Stage 2: Breast bud stage: small mound of breast and nipple develops; areola widens
Stage 3: Breast and areola enlarge; nipple is flush with breast surface
Stage 4: the areola and nipple form a secondary mound over the breast
Stage 5: Mature breast: only nipple protrudes; the areola is flush with breast contour
-Breast: Pain, Lump, Discharge, Rash, Swelling, Trauma, Hx of breast dx, srugery or radiation, medications, pt-centered
-Axilla: tenderness, lump, swelling, rash
-Inspection: General appearance, skin, lymphatic drainage areas, nipple, maneuvers for screen retration
-Inspect and Palpate the Axilla
-Teach breast self-examination
-Explain correct techniques and rationales and expected findings
-Perform in front of mirror while disrobed
-Palpate in shower, then while laying supine
*Perform right after menstrual period (or familiar date once a month after menopause)
-can just combine with anterior thorax
-Gynecomastia–> benign breast growth in adolescent male
Benign breast disease
abscess: Packet of puss that feels hard, looks red, and is tender
acute mastitis: Inflammatory mass before abscess. Usually single quadrant, red, swollen, tender, hot and hard.
*usually with lactation bc of stasis or plugged duct*
fibroadenoma: solitary nontender mass that is solid, firm, rubbery, and elastic; round, oval, or lobulated; detected in late adolescence. Benign!
cancer: solitary, unilateral, nontender. solid, hard, dense, and fixed. Grows constantly
-early lesion has unilateral, clear, yellow discharge and dry, scaling crusts, friable @ nipple axex. Erythmatous halo on areola
-later lesions show nipple reddened, excoriated and ulcerated with bloody discharge and erythematous plaque surrounding nipple
Size: width x length x thickness
Shape: oval, round, lobulated, or indistinct
Consistency: soft, firm, hard
Movable: freely or fixed?
Distinctness: solitary or multiple
Nipple: displaced or retracted
Note skin over lump: erythematous, dimpled, or retracted
Tenderness: tender on palpation
Lymphadenopathy: regional lymph nodes palpable?
Smooth, firm, movable disk
-Alcohol/western diet increases
-Mediterranean diet protective against
-also called tubercles of Montgomery