Female Anatomy Quiz: Breast Structure and Function
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Questions and Answers

What is the primary function of the female breasts?

  • Producing milk for nourishing the newborn (correct)
  • Producing hormones
  • Facilitating airflow during respiration
  • Providing structural support to the chest

Which of the following structures connects the nipple to the lobules of the mammary gland?

  • Pectoralis major
  • Lactiferous duct (correct)
  • Montgomery's glands
  • Cooper's ligaments

Where is the nipple located in relation to the ribs?

  • Aligned with the fifth rib
  • Directly on the second rib
  • Just below the fourth rib (correct)
  • Between the first and second ribs

What is the axillary tail of Spence?

<p>A fatty extension of breast tissue into the axilla (B)</p> Signup and view all the answers

Which muscle lies underneath the breast tissue?

<p>Pectoralis major (A)</p> Signup and view all the answers

What type of tissue predominantly covers the breast?

<p>Adipose tissue (B)</p> Signup and view all the answers

What do Montgomery's glands produce?

<p>Sebum that lubricates the nipple area (B)</p> Signup and view all the answers

How far do the breasts extend in terms of rib levels?

<p>From the second rib to the sixth rib (D)</p> Signup and view all the answers

What is the average time it takes for breast development to progress from stage 2 to stage 5?

<p>3 years (B)</p> Signup and view all the answers

At what stage of breast development does menarche typically occur?

<p>Stage 3 or 4 (D)</p> Signup and view all the answers

Which event typically happens about 2 years after the onset of thelarche?

<p>Axillary hair development (C)</p> Signup and view all the answers

How does breast tissue change after menopause?

<p>It atrophies and is replaced with fibrous tissue (D)</p> Signup and view all the answers

Which statement about gynecomastia is true?

<p>It can reappear in older males due to testosterone deficiency (B)</p> Signup and view all the answers

What physical change occurs in the breasts during pregnancy?

<p>The ductal system expands and fatty tissue increases (B)</p> Signup and view all the answers

When does lactation commonly begin postpartum?

<p>1 to 3 days after delivery (B)</p> Signup and view all the answers

What happens to breast size and elasticity in older females?

<p>They decrease and may droop or sag (B)</p> Signup and view all the answers

What is colostrum, and when is it produced during pregnancy?

<p>It is a thick yellow fluid produced in the second month of pregnancy (C)</p> Signup and view all the answers

What is the typical age range for the appearance of pubic hair in girls?

<p>9 to 14 years (B)</p> Signup and view all the answers

What condition is characterized by a benign proliferation of male breast tissue due to an increase in estrogen compared to testosterone?

<p>Gynecomastia (D)</p> Signup and view all the answers

What is a frequently observed first warning sign of male breast cancer?

<p>Nipple retraction (A)</p> Signup and view all the answers

What stage of diagnosis is crucial for determining the survival of males with breast cancer?

<p>Stage at diagnosis (D)</p> Signup and view all the answers

In older men, how does gynecomastia typically present?

<p>As a bilateral, firm, and tender enlargement (C)</p> Signup and view all the answers

Which of the following factors is NOT associated with the development of gynecomastia?

<p>Aging and menopause (D)</p> Signup and view all the answers

What is the purpose of hormone therapy in perimenopausal women?

<p>To relieve uncomfortable symptoms like hot flashes (B)</p> Signup and view all the answers

Which age group is recommended for mammography screening every 2 to 3 years?

<p>50 to 74 years old (C)</p> Signup and view all the answers

What should be considered when determining breast cancer screening for individuals?

<p>Age and individual risk factors (A)</p> Signup and view all the answers

Which tool calculates individual risk estimates for breast cancer that includes factors like age at menarche?

<p>The Gail Model (A)</p> Signup and view all the answers

What risk factors should be accounted for in breast cancer screening according to health assessments?

<p>Personal history of breast cancer (C)</p> Signup and view all the answers

What is NOT routinely recommended for Canadian women not at increased risk for breast cancer?

<p>Breast self-examination (BSE) (A)</p> Signup and view all the answers

What is a key feature of the Pedigree Assessment Tool (PAT)?

<p>Identifies hereditary breast cancer syndromes (C)</p> Signup and view all the answers

Which factor is known to be a common risk for breast cancer despite a lack of identifiable risk factors?

<p>Female hormones (A)</p> Signup and view all the answers

What counseling aspect is important when discussing hormone therapy with patients?

<p>Risk assessment and individual needs (C)</p> Signup and view all the answers

What is the five-year net survival rate for breast cancer in Canada?

<p>88% (A)</p> Signup and view all the answers

What factor plays a crucial role in the decision-making process for breast cancer screening?

<p>Shared decision-making (A)</p> Signup and view all the answers

Which of the following is true regarding breast cancer risk among females?

<p>Most breast cancers occur in women with no clear risk factors (B)</p> Signup and view all the answers

What does the Canadian Cancer Society emphasize for women regarding breast health?

<p>Knowledge of own breast changes (D)</p> Signup and view all the answers

What percentage of female breast cancers are diagnosed at either stage I or II in Canada?

<p>80% (C)</p> Signup and view all the answers

Which of the following is an unmodifiable risk factor for breast cancer?

<p>Age between 50 and 69 years (C)</p> Signup and view all the answers

What is the approximate lifetime risk of breast cancer in Canada?

<p>1 in 8 (B)</p> Signup and view all the answers

Which modifiable risk factor could contribute to obesity, a known risk for breast cancer?

<p>Physical inactivity (C)</p> Signup and view all the answers

What common barrier did Haitian immigrant women face regarding breast screening in Montreal?

<p>Literacy and language barriers (C)</p> Signup and view all the answers

Which of the following is considered a possible risk factor for breast cancer?

<p>High socioeconomic status (D)</p> Signup and view all the answers

What is the 5-year survival rate for breast cancer patients in Canada?

