Assessing Breasts and Axillae
Assessing Breasts and Axillae
Assessing Breasts and Axillae
Learning objectives:
1- Differentiate between breast examination & breast self examination
9-List the proper positions for assessment breasts and axillae. 10- Describe the techniques used to assess breasts and axilla.
Definitions
Breast examination. It is the technique by which a thorough inspection & palpation of the breast is made during antenatal and postnatal period to collect data condition of mother. about the breast Breast self examination( B S E). It mean the regular examination of breast performed by a woman in a systemic manner for the purpose of early detection of cancer breast(done monthly).
At puberty, after menopause and following hysterectomy for early detection of breast cancer
2.
Purposes
A. B.
C.
D. E.
To assess the breast size , shape and symmetry. To assess nipples for its type ,size and secretion. To assess areola. To check the breast tissue for presence of lump or mass. To detect and treat early any abnormalities or complications.
Preparation:
Verify
the clients identity. Induce self. Explain the procedure. Hand washing. Provide client privacy.
Ask for:
History
of breast masses and what was done about them. or tenderness in the breasts and relation to the womans menstrual cycle. from the nipple.
Pain
Discharge
Medication history (e.g., oral contraceptives, steroids, and diuretics) may cause nipple discharge.
Risk factors (e.g., mother, sister, aunt with breast cancer, alcohol consumption, high fat diet, obesity, use of oral contraceptives, menarche before age 12, menopause after age 55, age 30 or more at first pregnancy
Inquire
if the client performs breast self examination, technique used, and when performed in relation to the menstrual cycle.
Estrogen replacement therapy may be associated with the development of cyst or cancer.
Normal findings
Female: rounded shape, slightly unequal in size, generally symmetric. Male: breasts even with the chest wall, if obese may be similar in shape to female breasts.
Inspect for:
Normal findings
Skin : uniform in color and skin is smooth and intact. Striae, moles and nevi.
Normal findings
Normal findings
Rounded or oval bilaterally the same, -Color varies from light pink to dark brown. -Irregular placement of sebaceous glands on the surface of areola.
Inspect the nipples for size, shape, position, color, discharge, and lesions.
-Rounded, everted and equal in size. -Similar in color, smooth, soft, both nipples point in same direction. - No discharge, except from pregnant or breast feeding females. -Inversion of one or both nipples that is present from puberty.
-A symmetrical size and color. -Presence of discharge, crusts, or cracks. -Recent inversion of one or both nipples.
Use the flat surfaces of all fingertips to palpate the four areas of axilla:
The edge of the greater pectoral muscle. The thoracic wall in the midaxillary area. The upper art of the humerus. The anterior edge of the latissimus dorsi muscle along the posterior axillary line.
Palpate the breasts for masses, No tenderness, and any discharge tendernes from the nipples. s, masses, Client position: supine nodules, Rationale: The breasts flatten or nipple evenly against the chest wall, discharge. facilitating palpation
-Tenderness, masses, nodules, or nipple discharge. If a mass was detected, record the following data:
Strip the ducts towards the nipple. Normally, one or two drops of clear, milky or green-tinged secretions. Should not be bloody or in large quantity, squirting out or staining the inside of a bra.
For clients who have a past history of breast masses, who are at high risk for breast cancer, examination in both a Supine and a Setting position is recommended.
B-Size: the length, width, and thickness of the mass in cm. C-Shape: lobulated, irregular. round, oval, indistinct, or
If the client reports a breast lamp, start with the normal breast to obtain baseline ass. For palpation choose one of three patterns: 1- Concentric circles.
Assessment
2-Hands-of-the-clock or spokes-on-a-wheel
3-Vertical strips pattern: Start at one point for palpation, and move systematically to the end point to ensure that all breast surfaces are assessed. Teach the client the technique of breast self examination. Document findings.