Assessment of the Breast Dr. Freida Fuller-Jonap fulerjonap_f@mercer.edu

Risk Factors for Breast Cancer gender age genetics family history personal history early menarch and late menopause no natural children first child born to mother older than age 30 oral contraceptive use regular alcohol intake higher education and socioeconomic status previous breast irradiation

Subjective Data Collection History Surgeries involving the breast Medication history History of fibrocystic breast disease Any changes in the breasts

Observe for masses skin texture, rashes, pigmentation Peau d’orange Retraction or dimpling venous patterns areolar and nipple characteristics discharge Paget’s disease

Palpation Palpate axilla in sitting position preferrably

Breast Palpation Breast palpation position Use the flat pads of three fingers Vary the levels of pressure: light, medium, firm Use systematic pattern of examination

If a mass is detected the following should be noted Size in centimeters and its position Shape Delimitation or discreteness Consistency Mobility Tenderness Erythema Dimpling Depth

Examination of the Male Breast Essentially the same as for women, but can be done sitting up since not a large amount of tissue

Developmental Considerations Before 10: small nipples, small and slightly elevated Between 10 and 14: areola enlarges 14 and above: areola recedes into breast contour, adult female breast forms During reproductive years: cycle of size change, nodularity and tenderness Post-menopausal: more flabby

Differential Diagnoses Cancerous tumors Fibroadenomas Benign breast disease: fibrocystic breast disease

Diagnostic Testing Mammography Ultrasound