<p>88% (D)</p> Signup and view all the answers

Which of the following practices is mentioned as a way to promote a safe environment during health consultations?

<p>Use a person's preferred name and pronoun (A)</p> Signup and view all the answers

Which lifestyle factor might specifically increase the risk of breast cancer according to the discussed content?

<p>High alcohol intake of ≥1 drink daily (C)</p> Signup and view all the answers

Which psychological aspect related to breasts is highlighted in the discussion?

<p>Breasts contribute significantly to body image (B)</p> Signup and view all the answers

What role do social determinants play in breast cancer disparities?

<p>They exacerbate disparities in survival and diagnosis stages. (B)</p> Signup and view all the answers

What factor is listed as a risk related to breast density?

<p>Increased likelihood of false negatives in screening (B)</p> Signup and view all the answers

Which demographic is specifically mentioned as facing barriers to breast cancer screening?

<p>Haitian immigrant women (A)</p> Signup and view all the answers

What physical change in the breasts is most likely to occur during pregnancy?

<p>Development of jagged linear stretch marks (B)</p> Signup and view all the answers

What is the typical progression of milk production postpartum?

<p>Transitions from colostrum to milk around the third postpartum day (C)</p> Signup and view all the answers

Which characteristic is NOT associated with older females' breast tissue?

<p>Enhanced glandular tissue presence (C)</p> Signup and view all the answers

What condition would most likely be indicated by nipple soreness that lasts longer than expected?

<p>Plugged duct (C)</p> Signup and view all the answers

Which of the following palpation patterns is NOT used when examining the breast?

<p>Random touch method (D)</p> Signup and view all the answers

What indicates a potentially serious concern during a breast examination?

<p>Any palpable lump that cannot be identified as normal (D)</p> Signup and view all the answers

Which factor increases breast cancer risk in females older than 50 years?

<p>Atrophy of glandular breast tissue (B)</p> Signup and view all the answers

What is the recommended action for nipple soreness during breastfeeding?

<p>Increase the frequency of nursing (B)</p> Signup and view all the answers

What change occurs in the breasts during the first trimester of pregnancy?

<p>Development of a vascular pattern over the breasts (D)</p> Signup and view all the answers

What appearance do breasts have in older females upon inspection?

<p>Pendulous and sagging (D)</p> Signup and view all the answers

What describes a normal examination finding in a female breast during palpation?

<p>Granular feel with no tenderness (A)</p> Signup and view all the answers

What symptoms indicate breast inflammation in non-lactating, non-postpartum individuals?

<p>Heat, redness, and swelling (C)</p> Signup and view all the answers

What might cause red and tender areas on the breast surface?

<p>Blocked milk duct (A)</p> Signup and view all the answers

Which of the following statements regarding breast palpation is correct?

<p>Palpation can also include the axilla area (B)</p> Signup and view all the answers

Which of the following describes how to assess a breast lump's size?

<p>Judge in centimetres in three dimensions: width × length × thickness (B)</p> Signup and view all the answers

During a breast examination, how should a practitioner respond if abnormalities such as nipple discharge are observed?

<p>Test for the presence of blood and note the colour and consistency (A)</p> Signup and view all the answers

What characteristic differentiates gynecomastia from other breast tissue in males?

<p>It feels like a smooth, firm, movable disc (C)</p> Signup and view all the answers

Which of the following is noted when examining a breast lump for distinctness?

<p>Whether the lump is solitary or multiple (A)</p> Signup and view all the answers

What is the appropriate action when a person reports discovering a breast lump?

<p>Examine the unaffected breast first to establish a baseline (C)</p> Signup and view all the answers

Which observation is considered abnormal regarding nipple discharge?

<p>Spontaneous discharge occurring outside of pregnancy (B)</p> Signup and view all the answers

Which stage of breast development occurs on average between 8 and 10 years of age?

<p>Adolescent breast development (C)</p> Signup and view all the answers

How should a breast mass in an adolescent typically be described?

<p>It is almost always a benign fibroadenoma or cyst (C)</p> Signup and view all the answers

What method can be recommended for individuals to become familiar with their breast tissue?

<p>Breast self-examination in front of a mirror (B)</p> Signup and view all the answers

What should be noted about the skin over a breast lump during an examination?

<p>Any retraction or dimpled appearance (A)</p> Signup and view all the answers

What is a normal finding in the male breast examination?

<p>Flat disc of undeveloped breast tissue beneath the nipple (C)</p> Signup and view all the answers

When observing breast development in neonates, which of the following is considered a normal finding?

<p>Enlarged breasts due to maternal estrogen (D)</p> Signup and view all the answers

What type of tissue primarily provides the bulk of the breast?

<p>Adipose tissue (A)</p> Signup and view all the answers

Which anatomical feature is responsible for the dark pigmentation of the nipple and areola?

<p>Hormonal changes (A)</p> Signup and view all the answers

What is the function of Montgomery’s glands located in the areola?

<p>Secrete a protective lipid material (C)</p> Signup and view all the answers

Where do the majority of lymphatic drainage from the breast occur?

<p>Ipsilateral axillary nodes (D)</p> Signup and view all the answers

What does galactorrhea refer to?

<p>Secretion of milky-white discharge from non-pregnant individuals (A)</p> Signup and view all the answers

What is the primary role of the suspensory ligaments in the breast?

<p>Connect the breast to the chest wall muscles (A)</p> Signup and view all the answers

Which type of discharge should always be investigated?

<p>Bloody or blood-tinged discharge (D)</p> Signup and view all the answers

What causes the nipple to stiffen when stimulated?

<p>Smooth muscle fibers in the areola (A)</p> Signup and view all the answers

What is the anatomical term for the reservoirs that store milk behind the nipple?

<p>Ampullae (A)</p> Signup and view all the answers

What initial symptom is associated with Paget's disease?

<p>A small crust on the nipple apex (B)</p> Signup and view all the answers

What should be considered when a lump has been present for many years with no change?

