BREAST ASSESSMENT

Assessment

Techniques a. Inspection b. Palpation

 1.

Inspection

a. Size and Symmetry - relatively equal with slight variation Deviation from Normal - recent change to unequal size

Shape
-round, convex and pendulum

 Color

- pink, striae with age of

pregnancy Deviation from normal - redness, inflammation, blue hue,
increased venous engorgement

 Skin

surface

- smooth Deviation from normal - retraction, dimpling, enlarged pores, peau d orange, edema, lumps, lesions, rashes, ulcers

 B.

Observe areola and nipples for the following:

1. Size - relatively the same, slight variation Deviation from normal - large variation

Color

- pink to deep brown

 Shape

- round, oval, everted Deviation from normal - inversion, if it occurs after maturation or charges with movement

 Discharge

- none; clear yellow 2 days after

childbirth

Deviation from normal - foul, purulent, sanguineous discharge

 Texture

- presence of small

Montgomery tubercles Deviation from normal - retraction, dimpling, enlarged pores

 2.

Palpation

* palpate the breasts for the

following: a. Temperature -warm Deviation from normal -erythema

 B. Elasticity

- elastic

Deviation from normal

- lumpy

 C.

Tenderness

- non tender, slightly tender

Deviation from normal - painful

 D.

Masses ( note size, shape, mobility, consistency, and location) - bilateral firm infra mammary
transverse ridge at base of breasts Deviation from normal - masses or nodules present

* palpate nipple for discharge - none; clear yellow 2 days after childbirth Deviation from normal - presence of discharge; unilateral serous, serosanguineous, clear yellow, dark red

C. palpate lymph nodes in the following areas: *supraclavicular, subclavian, intermediate, brachial, scapular, mammary, internal mammary - none palpable Deviation from normal - palpable lymph nodes

 Variation

for Men

1. Inspect the nipple and areola.

- note nodules, swelling, or ulcerations.

- areolar areas and nipples are darker than surrounding breast tissue. - absence of edema

 Deviation

from normal

- distorted nipple and areola may indicate cancer.

2. Palpate the areola and note nodules. - small breast, nipple and areola overlie a thin disc of undeveloped breast that is indistinguishable from surrounding tissues. - Adolescent boys may develop temporary breast enlargement on one or both sides.

 Deviation

from normal

- a firm disc of glandular enlargement may indicate gynecomastia. - hard, irregular nodule frequently fixed to both nipple and underlying tissue may indicate breast cancer.

3. Inspect and palpate the axillae. Note any rash, infection, unusual pigmentation and nodes. - rashes may indicate allergy to deodorant. - reddened and inflamed area occurs with infected hidradenitis suppurative. - enlarged tender nodes may indicate lymphadenitis from hand or arm infection or axillary metastasis of breast cancer.

Pediatric *focus questions: - assymetrical growth? -Girls prior to puberty- pain or discomfort? -Boys during adolescence- abnormal increase in size?

 Geriatric

- breasts are less firm and pendulous - coarser and more nodular tissue

- girls prior to puberty pain or discomfort? - boys during adolescence abnormal increase in size?

Geriatric - breasts are less firm and pendulous

- coarser and more nodular tissue