Scribd Logo
Upload

Welcome to Scribd!

  • 326 views

    History:: Breast History and Examination

    Uploaded by

    kyliever
    This document outlines the important components of taking a history and performing a physical examination for breast issues. It describes gathering information on breast lumps, pain, discharge, menstrual history, obstetric history, and risk factors. The physical exam involves inspecting the breasts and surrounding areas for signs of asymmetry, size changes, skin issues, nipple abnormalities, and discharge. It also describes palpating the breasts while the patient is lying down and having them squeeze their nipples. The exam concludes with inspecting and palpating the axillary lymph nodes and other neck lymph nodes if indicated.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd

    History:: Breast History and Examination

    Uploaded by

    kyliever
    326 views4 pages
    This document outlines the important components of taking a history and performing a physical examination for breast issues. It describes gathering information on breast lumps, pain, discharge, menstrual history, obstetric history, and risk factors. The physical exam involves inspecting the breasts and surrounding areas for signs of asymmetry, size changes, skin issues, nipple abnormalities, and discharge. It also describes palpating the breasts while the patient is lying down and having them squeeze their nipples. The exam concludes with inspecting and palpating the axillary lymph nodes and other neck lymph nodes if indicated.

    Original Description:

    Breast Summary

    Original Title

    Breast Summary

    Copyright

    © © All Rights Reserved

    Available Formats

    DOC, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document outlines the important components of taking a history and performing a physical examination for breast issues. It describes gathering information on breast lumps, pain, discharge, menstrual history, obstetric history, and risk factors. The physical exam involves inspecting the breasts and surrounding areas for signs of asymmetry, size changes, skin issues, nipple abnormalities, and discharge. It also describes palpating the breasts while the patient is lying down and having them squeeze their nipples. The exam concludes with inspecting and palpating the axillary lymph nodes and other neck lymph nodes if indicated.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    326 views4 pages

    History:: Breast History and Examination

    Uploaded by

    kyliever
    This document outlines the important components of taking a history and performing a physical examination for breast issues. It describes gathering information on breast lumps, pain, discharge, menstrual history, obstetric history, and risk factors. The physical exam involves inspecting the breasts and surrounding areas for signs of asymmetry, size changes, skin issues, nipple abnormalities, and discharge. It also describes palpating the breasts while the patient is lying down and having them squeeze their nipples. The exam concludes with inspecting and palpating the axillary lymph nodes and other neck lymph nodes if indicated.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    You are on page 1of 4

    Bader Al-Mukhtar RCSI-MUB SC (2)

    Breast history and examination

    History:
    Important symptoms:
    1. Breast lump
    2. Breast pain
    3. Nipple discharge
    4. Skin changes
    5. Menstrual history
    6. Obstetrics history
    7. Risk factors

    Breast lumps
    o Onset: When the lump was first noticed.
    o Progression: Whether the lump has remained the same size or enlarged.
    o Periodicity: Whether the size of the lump changes according to the
    menstrual cycle.
    o Painful or painless?
    o Local skin changes?
    Tethering of the skin
    Dimpling of the skin

    Breast pain (mastalgia)


    o As for pain at any other site, you should establish the site, radiation, character,
    duration, severity, exacerbating factors, relieving factors, and associated
    symptoms. Also ask:
    o Is the pain cyclical or constantand is it related to menstruation?

    Nipple discharge
    o Duration
    o Location: Is the discharge unilateral or bilateral?
    o Content (milk or any other discharge)
    o Color (e.g. clear, white, yellow, blood-stained).
    o Quantity
    o Spontaneous or non-spontaneous discharge?

    Menstrual history
    o Age of first menses. (menarche) - Early menarche (<12 years).
    o Usual time between menstruations.
    o Usual duration of menstruation.
    o Usual quantity of menstruation heavy period
    o The date of the beginning of the last menstrual period (LMP)
    o Age of menopause (if applicable). - Late menopause (>55years).

    1
    Bader Al-Mukhtar RCSI-MUB SC (2)

    o OCP use or hormone replacement therapy

    Obstetric history
    o Number of pregnancies and how many children has the patient had
    (Nulliparity (no pregnancies))
    o Age at first pregnancy (> 30 year old)
    o Where the children breast-fed and, if so, for how long?

    Past medical history


    o Previous breast cancer or previous biopsy in the past.
    o Radiation exposure

    Family and drug history


    o Family history of breast cancer especially first degree relatives.
    o OCP and HRT

    Examination

    Inspection
    General inspection
    Patient sitting at 45 degrees, when raised her arm above her head and when pressed
    her hands against her hip.

    Stand in front of the patient and observe both breasts, noting:


    o Symmetry
    o Size
    o Skin
    o Scars
    o Discoloration
    o Ulceration
    o Prominent veins.
    o Dimpling or tethering of the skin.
    o Swelling
    An unusual finding, but one that should not be missed is the
    orange peel (shed skin) appearance of peau d'orange caused by
    local oedema. Seen in breast carcinoma and following breast
    radiotherapy.

    Nipples
    o Symmetrical.
    o Everted, flat, or inverted.
    o Retraction.
    o Scale (may indicate eczema or Paget's disease of the breast).

    1
    Bader Al-Mukhtar RCSI-MUB SC (2)

    o Discharge.
    Single duct discharge can indicate a papilloma or cancer.
    Multiple duct discharge at the nipple suggests duct ectasia.

    Axillae, arms, and supraclavicular fossae


    Dont forget to inspect in all the maneuvers
    o Ask the patient to place her hands on her head and repeat the inspection process.
    Pay particular attention to any asymmetry or dimpling that is now evident.
    o Visible masses, swellings, prominent veins, or skin discolouration.

    Palpation
    Palpation of the breast should be performed with the patient lying supine on the
    couch, then the arms stretched above the head.
    o Note the following:
    o Tenderness
    o Lumps if present then describe it fully.
    o Skin changes
    o Nipple discharge ask the patient to squeeze the nipple to note for any
    discharge.
    o increased temperature

    Examining beyond the breast - Lymph nodes


    o To examine the nodes at the right axilla:
    o The patient should be sitting comfortably and you should stand at their
    right-hand side.
    o Support their right arm abducted to 90 with your right hand.
    o Examine the axilla with your left hand.
    o To examine the nodes at the left axilla, perform the opposite manoeuvre to
    the above.
    o Examine the main sets of axillary nodes including:
    1. Medial
    2. Lateral
    3. Anterior
    4. Posterior

    1
    Bader Al-Mukhtar RCSI-MUB SC (2)

    5. Apical
    o If you feel any lymph nodes, consider site, size, number, consistency, tenderness,
    fixation, and overlying skin changes.
    o If necessary check all the head and neck lymph nodes.

    You might also like

    pFad - Phonifier reborn

    Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

    Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


    Alternative Proxies:

    Alternative Proxy

    pFad Proxy

    pFad v3 Proxy

    pFad v4 Proxy