<p>It is unlikely to be serious but still needs investigation (D)</p> Signup and view all the answers

Which quadrant of the breast is most commonly associated with breast tumors?

<p>Upper outer quadrant (B)</p> Signup and view all the answers

What is a common misconception about breast trauma?

<p>All injuries lead to permanent lumps (C)</p> Signup and view all the answers

During what stage of life does significant breast tissue change and development primarily occur due to estrogen?

<p>Adolescence (A)</p> Signup and view all the answers

What happens to the support structure of the breast when breast cancer develops?

<p>It results in contracted suspensory ligaments (D)</p> Signup and view all the answers

Which hormone-related factor is a risk for breast cancer?

<p>Use of hormonal contraceptives (A)</p> Signup and view all the answers

What anatomical structure develops along the 'milk lines' during embryonic life?

<p>Breast tissue (D)</p> Signup and view all the answers

What lifestyle factor is most associated with breast cancer risk?

<p>Frequent alcohol consumption (B)</p> Signup and view all the answers

What should be included when evaluating a history of breast disease?

<p>The time of initial diagnosis (A)</p> Signup and view all the answers

What is the significance of the four quadrants in breast anatomy?

<p>They assist in identifying clinical findings (A)</p> Signup and view all the answers

Which of the following structures is primarily involved in milk production?

<p>Lobules (A)</p> Signup and view all the answers

Which statement regarding breast self-examination (BSE) is false?

<p>All individuals are taught the same techniques for BSE (C)</p> Signup and view all the answers

What is an indicator of a need for special care in breastfeeding preparation?

<p>Presence of inverted nipples (D)</p> Signup and view all the answers

Which group of axillary nodes receives lymph from the other three groups?

<p>Central axillary nodes (B)</p> Signup and view all the answers

What should be assessed regarding breast changes in menopausal females?

<p>Any changes in breast contour or size (B)</p> Signup and view all the answers

What common temporary condition may occur during breast development in adolescence?

<p>Breast tenderness and asymmetry (C)</p> Signup and view all the answers

What symptom suggests a reaction to deodorant in the axilla?

<p>A localized rash (A)</p> Signup and view all the answers

What factors are considered when calculating a PAT score?

<p>Points for every family member with breast or ovarian cancer and additional points for specific conditions (B)</p> Signup and view all the answers

How should the presence of breast lumps in a person with ‘dense’ breasts be viewed?

<p>They conceal new lumps (D)</p> Signup and view all the answers

Which age group is recommended not to undergo routine mammography screening?

<p>Women aged 40 to 49 years (D)</p> Signup and view all the answers

What does a history of breast disease increase the likelihood of?

<p>Recurrent cancer diagnosis (A)</p> Signup and view all the answers

What should be assessed during the breast examination regarding symmetry?

<p>A slight asymmetry in size is normal (D)</p> Signup and view all the answers

What is the recommendation regarding the use of MRI for breast cancer screening in women not at increased risk?

<p>MRI should not be used for breast cancer screening (A)</p> Signup and view all the answers

When assessing the skin of the breasts, what finding is not considered normal?

<p>Localized areas of redness or dimpling (B)</p> Signup and view all the answers

What is a key consideration for women aged 50 to 69 years regarding mammography screening?

<p>The decision to screen is based on personal value placed on benefits versus harms (D)</p> Signup and view all the answers

What aspect of family history is emphasized in calculating risk for breast cancer?

<p>Both maternal and paternal family histories should be included (C)</p> Signup and view all the answers

Which screening method should not be advised for breast cancer screening?

<p>Breast self-examination (D)</p> Signup and view all the answers

In what scenario might a woman consider screening mammography between ages 40 to 49?

<p>If she wishes to based on her values and preferences (C)</p> Signup and view all the answers

What characteristic of breast tissue should be noted when inspecting?

<p>Edema may indicate inflammation or new growth (B)</p> Signup and view all the answers

What does the Gail Model and PAT help to assess for health practitioners?

<p>They assist in evaluating an individual's breast cancer risk (D)</p> Signup and view all the answers

What abnormal breast finding may indicate a need for further investigation?

<p>Unilateral dilated veins in a non-pregnant person (D)</p> Signup and view all the answers

What is stated about the evidence for performing clinical breast examinations?

<p>No evidence supports their effectiveness in screening (C)</p> Signup and view all the answers

Which statement about breast asymmetry is true?

<p>Slight asymmetry is common and often normal (D)</p> Signup and view all the answers

What age group has no current recommendations for breast cancer screening?

<p>Women aged 75 years and older (A)</p> Signup and view all the answers

What does recent nipple retraction indicate?

<p>Acquired disease (B)</p> Signup and view all the answers

What is a significant abnormal finding to investigate further during a breast examination?

<p>Dry scaling of the nipples (B)</p> Signup and view all the answers

During palpation of the breast, which pattern is currently recommended for detecting a breast mass?

<p>Vertical strip pattern (A)</p> Signup and view all the answers

What indicates skin retraction during a breast examination?

<p>Lag in the movement of one breast (B)</p> Signup and view all the answers

Which of the following findings would NOT typically require urgent investigation?

<p>Recent nipple inversion (A)</p> Signup and view all the answers

What condition is indicated by the presence of enlarged and tender lymph nodes in the axilla?

<p>Local infection or breast cancer (C)</p> Signup and view all the answers

When palpating the axillae, what is a normal finding?

<p>Soft, non-tender node (C)</p> Signup and view all the answers

Which maneuver helps to check for skin retraction in the breasts?

<p>Lifting the arms over the head (C)</p> Signup and view all the answers

Which type of nipple variation is a common and non-significant occurrence?

<p>Supernumerary nipple (D)</p> Signup and view all the answers

What sensation is commonly felt during palpation of the breast in nulliparous females?

<p>Firm, smooth, and elastic tissue (B)</p> Signup and view all the answers

What signifies that a nipple is likely a supernumerary nipple rather than a mole?

