Breast disorder

1. EXAMINATION OF BREAST

2. ANATOMY OF BREAST
• The breast is the tissue overlying the chest
muscles (pectoral).
• Components
• Glandular tissue (milk production)
• Fibrous tissue
• Fatty tissue
• The breast has no muscular tissue. Muscles
lie underneath the breast.
• Location – vertically the breast lies between
the 2nd and 6th ribs. Horizontally between the
lateral border of sternum and the mid axillary
line.

3. CONT..
• Parts
• Each breast has 8 – 10 sections that branch out from
the nipples called lobes.
• Inside each lobe are many smaller structures called
lobules.
• At the end of the each lobule has tiny hollow sacs
called alveoli.
• The lobes are linked by a network of thin tubes
called ducts.
• Ducts carry milk from the alveoli toward the dark
area of skin in the center of the breast (areola).

4. CONT..
• Spaces around the lobules and ducts
are filled with fat, ligaments and
connective tissues.
• The amount of fat in breasts largely
determine their size.
• Lymphatic system – It is a network of
lymph nodes and lymph ducts that
helps fight infection.

5. ASSESSMENT OF BREAST
INSPECTION
• The breast should be inspected with the patient
seated in the following positions –
• Hands pressing on the top of the head
• Arms raised in the air
• Arms at the side
• Hands pressing on the hips

6. CONT..
INSPECTION
• Size and shape of the breast
• Symmetry
• Skin colour (orange peel: present in edema)
• Superficial veins
• Areola rounded or oval and colour
• Nipples: everted, inverted
• Cracking or eczema
• Bleeding or discharge
• Retractions or dimpling

7. CONT..
PALPATION
• Sit the patient at 45⁰
• Ask the patient to place their hands behind the
head.
• Retract the breast with the left hand and palpate
with the right. Feel with the palmar surface of the
fingers.
• Palpation should be done by a clockwise rotary
motion from the periphery to center.
• Findings – palpable lumps or masses (size,
location, mobility), tenderness, discharge.

8. SELF BREAST EXAMINATION
PURPOSE
• To detects the majority of breast abnormalities
• Potentially life-saving
TIME
• Monthly exam, 5-7 days after menstruate ends.
• Start in front of mirror.

9. STEPS
STEP 1
• Stand before a mirror. Inspect both
breasts for skin changes, redness,
discharge from nipples, puckering,
dimpling, visible bumps, nipple crusting.

10. CONT..
STEP 2
• Watching closely in the mirror, clasp hands
behind your head. Note for changes in the
contour and shape of the breast.

11. CONT..
STEP 3
• Press hands firmly on hips and bow slightly
toward the mirror to pull shoulders and
elbows forward looking for the same
changes as step2.

12. CONT..
STEP 4
• Raise the left arm.
• Use three or four fingers of the right hand to feel
left breast firmly, carefully and thoroughly.
• Do the vice versa to feel any unusual lump, mass or
lymph nodes under the skin.
• Middle portion of fingers is used while palpating.

13. CONT..
STEP 5
• Gently squeeze the nipple and look for a
discharge. If discharge present seeking for
medical help.
• Repeat the step on another breast.

14. CONT..
STEP 6
• Step 4 and step 5 should be repeated on lying
down position.
• Lie flat on your back, right arm over the head
and a pillow or folded towel under the left
shoulder.
• This position flattens the breast and makes it
easier to examine.