PD II - breast and maxilla

what is the superior aspect of breast?

clavicle and 2nd rib

what is medial aspect of breast?

sternum

what is inferior aspect of breast?

6th rib

what is lateral aspect of breast?

mid-axillary line

the breast is a subcutaneous structure composed of how many lobes of mammary gland tissue and fat?

15-20

the breast typically extends into where?

axilla, known as tail of breast (tail of spence)

the breast extends from which ribs?

2-6 from sternal border to mid-axillary line

the suspensory ligaments are attached to what?

dermis of skin

the majority of lymph from breast drains into where?

axillary lymph nodes

secondary drainage to parasternal, inferior phrenic nodes and infraclavicular

what are the tissues that make up breast?

• hormonally sensitive tissue

• glandular tissue (milk-secreting glands and ducts)

• fibrous connective tissue (structural support- cooper ligaments)

• adipose tissue

tanner stages for breast

I: prepubertal

II: elevated as small mound, areolar diameter inc

III: further enlargement

IV: areola + papilla form a secondary mound

V: mature areola part of breast contour

what are you looking for in inspection?

skin changes (dimpling, edema (peau d’orange), retractions)

NEW asymmetry

supernumerary nipples

can form in a funnel shape pattern where it looks like you have an extra nipple somewhere else on body

what is paget’s disease?

uncommon form of breast cancer, scaly lesion on nipple that is persisten

what is paget’s disease associated with?

invasive ductal carcinoma or lobular carcinoma

what is the nipple discharge you’d see normally with manual expression?

• milky white to greenish/brown

• multiple ducts involved

what is spontaneous discharge assoc with?

pathologic,think pregnancy, endocrine/hypothyroidism, prolactinoma/pituitary, meds, cancer

edema (peau de orange)

erythema or skin changes around breast

looks like an orange on the breast

erythema on breast before menopause

mastitis

erythema on breast AFTER menopause

inflammatory breast cancer

how should pt be psoitioned for palpation?

supine

when measuring location of lesion of breast, where do you measure from?

nipple, in terms of hands on a clock

what are the changes in breasts during menopause?

no estrogen and progesterone → decrease in density and breast volume w/ replacement with adipose tissue