<p>A close inspection revealing a tiny nipple (B)</p> Signup and view all the answers

What can explain the presence of breast tenderness and nodularity prior to menstruation?

<p>Hormonal change due to progesterone (C)</p> Signup and view all the answers

What indicates that there might be a pathology related to breast tissue?

<p>Presence of significant lumps upon examination (A)</p> Signup and view all the answers

What characteristic distinguishes cancerous lumps from benign fibroadenomas?

<p>Cancerous lumps have poorly defined borders (D)</p> Signup and view all the answers

Which of the following age groups is most commonly affected by fibroadenomas?

<p>15-30 years (C)</p> Signup and view all the answers

What symptom is most typical of cancer as it advances?

<p>Firm or hard irregular axillary nodes (B)</p> Signup and view all the answers

What is the most significant risk associated with cancerous lumps?

<p>They necessitate early treatment (B)</p> Signup and view all the answers

Which condition is commonly associated with unilateral bloody discharge from the nipple?

<p>Intraductal Papilloma (D)</p> Signup and view all the answers

How does the consistency of lumps associated with fibroadenomas typically present?

<p>Firm, rubbery, and elastic (A)</p> Signup and view all the answers

Which of the following symptoms is associated with Paget’s Disease?

<p>Unilateral, clear, yellow discharge with an erythematous halo (C)</p> Signup and view all the answers

What defines plugged duct as a non-serious condition?

<p>It will resolve on its own within 1 day (C)</p> Signup and view all the answers

What type of discharge characterizes mammary duct ectasia?

<p>Paste-like and potentially purulent (A)</p> Signup and view all the answers

Which statement is true regarding the consistency of cancerous lumps?

<p>They are firm to stony hard (A)</p> Signup and view all the answers

What is a common characteristic of mastitis during lactation?

<p>It results in systemic flu-like symptoms (C)</p> Signup and view all the answers

What demographic is most likely to experience nipple discharge associated with Paget’s Disease?

<p>Women aged 40-60 (D)</p> Signup and view all the answers

Which of these findings usually accompanies the diagnosis of cancer?

<p>Irregular and often fixed lumps (D)</p> Signup and view all the answers

What is a common feature of malignant breast lumps based on the assessment provided?

<p>Irregular borders and fixed to tissues (C)</p> Signup and view all the answers

What symptom may indicate lymphatic obstruction in breast tissue?

<p>Dimpling of the skin (C)</p> Signup and view all the answers

Which benign breast condition is characterized by cyclical tenderness and nodularity?

<p>Fibrocystic breast disease (B)</p> Signup and view all the answers

What is a common emotional response to a diagnosis of a breast lump, as demonstrated by the cases?

<p>Significant anxiety and nervousness (A)</p> Signup and view all the answers

Which characteristic of a breast lump suggests a higher likelihood of malignancy?

<p>Irregular, hard, and fixed to tissue (D)</p> Signup and view all the answers

What physical sign may indicate retraction in the breast tissue?

<p>Dimpling on arm elevation (A)</p> Signup and view all the answers

What is the significance of a firm, tender breast lump in a 62-year-old woman with no children and a family history of breast cancer?

<p>Possible malignancy (B)</p> Signup and view all the answers

What type of discharge might indicate a benign lesion such as ectasia of the ducts?

<p>Thick, white discharge (D)</p> Signup and view all the answers

Which of the following is necessary to rule out cancer in patients with dominant lumps or nipple discharge?

<p>Biopsy (D)</p> Signup and view all the answers

Menarche at what age may affect breast cancer risk assessment in patients?

<p>Before age 12 (A)</p> Signup and view all the answers

What is a notable risk factor for breast cancer, especially in older women?

<p>Family history of breast cancer (B)</p> Signup and view all the answers

What type of breast mass tends to be soft and mobile, typically found in benign breast disease?

<p>Cyst (D)</p> Signup and view all the answers

What physical change signifies the presence of underlying cancer due to fibrosis?

<p>Retraction of the nipple (B)</p> Signup and view all the answers

What do tender, well-demarcated nodules in breast tissue typically indicate?

<p>Cyclical hormonal changes (D)</p> Signup and view all the answers

With regard to breast lump prognosis, which characteristic is generally favorable?

<p>Soft, mobile, and well-defined lump (C)</p> Signup and view all the answers

Flashcards

Breast Function

The female breasts, or mammary glands, are accessory reproductive organs that produce milk to nourish newborns.

Axillary Tail of Spence

The superior lateral corner of breast tissue that extends into the axilla.

Montgomery's Glands

Small bumps around the areola that secrete a lubricating substance during lactation.

Cooper's Ligaments

Connective tissues within the breast that provide support and shape.

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Lactiferous Ducts

Ducts that connect the lobules of the mammary gland to the nipple.

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Breast Location

The breasts are located between the second and sixth ribs, extending from the sternum to the midaxillary line.

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Lobules

Glands within the breast that produce milk.

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Lactiferous Sinus

Dilated ducts that emerge directly from the nipple.

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Tanner Staging

A system used to classify stages of breast development in females, ranging from preadolescence to mature breasts.

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Thelarche

The beginning of breast development in females.

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Menarche

The first occurrence of menstruation in females.

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Breast Changes During Pregnancy

Significant breast enlargement, increased nodularity, darker nipples and areolae, and colostrum production.

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Colostrum

A thick yellow fluid produced by the breasts during late pregnancy and early postpartum.

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Lactation

The production of milk by the breasts.

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Breast Changes After Menopause

Decreased breast size, atrophy of glandular tissue, and increased prominence of inner structures.

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Gynecomastia

Temporary enlargement of breast tissue in males, usually during adolescence or in older men.

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Breast Changes During Menstrual Cycle

Nodularity increases from midcycle to menstruation, breasts feel full and sore before menstruation.

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Breast Development Time

Full breast development from stage 2 to stage 5 takes an average of 3 years, but can vary from 1.5 to 6 years.

