Breast and Lymphatic Assessment

Breast and Lymphatic
Assessment
Breast and Lymphatic Assessment
• Breasts: paired
mammary glands
– lie over muscles,
anterior chest wall -
anterior to: pectoralis
major, serratus
anterior
– Extend:
horizontally:2nd to 6th
rib; vertically:sternum
to midaxillary line
• Male and female breasts

– Similar until puberty when
• Female: develops into accessory
reproduction organ with 2 functions
(produce and store milk; aid in sexual
stimulation)
• Male: no functional capability
• Location of Assessment
Findings
– Breasts: divided into 4
quadrants intersecting
at nipple
• Tail of Spence: upper
outer quadrant;
extends to axillary
area; location of
most frequent
occurrences of
breast tumors
• In females, the largest
portion of the glandular
breast tissue is located at
the upper outer quadrant of
each breast.
• The majority of the breast
tumors are located in the
UOBQ including the tail of
the Spence.
• Lymph Nodes
• Present in male
and female
breasts
• Drain lymph
from breasts
(filter out
microorganisms;
return water and
protein to blood)
• External anatomy of breast
– Skin: smooth; varies in color
– Areola: surrounds nipple; contains
sebaceous glands, hair follicles, smooth
muscle fibers that contract nipple with
stimulation
• Areola – is the pigmented
area of the breast it
surrounds the protruding
Nipple.
• Nipple – contains the tiny
opening of the lactiferous
ducts.
• lactiferous ducts –
passageway of the milk
• Each mammary glands
consists of 15 to 25 lobes
which radiates around the
nipple.
• within each lobe are smaller
chamber called the lobules
which contains the alveolar
glands that produce milk.
• Internal anatomy of
breast
– 3 types of tissue
• Glandular
• Fibrous
• Fatty
The breast of men and
women need to be
inspected and palpated.
Health Assessment
• Introduction
– Understanding required
• Normal structure and function;
components of PE
– Outcome of required knowledge
• Differentiate normal from abnormal;
accuracy in assessment
Health Assessment
• Collecting subjective data
– Before assessing the client explore your feeling
first about body image, fear of breast cancer, and
the influence of the breast on the self-esteem.
– Use the COLDSPA as a guideline to collect for
information.
Health Assessment
• History of present illness
– Lumps or swelling on the breast & underarm area
– Redness, warmth, or dimpling or retraction
– Any rash on the breast, nipple or axillary area
– Changes in size or firmness
– Pain
– Discharges
Health Assessment
• Past Health History
– Prior breast disease
– Breast surgery, breast biopsy, breast implants or
breast trauma.
– Onset of menstruation and menopause
– Given birth at what age
– First and last day of menstruation
Health Assessment
• Family History
– History of breast cancer in the family
• Lifestyle and Health practices
– Taking hormones, contraceptives or anti-psychotic
drugs
– Exposure to environmental hazards
– Typical daily diet
Health Assessment
• Alcohol intake
• Caffeine intake
• Exercise
• Importance of breast to self-worth
• BSE – every month right after menstruation
beginning @ age 20
• CBE – every 3 years for ages 20 – 39 & every year
for women age 40 and older.
• Mammogram – annual for women age 40
Health Assessment
• Breast cancer is the most common cancer among women,
and the incidence is rising.
– 2nd leading cause of cancer death in white American women
– Leading cause of death in African – American women.
– Risk factors
• 100 times more common in women
• Age
• Genetics
• Family history
• Personal history
• Early menarche and late menopause
• No natural children
• First child born to mother older than age 30
• Oral contraceptives
• Regular alcohol intake
• Higher education and socioeconomic status
• Breast irradiation
• Hormone replacement therapy with progesterone
• Wet ear wax
Health Assessment
• Possible risk factors • Risk reduction technique
– Taller height tips
– High waist-to-hip: obesity – Not delaying pregnancy
beginning as adult or after until after 30 years of age
menopause – Breast feeding
– High fat diet – performing monthly BSE
– Low number of births – Following ACS guidelines
– No breast-feeding for clinical evaluation and
– Low level of physical activity mammography
• Possible risk factors for – Strenuous exercise,
especially in youth but also
mortality in adulthood
– No or poor BSE – NAISD may have protective
– Poor screening effect
Instruction to Breast Self exam
• The purpose of breast assessment is to identify
signs of breast disease and then initiate early
treatment.
• Equipment and supplies
– Centimeter ruler
– Small pillow
– Gloves
– Slides for specimen
– Handout: Breast Self-Examination
• Key assessment points

–Explain steps of exam with
rationale; perform as carefully on
male as female
–Observe, inspect: breast skin,
areolas, and nipples
–Palpate (warm hands): breasts and
axillary nodes
• Physical Assessment: Female Breasts
– Inspect:
• Size and symmetry
• Color and texture
• Superficial venous pattern
Physical Assessment:
• Female Breasts,
continued
– Inspect:
• Areolas
• Nipples
• Inspect For
retraction and
dimplings.
• Palpate
– Texture and elasticity
– Tenderness and temperature
– Masses
– Nipples
– Mastectomy or lumpectomy
• The axillae
– Inspect and palpate
• Male Breasts
– Inspect and palpate
• Breasts
• Areolas
• Nipples
• Axillae
Health Assessment
• Validation and Documentation of Findings
– Subjective and objective data
• Analysis of Data
– Wellness nursing diagnosis example
• Opportunity to enhance management of
breasts
Health Assessment
– Risk nursing diagnosis example
• Risk for Ineffective Management of
Therapeutic Regimen
– Actual nursing diagnosis example
• Body image disturbance related to
mastectomy
Health Assessment
– Collaborative Problem example
• PC: Benign breast disease

Breast and Lymphatic Assessment

Uploaded by

Copyright:

Available Formats

Breast and Lymphatic Assessment

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Breast and Lymphatic Assessment

Uploaded by

Copyright:

Available Formats

Breast and Lymphatic

• Male and female breasts

• Key assessment points

You might also like