1. Chapter 17

2.  Structure and Function  Subjective Data—Health History Questions  Objective Data—Physical Exam  Abnormal Findings Slide 17- 2

3. Surface anatomy  Location of breasts on chest wall  Axillary tail of Spence  Nipple and areola Slide 17-3

4. 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

5. Lymphatics  Axillary nodes  Central  Pectoral (anterior)  Subscapular (posterior)  Lateral  Drainage patterns Slide 17-5

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

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

8.  History of breast disease  Surgery  Self-care behaviors Breast self-examination Last mammogram  Axilla  Tenderness, lump, or swelling  Rash Slide 17- 8

9. 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

10.  Preparation  Position  Draping  Equipment  Small pillow  Ruler marked in centimeters  Pamphlet or teaching aid for breast self-examination Slide 17- 10

11. Breasts—Inspect  General appearance  Skin  Lymphatic drainage areas  Nipple  Maneuvers to screen for retraction Axillae—Inspect and Palpate  Skin  Palpation technique  Lymph nodes Slide 17- 11

12.  If a lump is present, note  Location  Size  Shape  Consistency  Mobility  Distinctness  Nipple retraction  Overlying skin  Tenderness  Lymphadenopathy Slide 17- 12

13.  Schedule for self-exam  Correct technique  Return demonstration Slide 17- 13

14. Male breast  Gynecomastia Developmental care  Infants and children  Adolescent  Pregnant female  Lactating female  Aging female Slide 17- 14

15.  Dimpling  Fixation  Edema (peau d’orange)  Deviation in nipple pointing  Nipple retraction Slide 17- 15

16.  Benign breast disease (formerly fibrocystic breast disease)  Cancer  Fibroadenoma Slide 17- 16

17.  Mammary duct ectasia  Carcinoma  Intraductal papilloma  Paget’s disease (intraductal carcinoma) Slide 17- 17

18.  Plugged duct  Breast abscess  Mastitis Slide 17- 18

19.  Gynecomastia  Carcinoma Slide 17- 19