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Areola

The pigmented area surrounding the nipple, usually 1-2 cm in radius. Contains Montgomery's glands and smooth muscle fibers.

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Nipple

The protuberant, rough, and often round part of the breast; surface is wrinkled and indented with tiny milk duct openings.

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Breast Lobes

15-20 sections radiating from the nipple, each composed of lobules.

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Breast Lobules

Smaller structures within the lobes, containing clusters of alveoli that produce milk.

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Alveoli

Clusters of cells within the lobules that produce milk.

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Lactiferous Sinuses (Ampullae)

Reservoirs behind the nipple where milk accumulates.

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Suspensory Ligaments (Cooper's Ligaments)

Fibrous bands supporting breast tissue, extending from the surface to chest wall muscles.

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Breast Quadrants

Imaginary division of the breast into four sections: upper outer, upper inner, lower inner, and lower outer.

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Lymphatic Drainage of the Breast

The network of vessels that carry lymph fluid from the breast, primarily to the ipsilateral axillary nodes.

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Central Axillary Nodes

Lymph nodes located in the middle of the axilla, receiving lymph from other axillary nodes.

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Pectoral Axillary Nodes

Lymph nodes along the lateral edge of the pectoralis major muscle.

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Subscapular Axillary Nodes

Lymph nodes along the lateral edge of the scapula, in the posterior axillary fold.

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Discharge from Nipple

Any milky, watery, or bloody fluid leaking from the nipple should be investigated, especially when a lump is present.

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Breast Cancer Risk Factors

Factors that can increase the likelihood of developing breast cancer. They can be unmodifiable (can't be changed) or modifiable (can be changed).

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Galactorrhea

Secretion of milky-white discharge from breasts in a male or non-breastfeeding female.

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Unmodifiable Risk Factors

Breast cancer risk factors that cannot be changed. These include factors like age, genetics, and family history.

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Bloody Nipple Discharge

Always warrants investigation as it may indicate an underlying issue.

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Modifiable Risk Factors

Breast cancer risk factors that can be changed through lifestyle choices. These include factors like diet, exercise, and alcohol intake.

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Paget's Disease

A rare type of breast cancer characterized by crusting and scaling on the nipple, possibly spreading to the areola.

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Social Determinants of Health

Factors outside of healthcare that influence a person's health, such as socioeconomic status, education, and access to healthcare.

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Breast Cancer Disparities

Differences in the survival rate and stage of breast cancer at diagnosis among different population groups.

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Nipple Eczema

A skin condition that rarely starts on the nipple, usually affecting the areola or surrounding skin first.

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Breast Swelling

Any swelling, especially in one specific spot, should be assessed.

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Cultural Sensitivity in Breast Care

Providing healthcare services that respect and consider the cultural background and beliefs of individuals.

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Breast Trauma

Injury to the breast, potentially causing lumps or swelling due to hematoma or edema.

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Breast Self-Examination

A regular practice where individuals check their breasts for any changes or abnormalities.

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Mammography

A type of medical imaging that uses low-dose X-rays to examine breast tissue for any signs of cancer.

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Dense Breasts

A condition where the breast tissue is dense, making it harder to detect lumps on mammograms.

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Food Insecurity

Limited access to adequate food due to financial constraints or lack of availability.

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Atypical Hyperplasia

An abnormal increase in breast cells that increases the risk of breast cancer.

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First-Degree Relative with Breast Cancer

Increases the risk of developing breast cancer by approximately double.

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Breast Pain (Mastalgia)

Pain or tenderness in the breasts, which can be cyclical (related to the menstrual cycle) or non-cyclical.

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Breast Lump

A thickening or mass in the breast that can be solid, fluid-filled, or a combination of both.

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Genetic Factors in Breast Cancer

Only 5-10% of breast cancers are linked to identifiable breast cancer genes like BRCA1 or BRCA2.

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Surgery on Breasts

Past breast surgery, particularly biopsies and mastectomy, should be documented.

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Breast Discharge

Fluid released from the nipple, which can be clear, white, yellow, brown, or bloody.

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Breast Surgery

Surgical procedures performed on the breast, such as biopsy, lumpectomy, or mastectomy.

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Breast Self-Examination (BSE)

Regular self-examination of the breasts to detect any changes.

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Body Image and Breast Health

The way individuals perceive and feel about their breasts, which can be influenced by cultural norms and personal experiences.

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Mammography

A screening X-ray examination of the breasts to detect abnormalities.

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Axillary Tenderness

Pain or a lump in the underarm area, possibly related to breast tissue or lymph nodes.

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Hormone Therapy Risk

Using hormone therapy during perimenopause can reduce uncomfortable symptoms like hot flashes, but it's essential to assess individual risks before prescribing.

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Breast Cancer Screening

Regular screening is crucial for early detection of breast cancer, especially for women at high risk. Recommendations depend on individual risk factors and age.

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Gail Model

A tool used to estimate an individual's risk of developing breast cancer based on factors like age and family history.

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Pedigree Assessment Tool (PAT)

Used to identify individuals with a higher risk of hereditary breast cancer syndromes, especially those with BRCA1 and BRCA2 mutations.

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Breast Cancer and Female Hormones

Exposure to female hormones, particularly estrogen, is a factor in breast cancer risk. However, not all breast cancers are linked to these factors.

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Breast Cancer Screening Recommendations

For women not at increased risk, mammography every 2-3 years between ages 50-74 is recommended. Shared decision-making is encouraged.

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Clinical Breast Examination (CBE)

Not routinely recommended for screening, but can be part of a regular checkup for women at an increased risk.

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Breast Cancer Survival

The 5-year net survival rate for breast cancer in Canada is high at 88%, due to early detection and improved treatments.

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Breast Cancer Risk Assessment Tools

These tools support early detection by helping identify individuals at a higher risk for breast cancer.

