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  Adolescent  Puberty  Pregnant female  Aging female  Menopause  Male breast Cross-cultural care  Breast cancer Slide 17- 6

 Breast  Pain  Lump  Discharge  Rash  Swelling  Trauma Slide 17- 7

 History of breast disease  Surgery  Self-care behaviors Breast self-examination Last mammogram  Axilla  Tenderness, lump, or swelling  Rash 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

 Preparation  Position  Draping  Equipment  Small pillow  Ruler marked in centimeters  Pamphlet or teaching aid for breast self-examination Slide

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

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

 Schedule for self-exam  Correct technique  Return demonstration Slide

Male breast  Gynecomastia Developmental care  Infants and children  Adolescent  Pregnant female  Lactating female  Aging female Slide

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

 Benign breast disease (formerly fibrocystic breast disease)  Cancer  Fibroadenoma Slide

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

 Plugged duct  Breast abscess  Mastitis Slide

 Gynecomastia  Carcinoma Slide