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Exam of the breasts and axillae (exam 3)

Terms in this set (40)

breast borders
inferior clavicular line
inframammary fold
mid sternum
axilla
Breast lobes
wedge shaped
Lymph node chains
-central (deep in axilla)
-pectoral (anterior)
-lateral (proximal humerus)
-subscapular (posterior)
Stage 1
preadolescent
Stage 2
breast bud
Stage 3
further enlargement elevation of areola and breast
Stage 4
projection of nipple and areola, secondary mound
Stage 5
mature stage
projection of nipple only
areola recedes to general contour of breast
Whats the best time for a SBE?
week after menses
CBE may detect.....
mass that mammogram missed
20-40 y/o should have a CBE.....
every 3 yrs
40 and up should have a CBE.....
annually
4 positions for CBE
-arms at side
-arms overhead
-arms pressed on hips
-leaning forward
Methods of palpation for CBE
-circles
-wedges
-lines
if nodule how do you note location
quadrant or clock
distance from areola
casuses of tenderness
premenstrual fullness
fibrocystic tissue
malignancy
-no tenderness
-poor delimitation
-stuck down
-irregular
How often should a SBE be done?
once a month
5-7 days after menses
Most BrCA occur here
UOQ
Supernumerary breast
-along the milk line
-benign
-often mistaken for nevi
Galactorrhea
lactation in the absence of nursing
Galactorrhea and not getting periods
pituitary adenoma
due to hyperprolactenemia
intraductal papilloma
-benign tumor in milk duct
-breast pain, lump, discharge
-ductogram shows filling defect
Congestive mastitis
-b/l breast engorgement
-2-3 days post partum
-swollen, tender, tense, warm
-Tx=feed, feed, feed!
Infective mastitis
- >7 days post partum
-u/l
-tender, red, swollen, hot
- oral or nasal organism
-Tx= local heat, ABX, nurse often
types of breast masses
- fibroadenoma, cyst, fibrocystic disease, cancer
Fibroadenoma
-15-25 y/o
-benign
-firm/well demarcated
-mobile/non tender
-round, disc, lobular
- single or multiple
Cysts
-30-50 y/o
-regress after menopause
-round
-soft/firm, rubbery
-well demarcated
-mobile/tender
- single or multiple
Fibrocystic dz
-25-50 y/o
-nodular/ rope like
-multiple cysts
BrCA
-30-90 yo
-usually single mass
- irregular/stellate shape
-firm/hard
-not well demarcated
-fixed/nontender
- +/- skin changes/nipple retraction
modifiable RF
postmenopausal obesity
combination HRT
alcohol use
physical inactivity
estrogen containing contraceptive use
nulliparity/never prego
>30 yo at first full term pregnancy
never breast fed
Higher risk of BrCA
-older
-AA
Peau d-orange
-lymph blockage
-tumor/mass
Paget's dz of the nipple
-scaly lesion of the nipple
-may weep, crust, erode
-rare
Inflammatory BrCA
-aggressive
-cancer cells block lymphatic channels
-rare
#1 screening tool for BrCA
traditional mammography
good screening tool for young pts and those with dense breasts
digital mammography
contrast enhanced MRI
-breast cancer screening method
-more sensitive than mammography
-reserved for high risk populations
BRCA1 and BRCA2 mutations
Autosomal dominant genetic mutations
BrCA detection methods from most important to least
1) Pt Ed
2) Mammograms
3) CBE
4) SBE
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