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Breast Cancer: Shared Decision-Making

Involving the patient in screening decisions, considering individual risks, benefits, and preferences is vital.

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Importance of Breast Awareness

It's important for all women to be familiar with their own breasts and consult a healthcare provider if they notice any changes.

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Age and Breast Cancer Risk

While the highest risk is for women over 50, it's important to understand that younger women can also be affected.

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Breast Cancer Screening for High-Risk Individuals

Individuals with a history of breast cancer, strong family history, or BRCA gene mutations require increased surveillance and screening.

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PAT Score

A numerical score calculated to assess a person's individual risk of developing breast or ovarian cancer based on family history.

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Family History Components

The PAT score considers both maternal and paternal lineages, including second- and third-degree relatives with breast or ovarian cancer diagnoses.

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Bilateral Disease

When cancer affects both breasts or ovaries.

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Combined Cancer

The occurrence of both breast and ovarian cancer in an individual.

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Age at Diagnosis

The age at which a person is diagnosed with breast or ovarian cancer.

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Higher Score

The PAT score uses the higher value from the maternal and paternal family history calculations.

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Paternal Lineage

The family side related to the father, often disregarded in breast cancer risk assessments.

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Mammography Recommendations: 40-49 Years

For women aged 40-49 years, mammography screening is not recommended routinely, but a shared decision-making approach is encouraged based on individual values and preferences.

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Mammography Recommendations: 50-69 Years

For women aged 50-69 years, mammography screening is recommended every 2-3 years, with shared decision-making considering individual risk factors.

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Mammography Recommendations: 70-74 Years

For women aged 70-74 years, mammography screening is recommended every 2-3 years, with shared decision-making considering individual risk factors.

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MRI Screening for Average Risk

Magnetic Resonance Imaging (MRI) is not recommended for breast cancer screening in women at average risk.

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Clinical Breast Examination

Clinical breast examinations are not recommended for routine screening.

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Screening Tool Limitations

Tools like the Gail Model and PAT are useful but have limitations and should be interpreted with a critical eye by health practitioners.

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Shared Decision-Making

A process where patients and doctors work together to make informed decisions about medical treatments, including breast cancer screening.

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Male Breast Cancer

Occurs in about 1% of breast cancers, often detected later due to lack of regular screening.

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Nipple Retraction

A significant sign of male breast cancer, often the first to appear, indicating a mass behind the nipple.

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Axillary Lymph Node Spread

Early spreading of male breast cancer to lymph nodes under the arm, due to minimal breast tissue.

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Male Breast Cancer Diagnosis Age

Men are diagnosed an average of 10 years later than women, usually between 60 and 70 years old.

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Areola Appearance

Normal areola has evenly pigmented skin. Note any dry scaling, fissures, ulcerations, or bleeding/discharge.

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Supernumerary Nipple

An extra nipple along the embryonic milk line (usually 5-6 cm below the breast) is a normal variation. No associated glandular tissue, and it's often mistaken for a mole due to its size.

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Breast Movement During Arm Lift

Both breasts should move up symmetrically when the person lifts their arms slowly over their head. A lag in movement in one breast indicates potential retraction.

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Breast Movement With Hand Maneuvers

Ask the person to push hands on hips and then palms together. Both breasts should lift slightly. Dimples or puckering during these movements indicate skin retraction.

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Breast Movement While Leaning Forward

Ask a person with large breasts to lean forward. Note the symmetrical movement of both breasts. Fixation to the chest or skin retraction indicates potential problems.

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Palpating the Axilla

Palpate the axilla while the person is sitting and their arm is relaxed. Feel for tenderness and lymph nodes in a systematic pattern.

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Normal Axillary Lymph Nodes

Usually, nodes are not palpable. You may feel a small, soft, and nontender node in the central group. Tenderness in the upper axilla is normal.

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Enlarged and Tender Axillary Nodes

Enlarged and tender lymph nodes can indicate infection or metastases (spread) of breast cancer.

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Palpating the Breasts

Use a systematic pattern (vertical strip pattern) to palpate the breast in a gentle rotary motion.

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Breast Tissue During Examination

In nulliparous women, breast tissue feels firm and smooth. After pregnancy, it feels softer and looser. Premenstrual engorgement causes normal increased tenderness and nodularity.

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Inframammary Ridge

A firm transverse ridge of compressed tissue in the lower quadrants, more noticeable in large breasts. This is normal and should not be confused with a lump.

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Critical Findings in Breast Examination

Unexplained discharge, bleeding, open sores, or a breast mass in people with cancer history require urgent investigation and referral to a specialist.

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Diagnostic Tests for Breast Issues

Diagnostic tests may include mammography, ultrasound, biopsy, or MRI based on the findings and person's history.

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Breast Examination: Importance of Consistency

Use the same thorough and consistent approach with every patient to ensure all areas are examined thoroughly and potential abnormalities are caught.

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Inflammation of the breast

In non-lactating, non-postpartum individuals, heat, redness, and swelling in the breast indicate inflammation.

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Breast Palpation: Nipple

During breast palpation, gently depress the nipple tissue into the well behind the areola. It should move inward easily. If the nipple doesn't move freely, it might indicate an abnormality.

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Breast Discharge: Abnormal

Except during pregnancy and lactation, any breast discharge is considered abnormal.

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Breast Discharge Assessment

If there's breast discharge, note its colour, consistency, number of droplets, and the quadrant(s) it originates from. Test it for blood.

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Breast Lump Examination: Location

Describe the location of a breast lump using the breast as a clock face and the distance from the nipple in centimetres.

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Breast Lump Examination: Size

Measure the size of a breast lump in three dimensions (width × length × thickness) in centimetres.

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Breast Lump Examination: Shape

Note the shape of a breast lump (e.g., oval, round, lobulated, or indistinct).

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Breast Lump Examination: Consistency

Describe the consistency of a breast lump: soft, firm, or hard.

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Breast Lump Examination: Movable

Determine if the lump is freely mobile or fixed when you try to slide it over the chest wall.

