BREASTS AND LYMPHATIC SYSTEM ASSESSMENT

BREASTS

paired mammary glands that lie over the muscles of the anterior chest wall, anterior to the pectoralis major and serratus anterior muscles

FEMALE BREAST

accessory reproductive organ with two functions; to produce and store milk that provides nourishment for newborns and to aid in sexual stimulation

TAIL OF SPENCE

upper outer quadrant, which extends into axillary area;

where most breast tumors occur

LYMPH NODES OF BREAST

drain lymph from breasts to filter out microorganisms and return water and protein to the blood

INFLAMMATION OR ABNORMAL GROWTH OF BREAST

recent increase in the size of one breast

REDNESS

breast inflammation

PIGSKIN-LIKE OR ORANGE-PEEL (PEAU D'ORANGE)

edema; seen in metastatic breast disease

EDEMA

caused by blocked lymphatic drainage

PAGET'S DISEASE

early signs: redness, mild scaling, and flaking of the nipple

late signs: tingling, itching, increased sensitivity, burning, discharge and pain in the nipple

RETRACTED NIPPLE, DIMPLING, RETRACTED BREAST TISSUE

malignancy

DIMPLING OR RETRACTION

usually caused by a malignant tumor that has fibrous strands attached to the breast tissue and the fascia of the muscles.

ASSESSMENT FOR DIMPLING OR RETRACTION

a. raise arm

b. lower and press

c. press together

FIBROSIS OR FIXATION OF THE UNDERLYING TISSUES

restricted movement of breast or retraction of the skin or nipple

PATTERNS OF PALPATING THE BREASTS

circular or clockwise, wedged, vertical strip, flat pads of three fingers, bimanual palpation

FIBROCYSTIC BREASTS

painful, tender breasts; right before menstruation

INFLAMMATION

heat in the breasts of women who have not just given birth or who are not lactating

MALIGNANT TUMORS

upper outer quadrant of breasts; unilateral, with irregular, poorly delineated borders; hard and nontender and fixed to underlying tissues

FIBROCYSTIC BREAST TISSUE

feel ropy, lumpy or bumpy; nodular, glandular

BENIGN BREAST DISEASE

• also called fibrocystic breast disease

• bilateral, multiple, firm, regular, rubbery, mobile nodules with well-demarcated borders;

• marked by round, elastic, defined, tender, and mobile cysts; most common from age 30 to menopause

FIBROADENOMAS

usually 1-5 cm, round or oval, mobile, firm, solid, elastic, nontender, single or multiple benign masses found in one or both breasts; lobular, ovoid or round, firm, well defined, seldom tender, usually singular and mobile; common between puberty and menopause

MILK CYSTS

(sacs filled with milk) and infections (mastitis), may turn into an abscess and occur if breastfeeding or recently given birth.

LIPOMAS

collection of fatty tissue that may also appear as a lump

INTRADUCTAL PAPILLOMA

a small growth inside a milk duct of the breast, often near the areola. It is harmless and occurs in women ages 35-50

CANCEROUS TUMORS

irregular, firm, hard, not defined masses; may be fixed or mobile; not usually tender and usually occur after age 50

DISCHARGE

seen in endocrine disorders; may indicate benign intraductal papilloma, fibrocystic disease, cancer of the breast

ACANTHOSIS NIGRCANS

dark, velvety pigmentation of the axillae

ENLARGED LYMPH NODES

infection of the hand or arm

OBESITY

soft, fatty enlargement of breast tissue

GYNECOMASTIA

smooth, firm, movable disc of glandular tissue, may be seen in one breast in males during puberty (temporary)

ANTERIOR CHEST WALL

anterior to the pectoralis major and serratus anterior muscles

breasts extend vertically

sixth rib and horizontally from the sternum to the mid-axillary line

prominent venous pattern

may occur as a result of increased circulation due to a malignancy

Areolas

vary from dark pink to dark brown

Nipples

• nearly equal bilaterally in size and are in the same location on each breasT

• everted, but they may be inverted or flat.

Supernumerary nipples

may appear along the embryonic “milk line.”

No discharge should be present.

Dimpling or retraction

usually caused by a malignant tumor that has fibrous strands attached to the breast tissue and the fascia of the muscles

Freely and symmetrically

Breasts should hang

Thickening of the tissues

may with an underlying malignant tumor

Circular or Clockwise

wedge

vertical strip

Discharge from one breast

may indicate benign intraductal papilloma, fibrocystic disease, or cancer of the breast

Redness and inflammation

may be seen with infection of the sweat gland

Large nodes

hard and fixed to the skin may indicate an underlying malignancy