Final Review Ch 10

Front 1

Heath hx

Back 1

Breast lump or mass; Breast pain or discomfort; Nipple discharge: color, timing, consistency, quantity, unilateral; Breast self exam (5-7 d after onset of period); Change in breast contour, dimpling, swelling, puckering of skin

Front 2

Phys exam techniques: Inspection

Back 2

1. Sitting, with arms at sides. Note appearance of skin, size and symmetry of breasts, contours, characteristics of nipples.

2. Arms over head, hands pressed against hips, leaning forward. Look for dimpling, asymmetry, retraction.

Front 3

Phys exam techniques: Palpation

Back 3

1. Lateral portion: with pt supine, have pt roll onto opposite hip, head at forehead, shoulders against table. Begin at axilla, move in vertical strips until you reach the nipple.

2. Medial portion: Pt supine with hand by shoulder. Palpate in vertical strips from nipple to midsternum

3. Palpate nipples, noting the elasticity.

Front 4

normal findings

Back 4

Normal consistency variable;

Nodules may be present, esp before menses; May be firm transverse ridge of compressed breast tissue;

Tenderness, esp before menses

Front 5

abnormal findings

Back 5

milky d/c unrelated to pregnancy/lactation; abnormal contours (ie. flattening), retraction, dimpling caused by scar tissue;

deviation of the nipple; enlarged axillary nodes; enlarged, firm, matted or fixed nodes;

deeply pigmented, velvety axillary skin;

redness, thickening, prominent pores

Front 6

sx and exam findings of fibroadenoma

Back 6

Usual age 15-25; Usually single, can be multiple; Round, disclike, lobular;

Usually firm, may be soft;

Well delineated;

Very mobile, non-tender;

No retraction

Front 7

sx and exam findings of cancer

Back 7

Usual age 30-90, most common >50;

Usually single;

Irregular shape;

Firm/hard, usually non-tender;

Not well delineated;

May be fixed to skin or other tissue;

Retraction may be present;

Thickening of nipple/loss of elasticity;

bloody d/c - unilateral

Front 8

sx and exam findings of benign cyst

Back 8

usual age 30-50;

Round single or multiple;

Soft to firm, elastic, mobile, tender;

well delineated;

No retraction

Front 9

sx and exam findings of Paget's disease

Back 9

An uncommon form of breast cancer;

Starts as scaly, eczemalike lesion that weeps, crusts or erodes the nipple/areola;

There may be a breast mass;

Suspect with any persistent dermatitis of nipple and areola;

May present with invasive breast cancer

Front 10

sx and exam findings of supernumerary nipple

Back 10

Common minor congenital malformation of extra nipple or related tissue on chest wall, along "milk line";

Can occur with males and female;

Smaller than normal nipples,

Usually overlooked d/t small size;

No pathological significance

Front 11

sx and exam findings of peau d'orange

Back 11

Produced by lymphatic blockage, causes edema; Thickened skin with enlarged pores;

Often in lower portion of breast or areola;

Can also be malignant