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Breast Lump Examination: Distinctness

Note if the lump is solitary or multiple.

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Breast Lump Examination: Nipple

Determine whether the breast lump displaces or retracts the nipple.

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Breast Lump Examination: Skin Changes

Observe the skin over the lump: is it red, dimpled, or retracted?

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Breast Lump Examination: Tenderness

Note if the breast lump is tender to palpation.

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Breast Lump Examination: Lymph Nodes

Determine if any regional lymph nodes are palpable.

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Breast Self-Care: Inspection

Encourage individuals to inspect their breasts in front of a mirror, while disrobed to the waist.

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Breast Changes in Pregnancy

During pregnancy, breasts enlarge, nipples darken, areolae widen, and Montgomery's glands become prominent. Breasts become more nodular, and colostrum can be expressed after the first trimester.

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Breast Engorgement

After childbirth, breasts can become engorged due to milk production. They appear enlarged, red, shiny, and feel warm and hard.

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Colostrum vs. Milk

Colostrum is a thick, yellow fluid produced before milk. It's rich in antibodies and nutrients. Milk production starts around the third postpartum day.

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Nipple Soreness

Nipple soreness is common after the baby first feeds for about 20 times. It lasts 24-48 hours and heals quickly with frequent nursing.

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Breast Changes in Older Females

Breasts appear pendulous, flattened, and sagging. Nipples may retract. Breasts feel granular, and the terminal ducts around the nipple are more prominent.

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Breast Cancer Risk in Older Females

Females over 50 have an increased risk for breast cancer. Atrophy makes cancer detection easier due to shrinkage of normal tissue.

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Breast Retraction

A pulling inward of the breast tissue or nipple, which can be a sign of breast cancer.

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Breast Palpation Technique

Palpating the breast involves systematically feeling for lumps or abnormalities. Different patterns are used, such as vertical strips, spokes-on-a-wheel, or concentric circles.

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Axillary Lymph Node Palpation

Palpating the lymph nodes in the armpit region, which can be affected by breast cancer.

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Breast Examination Documentation

Record findings from breast examinations, including subjective information (patient's report) and objective findings (physical examination).

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Clinical Case Study: Lump in the Breast

A case study involves a patient presenting with a breast lump and requires a thorough evaluation, including history, physical exam, and further investigations.

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Breast Health Practices

Regular self-examinations, professional breast exams, and mammography screenings are essential for maintaining breast health.

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What is Peau d'Orange?

A condition where lymphatic obstruction causes edema in the breast, making the skin thick and resembling an orange peel. It's a significant sign of cancer.

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What does a retracted nipple indicate?

A retracted nipple, flatter and broader than usual, is a possible sign of cancer. It can also be caused by non-cancerous conditions like duct ectasia.

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What is nipple retraction?

The nipple looks flatter and broader, like an underlying crater. It can suggest recent cancer, but also benign lesions like ectasia of the ducts.

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What is dimpling in the breast?

A shallow dimple on the breast surface, called skin tether, is a sign of skin retraction caused by fibrosis from cancer. It may be seen at rest, with compression, or when lifting arms.

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What is a fixed breast mass?

A breast mass that feels attached to the underlying tissue, often due to invasive cancer. The breast won't move freely when lifting the arm or leaning forward.

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What is a dominant breast lump?

A noticeable breast lump that needs careful investigation. It can be a cyst, fibroadenoma, or potentially cancerous.

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What is a firm mobile breast nodule?

A firm, rubbery, well-defined lump in the breast, easily moved under the skin. It's often associated with benign breast disease.

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What is nodularity in the breast?

Significant lumpiness in the breast, often associated with benign breast disease. It can occur bilaterally and may be cyclical or non-cyclical.

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What is the significance of a breast mass that is fixed to tissues?

A breast mass that feels firmly attached to the underlying tissue, often indicating invasive breast cancer.

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What is a breast mass that is tender to palpation?

A breast mass that causes pain when pressed on. It can be a sign of inflammation or infection, but also potential cancer.

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What is breast 'deviation in nipple pointing'?

The nipple points in a different direction than usual, suggesting cancer-related fibrosis pulling on the mammary ducts. Often seen with swelling behind the nipple.

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What is the significance of a breast lump that is irregular in shape?

An irregular breast lump is more likely to be cancerous than a smooth, well-defined lump.

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What is the difference between a benign breast lump and a cancerous breast lump?

Benign breast lumps are usually multiple, tender, mobile, and well-defined, whereas cancerous lumps are often solitary, painless, fixed, and irregular in shape.

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What is situational stress?

Stress caused by a specific event or situation, like a new diagnosis of breast cancer.

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What is the significance of axillary lymphadenopathy in breast cancer?

Enlarged lymph nodes in the armpit are often a sign of breast cancer spreading. However, it can also be caused by other conditions.

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Fibroadenoma

A common benign breast tumor, usually found in women between 14 and 35 years old. It is firm, rubbery, round, and easily movable.

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Cancer in the Breast

A malignant tumor in the breast, often characterized by a hard, irregular lump that is fixed to surrounding tissue. It typically grows steadily and can cause pain or other symptoms.

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Mammary Duct Ectasia

A condition causing a sticky, purulent discharge from the breast duct due to blockage and inflammation. Often found in women who have lactated.

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Plugged Duct

A common, non-serious condition where a milk duct becomes blocked, causing tenderness and redness in the breast. It often resolves quickly.

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Mastitis

An inflammatory condition of the breast, often caused by infection, resulting in redness, swelling, pain, and flu-like symptoms. Usually occurs during the first 4 months of lactation.

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Breast Abscess

A rare complication of mastitis where a pocket of pus accumulates in the breast, causing nipple edema and pain. It requires medical attention.

