Chapter 17

Structure and Function Subjective Data—Health History

Questions Objective Data—Physical Exam Abnormal Findings

Slide 17-2

Surface anatomy Location of breasts

on chest wall Axillary tail

of Spence Nipple and areola

Slide 17-3

Internal anatomy Glandular tissue

Lobes, lobules, and alveoli Lactiferous ducts and sinuses

Fibrous tissue Suspensory ligaments or

Cooper’s ligaments

Adipose tissue

Four quadrants of the breast

Slide 17-4

Lymphatics Axillary nodes

Central

Pectoral (anterior)

Subscapular (posterior)

Lateral

Drainage patterns

Slide 17-5

Developmental care

AdolescentPuberty

Pregnant female Aging female

Menopause Male breast

Cross-cultural care Breast cancer

Slide 17-6

BreastPainLumpDischargeRashSwellingTrauma

Slide 17-7

History of breast diseaseSurgerySelf-care behaviors

Breast self-examination Last mammogram

AxillaTenderness, lump, or swellingRash

Slide 17-8

Additional history for preadolescent Changes in breasts Other changes

Additional history for pregnant female Enlargement of breasts Plans to breastfeed

Additional history for menopausal woman Changes in breasts

Slide 17-9

PreparationPositionDraping

EquipmentSmall pillowRuler marked in centimetersPamphlet or teaching aid for breast self-

examination

Slide 17-10

Breasts—Inspect General appearance Skin Lymphatic drainage areas Nipple Maneuvers to screen for retractionAxillae—Inspect and Palpate Skin Palpation technique Lymph nodes

Slide 17-11

If a lump is present, note Location Size Shape Consistency Mobility Distinctness Nipple retraction Overlying skin Tenderness Lymphadenopathy

Slide 17-12

Schedule for self-exam Correct technique Return demonstration

Slide 17-13

Male breast Gynecomastia

Developmental care Infants and children Adolescent Pregnant female Lactating female Aging female

Slide 17-14

Dimpling Fixation Edema (peau d’orange) Deviation in nipple pointing Nipple retraction

Slide 17-15

Benign breast disease (formerly fibrocysticbreast disease)

Cancer Fibroadenoma

Slide 17-16

Mammary duct ectasia Carcinoma Intraductal papilloma Paget’s disease (intraductal carcinoma)

Slide 17-17

Plugged duct Breast abscess Mastitis

Slide 17-18

Gynecomastia Carcinoma

Slide 17-19