Download - Assessing Breasts and Axillae
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Assessing Breasts and Axillae
By
Maria Kamile A. Garcia
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DefinitionsBreast examination.
It is the technique by which a thorough inspection
& palpation of the breast is made during
antenatal and postnatal period to collect data
about the breastcondition of mother.
Breast self examination( B S E).
It mean the regular examination of breast
performed by a woman in a systemic manner
for the purpose of early detection of cancer
breast(done monthly).
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Purpose
- To identify signs of breast disease and then to
initiate early treatment.
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Preparation:
Verify the clients identity.Client will sit in an upright position
Explain the procedure.
Hand washing.
Provide client privacy.
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Ask for:
History of breast masses and what was done
about them.
Pain or tenderness in the breasts and relation to
the womans menstrual cycle.
Discharge from the nipple.
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Medication history (e.g., oral contraceptives,
steroids, and diuretics) may cause nipple discharge.
Risk factors (e.g., mother, sister, aunt with breast
cancer, alcohol consumption, high fat diet, obesity,use of oral contraceptives, menarche before age 12,
menopause after age 55, age 30 or more at first
pregnancy
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Inquire if the client performs breast self
examination, technique used, and when performed
in relation to the menstrual cycle.
Estrogen replacement therapy may be associated
with the development of cyst or cancer.
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Assessing Breasts and axillae
Deviation fromnormalNormal findingsAssessment
-Recent change in
breast size,
swelling, markedasymmetry.
rounded shape,Female:
slightly
unequal in size, generallysymmetric.
breasts even withMale:
the chest wall, if obese
may be similar in shape
to female breasts.
Inspect the
breasts for:
Size.Symmetry.
Shape.
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Inspect for:
Skin changes
Redness
Visible bumps Nipple crusting
Symmetry
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Deviation from
normal
Normal findingsAssessment
Any a symmetry,mass, or lesion.-Rounded or ovalbilaterally the same,
--Color varies from
light pink to dark
brown.
-Irregularplacement of
sebaceous glands
on the surface of
areola.
Inspect the areolaarea for size, shape,
symmetry, color,
surface
characteristics, and
any masses orlesions.
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Deviation from normalNormal findingsAssessment
-A symmetrical size and
color.
-Presence of discharge,
crusts, or cracks.
-Recent inversion ofone or both nipples.
-Rounded, everted and
equal in size.-Similar in color,
smooth, soft, both
nipples point in same
direction.
- No discharge, exceptfrom pregnant or breast
feeding females.
-Inversion of one or
both nipples that is
present from puberty.
Inspect the nipples for
size, shape, position,color, discharge, and
lesions.
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Deviation from
normal
Normal findingsAssessment
-Localized
discolorations or
hyperpigmentation.
-Retraction or
dimpling.-Unilateral localized
hypervascular areas.
-Swelling or edema
appearing as pig skinor orange peel due
to exaggeration of
the pores.
Skin : uniform in
color and skin is
smooth and intact.
Striae, moles andnevi.
*Inspect the skin for
localized
hyperpigmentation,
retraction or
dimpling, localizedhypervascular
areas, swelling or
edema.
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Deviation
from normal
Normal
findings
Assessment
Breasts should rise
evenly Watch for
dimpling or retraction
*Emphasize anyretraction by having the
client:
-Raise the arms above
the head.
-Push the hands
together, with elbows
flexed.
-Press the hands down
on the hips.
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Deviation from normalNormal
findings
Assessment
-Tenderness, masses,
nodules, or nipple
discharge.
If a mass was detected,
record the following
data:
A-Location and
distance from the
nipple in cm.
No
tenderness,
masses,
nodules, or
nipple
discharge.
Palpate the breasts for masses,
tenderness, and any discharge
from the nipples.
Client position: lie down, place
overhead the arm on the same
side as the breast being
palpated. Place a small pillow or
rolled towel under the breast
being palpated.
Rationale: The breasts flatten
evenly against the chest wall,
facilitating palpation
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Feel for Lumps
Raise the arm
Feel with opposite
hand Feel for a marble in a
bag of rice
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Use the Middle of Your Fingers
Fingertips are too
sensitive (all
breasts are
somewhat lumpy) Palm is too
insensitive
Middle portion offingers is just right
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Move your hand in small
circles Stay in one place
Press in while circling
with your hand
Feel for thickenings
the size of a marble
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Try to Express Nipple
Discharge Strip the ducts towardsthe nipple.
Normally, one or two
drops of clear, milky orgreen-tinged
secretions.
Should not be bloodyor in large quantity,
squirting out or
staining the inside of a
bra.
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Assessment
Circular or clockwise and Wedged
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3-Vertical strips pattern:
Start at one point for palpation, and movesystematically to the end point to ensure that
all breast surfaces are assessed.
Teach the client the technique of breast selfexamination.
Document findings.
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The Axillae Use the same circular
motions.
Feel for breast lumps
and lymph nodes. Normal lymph nodes
cannot be felt.
Enlarged lymph nodes
are about the size of a
pencil eraser, but
longer and thinner.