Breast and Lymphatics (UNRS 220, HealthAssess)

Lymphatic system:

A network with the primary purpose of returning fluid from the interstitial spaces to the blood; it also fights infections and helps to absorb lipids

Axilla:

The technical term for armpit

Mammogram:

X-ray image technique used to screen for breast cancer

Areola:

Pigmented area surrounding the nipple

Breast tissue is divided into these areas:

4 quadrants (upper outer, lower outer, upper inner, lower inner) and the Tail of Spence

Tail of Spence:

Breast tissue that extends into the axilla

Lymph nodes:

Small lymphatic glands arranged in chain-like groupings along the lymphatic vessels

When conducting a health history interview related to the present health of the breast, ask about the following:

Pain, lumps, discharge, any changes

When conducting a health history interview related to the past health of the breast, ask about the following:

Diagnosis of breast disease such as cancer, clinician breast examinations, breast self-examinations

When inspecting the skin of the breast, how should the assessment be modified for a client with large breasts?

Lift the breast tissue to inspect the underside

Are striae and a visible vein pattern on the breast concerning?

Not usually, this is an expected variation

Breast cancer will always cause abnormal findings with this characteristic:

The findings will always be asymmetrical, since it's almost impossible for both breasts to get breast cancer in the same way at the same time

Breast cancer may cause what abnormal findings that may be inspected on the skin of the breast?

An unusual texture or dimpling of the skin

Peau d'orange:

An orange-peel-like texture of the skin over the breast caused by edema of the underlying breast tissue

When inspecting the breast for signs of breast cancer, what instructions should the nurse give the patient?

Inspect at rest and with arm movements

When inspecting the breast for signs of breast cancer, what should the nurse inspect for as the client moves her arms?

Smooth and symmetric movements of both breasts

Gynecomastia:

Breast growth in a male

Is asymmetric breast size a concerning finding?

It depends; if it is a new change, then it is concerning. If it is a small difference and has been the same over time, then it is unconcerning

Breast cancer may cause what abnormal findings that may be inspected on the nipple?

The nipple is protruding, inverted, pointing a different direction than usual, or has unusual drainage

If a nipple is not pointing directly forward, is inverted, or is asymmetrical, is this a concerning finding?

It depends; if it is a new change, then it is concerning

When palpating the breast, how should the client be positioned?

Supine, with the arm on the side of the breast raised

What is the proper technique for palpating the female breast?

Apply light, medium, and deep pressure, in a circular motion

When should women get a mammogram?

Recommendations will vary depending on risk factors for breast cancer

When palpating the breast, which part of the hand should be used?

The pads of the three middle fingers

When palpating the breast, what pattern should be followed?

There is no single best pattern, as long as all areas are systematically covered

Should women be taught how to perform breast self-examinations?

Typically only if the woman requests it; the evidence for its efficacy at accurately detecting breast cancer is not good enough to be widely recommended