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ASSESSING THE BREASTS. NUR211 Kathleen Hancock. Assessing the Breasts. Obtain a breast history. Perform a breast physical assessment. Document breast assessment findings . Differentiate between normal and abnormal findings. Breast Composition. 3 types of tissue: *Glandular

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assessing the breasts

ASSESSING THE BREASTS

NUR211

Kathleen Hancock

assessing the breasts2
Assessing the Breasts
  • Obtain a breast history.
  • Perform a breast physical assessment.
  • Document breast assessment findings.
  • Differentiate between normal and abnormal findings.
breast composition
Breast Composition
  • 3 types of tissue:
    • *Glandular
    • *Fibrous
    • *Adipose
structures
Structures
  • Lobes and lobules
  • Lactiferous ducts and sinuses
  • Areola
  • Montgomery’s glands
structures5
Structures
  • Nipple
  • Cooper’s ligament
  • Pectoralis major and serratus anterior muscles
functions what are the functions of
FunctionsWhat are the functions of…

Lobes & lobules:

Contain alveoli cells that produce milk

Lactiferous ducts & sinuses:

Carry and store milk

Areola:

Dark tissue surrounding nipple

(Continued)

functions what are the functions of10
FunctionsWhat are the functions of…

Montgomery’s glands:

Sebaceous gland

Nipple:

Nursing and sexual stimulation

Cooper’s Ligament:

Ligament attached to chest wall muscles that supports breasts

(Continued)

functions what are the functions of11
FunctionsWhat are the functions of…

Pectoralis major & serratus anterior muscles:

Breast overlies these muscles

Lymph nodes:

Drain breast, chest, and arms

breast health cancer prevention
Breast Health:Cancer Prevention
  • Self Breast Exam (SBE)
    • Every month
  • Mammogram
    • After age 40 every year
    • More frequent if personal or family history
  • Breast Exam by nurse or doctor every year
developmental variations
DevelopmentalVariations

What developmental breast variations might be seen with:

  • Children
  • Pregnant clients
  • Older adults
history what can the history tell you about the breast
HistoryWhat can the history tell you about the breast?
  • Biographical data
  • Current health status
  • Past health history
  • Family history
  • Review of systems
  • Psychosocial history
symptoms what symptoms signal a problem with the breasts
SymptomsWhat symptoms signal a problem with the breasts?
  • Breast lump or mass
  • Pain or tenderness
  • Nipple discharge
physical assessment
Physical Assessment

Anatomical landmarks: quadrants of the breast, include Tail of Spence

(Continued)

inspection
Inspection

Breasts: size, shape, symmetry, color, lesions, venous pattern, dimpling, or retraction

Nipple and areola: nipple position and direction; discharge

Axillae: color, lesions, rashes

physical exam inspection
Physical Exam - Inspection

Position: sitting, hands on hips, hands over head, leaning forward

Tools: small pillow or towel, ruler, gloves, slide, and culture slide.

palpation
Palpation

Lymph nodes: axillary, clavicular while sitting

Breasts: consistency, masses, tenderness in supine position

Nipple: elasticity, masses, tenderness, discharge

palpation vertical strip method preferred
Palpation –Vertical Strip Method Preferred
  • Approach: supine with pillow or towel under shoulder
  • Pattern (vertical, wedge, or circular) light, medium, and deep
strip method of palpation
Strip Method of Palpation
  • Cover all of breast
  • Use 3 middle finger pads, not tips
  • Use sliding motion
  • Overlapping dime size circles
  • 3 pressure levels: light, medium, deep
  • Include nipple and areola
large breasts
Large Breasts
  • Bimanual palpation to adequately examine all areas
  • Often have an inframammary ridge
male breast
Male Breast
  • Inspection
  • Palpation
    • Lymph nodes while sitting
    • Breast while sitting or if large while lying down
characteristics of masses
Characteristics of Masses

Note:

  • Location  Shape/Borders
  • Size  Tenderness
  • Mobility  Consistency
  • Temperature  Redness
example pertinent physical findings
Example: Pertinent Physical Findings
  • Right breast larger than left
  • No dimpling, retraction
  • Small, pea size (0.5cm), movable, rubbery, smooth-edged lesion in right breast at 2 o’clock in RUQ
  • No palpable nodes