Breast Assessment Techniques and Importance

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Questions and Answers

What normal changes occur in the breast tissue of older adults?

Breasts becoming larger and more toned

Skin becoming thicker and more elastic

Increased glandular tissue and firmness

Glandular tissue atrophy and replacement with adipose tissue (correct)

When should a breast self-examination (BSE) be performed for someone who has menstruated?

At any time during the menstrual cycle

Weekly during menstruation

Immediately before the period starts

2-3 days after the period ends (correct)

Which of the following is an indicator for men at risk of breast cancer?

Experiencing significant chest pain

Having a mother or sister with a history of breast cancer (correct)

Having a personal history of testicular cancer

Being overweight regardless of family history

Which examination method is no longer recommended by the American Cancer Society due to lack of evidence?

Breast Self-Examination (BSE) Signup and view all the answers

What should be documented when there are abnormal findings in a breast exam?

Location, size, shape, and consistency of any lumps Signup and view all the answers

What are the two primary components of breast physical assessment?

Inspection and palpation Signup and view all the answers

During breast inspection, which of the following is considered an abnormal finding?

Orange peel appearance of the skin Signup and view all the answers

Which risk factor is NOT associated with the development of breast cancer?

Low-fat diet Signup and view all the answers

What is the recommended palpation method for breast assessment according to the American Cancer Society?

Vertical strip method Signup and view all the answers

Which finding during the inspection of the nipple may indicate a potential issue?

Recent inversion of one or both nipples Signup and view all the answers

What should be assessed for when palpating the breast?

Temperature, consistency, and tenderness Signup and view all the answers

What is a normal characteristic of breast tissue in a postmenopausal woman?

Flaccid and pendulous Signup and view all the answers

What aspect should be specifically checked for tenderness during breast palpation?

Inferior aspect of the breast Signup and view all the answers

What type of discharge should be expected during breast assessment if no abnormalities are present?

No discharge Signup and view all the answers

What should be done if a lump is reported during breast examination?

Begin with the normal breast Signup and view all the answers

Study Notes

Assessment of the Breast

Importance of breast assessment:
- Early detection of breast cancer
- Identify benign breast conditions
- Monitor breast health over time
Assessment techniques:
- Inspection: Assess breast size, symmetry, contour, color, skin surface, areola size, shape, color, nipple size, shape, position, color, and discharge.
- Palpation: Examine breast tissue for temperature, consistency, tenderness, and masses.
- Lymph node palpation: Assess axillary, supraclavicular, and infraclavicular lymph nodes for size, tenderness, and mobility.
Nursing History:
- Reason for seeking care: Breast pain, tenderness, nipple discharge, rash, lumps
- Medical History: Breast disorders, trauma, biopsy, surgery, cancer, medications
- Risk factors: Family history (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
Normal breast changes in older adults:
- Glandular tissue atrophy replaced by adipose tissue, breasts are softer, elongated, and pendulous.
- Skin becomes wrinkled, loose, and flabby.
- Nipples become smaller, flatter, and may invert.
- Loss of erectile ability.
Breast self-exam (BSE):
- Not recommended by the American Cancer Society (2017) but may still be recommended by healthcare providers based on patient condition and history.
- Perform monthly, 2-3 days after the period ends if menstruating.
- If menstruation has ceased, perform on the same day monthly.
Male breasts:
- Breast cancer in men is rare.
- Men with a mother or sister with a history of breast cancer are at higher risk.
- Inspect for size, symmetry, shape, nipple, and areola appearance.
- Palpate for masses.

Palpatory Techniques

Vertical strip method: Up and down pattern, recommended by the American Cancer Society.
Circular method: Circular pattern used for breast palpation.
Wedged method: Also known as hands-of-the-clock or spokes-on-a-wheel method.

Documentation of abnormal findings:

Location
Size and shape
Consistency
Mobility
Skin over the lump
Nipple appearance
Tenderness

Tail of Spence

The upper outer quadrant of the breast extending into the axilla
Contains a higher concentration of breast tissue
Often the area where breast cancers are discovered later, due to its position
Should be carefully palpated

Inspection of Breast

Normal:
- Generally symmetrical
- May be slightly unequal in size, the dominant arm side may be slightly larger
- Rounded shape with no retractions, puckering, or dimpling
- Flesh tone, uniform color
- Smooth and intact skin surface, striae, moles, nevi are considered normal variants
Abnormal:
- Edema, discoloration, orange peel appearance, redness

Inspection of Areola

Normal:
- Round or oval, bilaterally the same
- Varies from light pink to dark brown
Abnormal:
- Asymmetry, mass, or lesion

Inspection of Nipple

Normal:
- Round, everted, and equal in size
- Similar in color
- Soft, smooth
- Point in the same direction
Abnormal:
- Asymmetrical size and color
- Discharge
- Recent inversion of one or both nipples

Palpation of Breast

Normal:
- Uniform temperature
- Firm, smooth, elastic consistency
  - Postmenopausal breasts tend to be flaccid and pendulous
- No tenderness
- No masses
  - The inferior aspect of the breast is firmer due to the transverse inframammary ridge
- No nipple discharge when compressed
Abnormal:
- Any unusual temperature, consistency, tenderness, masses, or nipple discharge

Palpation of Lymph Nodes

Normal:
- All lymph nodes are normally non-palpable
Abnormal:
- Palpable lymph nodes, indicating infection or malignancy
- Tenderness, size, and mobility of lymph nodes should be documented.

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Description

Explore the vital techniques and significance of breast assessment in early detection of breast cancer and monitoring breast health. This quiz covers inspection and palpation methods, nursing history, and risk factors associated with breast conditions.