1. Assessment of the Breast
Dr. Freida Fuller-Jonap

2. 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

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

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

10. Palpation
Palpate axilla in sitting position preferrably

12. 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

15. 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

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

18. 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

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

20. Diagnostic Testing
Mammography
Ultrasound