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Study Notes

Breast Health Assessment

  • Breast health assessment is crucial for health promotion and preventive care, especially in light of breast cancer prevalence. Keeping updated on health recommendations is essential for health practitioners.
  • Mammary glands are present in both sexes, but are rudimentary in males. Female breasts are accessory reproductive organs that produce milk for newborns.

Structure and Function

  • Breasts are located anterior to the pectoralis major and serratus anterior muscles, between the second and sixth ribs.
  • The axillary tail of Spence is breast tissue extending into the axilla.
  • The nipple is centered, surrounded by the areola.
  • Montgomery's glands are small bumps around the areola, secreting a protective lipid during lactation.
  • The areola has smooth muscle, causing nipple firmness upon stimulation.
  • Nipple and areola are darker than other breast surfaces, differing by skin tone.
  • Internally, breasts consist of glandular, fibrous (including Cooper's ligaments), and adipose tissues.
  • 15-20 lobes radiate from the nipple, comprised of lobules containing alveoli that create milk.
  • Lactiferous ducts drain each lobe, converging on the nipple.
  • Lactiferous sinuses store milk behind the nipple.
  • Cooper's ligaments support breast tissue; contraction in cancer creates skin dimpling.
  • Subcutaneous and retromammary fat make up most of the breast volume.

Surface Anatomy

  • Breasts lie anterior to the pectoralis major and serratus anterior muscles.
  • Positioning is between the 2nd to 6th ribs, from sternum to midaxillary line.
  • The axillary tail of Spence extends laterally and superiorly into the axilla.
  • The nipple is centrally located and usually protuberant.
  • Areola surrounds the nipple (1-2 cm radius).
  • Montgomery's glands are located within the areola.

Internal Anatomy

  • Breast tissue composition varies with age, pregnancy, lactation, and nutrition, including the relative proportion of glandular, fibrous, and fatty tissue.
  • Breast quadrants are used for clinical description, often used to locate common tumor sites. The upper outer quadrant is the most common location for breast tumours.

Lymphatic System

  • Most breast lymph drains into ipsilateral axillary nodes (over 75%).
  • Breast cancer can spread via the lymphatic system to the axillary nodes.
  • 4 groups of axillary nodes are defined: central, pectoral, subscapular, and lateral.
  • Lymph from central axillary nodes flows to infraclavicular and supraclavicular nodes, or directly to other areas like the abdomen or opposite breast.

Developmental Considerations

  • Milk lines (ventral epidermal ridges) form during embryonic life from the axilla to groin.
  • Breast development occurs along milk lines.
  • Supernumerary nipples can exist along these lines.
  • At birth, only lactiferous ducts are present; alveoli develop later.
  • Puberty stimulates breast enlargement (fat deposition), duct growth, and potential alveoli formation.
  • Adolescent breast development follows Tanner stages, typically taking 1.5-6 years.
  • Thelarche precedes menarche by about 2 years.
  • Breast changes occur with hormonal shifts during the menstrual cycle.

Pregnant Women

  • Breast changes start in the second month of pregnancy.
  • Ductal system and fatty tissue expand, and secretory alveoli develop.
  • Nipples are larger, darker, and more erectile. Areolae enlarge and darken.
  • Colostrum, a precursor to milk, is expressed after the fourth month.
  • Colostrum is richer in antibodies than mature milk.
  • Milk production (lactation) begins 1–3 days postpartum.

Older Females

  • Ovarian estrogen/progesterone decreases in menopause, causing breast glandular tissue to atrophy.
  • Adipose tissue also atrophies.
  • Breast size and elasticity decrease; breasts may droop.

Male Breast

  • Male breast tissue is underdeveloped, thin, and a disc.
  • Areola is well-developed, while the nipple is smaller.
  • Gynecomastia (breast tissue enlargement) is common during adolescence, usually temporary.
  • It can reappear in older men due to testosterone deficiency.

Social Determinants of Health Considerations

  • Breast screening is a key part of cancer detection; a majority of cases are diagnosed in early stages (I or II).
  • Stability in breast cancer incidence and decreasing mortality are linked to screening, improved therapies, and fewer HRT users.
  • Lifetime risk of breast cancer is ~1 in 8 for Canadian women; ~1 in 33 may die.
  • 5-year survival rate is approximately 88%.
  • Risk factors from demographics to lifestyle play a role.
  • Social determinants (access, racism, financial insecurity) worsen disparities in survival.
  • Initiatives to address these issues (e.g., culturally sensitive care, screening awareness) are crucial to impacting outcomes.

Subjective Data

  • Includes pain, lumps, discharge, rashes, swelling, trauma, history of breast disease, risk factors, surgeries, and self-care behaviors.
  • Includes detailed questions about breast self-exams, mammograms, and hormone therapy.

Objective Data

  • Breast inspections focused on symmetry, skin conditions, and nipple characteristics.
  • Palpation techniques emphasizing thoroughness and consistency across quadrants, including nipple and areola assessment.
  • Axillary lymph node palpation is crucial.

Critical Findings

  • Unexplained discharge, lesions, and masses in individuals with previous cancer warrants immediate referral for diagnostics (mammography, ultrasound, biopsy, or MRI).

Breast Examination (Additional):

  • Includes specific examination methods (e.g., positions, palpation patterns, maneuvers)
  • Tables describing critical/abnormal findings by category (retraction, edema, fixation).

Examination of the male breast

  • Includes considerations for male breast examination emphasizing abbreviation and combination with anterior thorax examination.
  • Includes details of gynecomastia, and male breast cancer.

Developmental Considerations

  • Infant and child: Normal breast changes, premature thelarche, delayed development.
  • Adolescent: Tanner stages, asymmetry during development, obesity distinction.
  • Pregnant/lactating women: Normal breast changes, plugged ducts, mastitis, and breast abscess information.
  • Older females: Changes occurring with age, including nipple retraction or droopiness.

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Test your knowledge on the anatomy and function of female breasts with this quiz. Explore topics such as the nipple's location, mammary gland structures, and underlying tissues. Ideal for students in anatomy or biology classes.

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