Assessment of the Breast

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Assessment of the Breast

• Dr. Freida Fuller-Jonap
• fulerjonap_f_at_mercer.edu

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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

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Subjective Data Collection

• History
• Surgeries involving the breast
• Medication history
• History of fibrocystic breast disease
• Any changes in the breasts

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Observe for

• masses
• skin texture, rashes, pigmentation
• Peau dorange
• Retraction or dimpling
• venous patterns
• areolar and nipple characteristics

• discharge
• Pagets disease

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Palpation

• Palpate axilla in sitting position preferrably

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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

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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

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Examination of the Male Breast

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

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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

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Differential Diagnoses

• Cancerous tumors
• Fibroadenomas
• Benign breast disease fibrocystic breast disease

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Diagnostic Testing

• Mammography
• Ultrasound