chap. 20 - breast, lymphatic system

breast function

produce and store milk + aid in sexual stimulation

• lactiferous ducts → carry milk to nipple

• lactiferous sinuses → stores milk

upper outer quadrant (tail of spence)

most common site of tumors

lymph nodes in breasts

drain breast tissue to filter microorganisms + return fluid to the blood

anterior (pectoral) axillary lymph node

drains anterior chest wall + breasts

posterior (sub-scapular) axillary lymph node

drains posterior chest wall + arms

lateral (brachial) axillary lymph node

drains most of the arm

central (mid-axillary) axillary lymph node

receives drainage from all other axillary nodes

older adult considerations

• decrease in size + firmness due to decrease in estrogen levels

• glandular tissue decreases, while fatty tissue increases

• often has more pendulous, less firm, and saggy breasts

• smaller, flatter nipples that are less erect on stimulation

• may feel more granular — inframammary ridge may be more easily palpated

breast cancer risk factors

female, age, personal/family history (menstruation, menopause, pregnancy, breast cancer, radiation tx), alcohol, obesity, ashkenazi jewish heritage, dense breasts, milk, night shift/dim light

breast cancer prevention

physical activity, decreased alcohol intake, exercise

cancerous tumors

irregular, firm, hard, not defined masses that may be fixed or mobile

• not usually tender + usually occurs AFTER age 50

fibroadenomas

firm, well defined, seldom tender, and usually singular and mobile

• lobular, ovoid, or round

• occur more commonly between puberty and menopause

benign breast disease (fibrocystic breasts)

benign, marked by round, elastic, defined, tender, and mobile cysts

• common from age 30 to menopause (after it decreases)

peau D’ orange

orange peel appearance in breast associated with cancer resulting from edema

paget

1. early = redness + flaking of the nipple

2. late = tingling, itching, increased sensitivity, burning, discharge, and pain in nipple

nipple inversion

may suggest malignancy

retracted breast tissue

SUGGESTS malignancy

mastitis

due to infection while breast feeding

supernumerary nipple (extra nipple)

usually disappears in utero or during young age

gynecomastia

soft, fatty enlargement of breast tissue seen in obesity

• smooth, firm, moveable disc of glandular tissue

• may been seen in 1 breast in males during puberty

• usually temporary

• can be seen in hormonal imbalances, drug abuse, cirrhosis, leukemia, thyrotoxicosis