meducal students

2. Nursing assessment
• History- present/ past-
• Drug and diet history- over the counter drugs
• Social and personal history- smoking, alcohol or
substance use.
• Family history- h/o diabetes, cardiovascular
disease, caner of reproductive organs and breast.
• Menstrual and obstetrics history- age of
menarche, age of menopause,
• Use of contraceptive drug or device, or hormone
replacement therapy.

3. Physical examination

5. Diagnostic test
• Breast exam. Your doctor will check both of your breasts
and lymph nodes in your armpit, feeling for any lumps or
other abnormalities.
• Mammogram. A mammogram is an X-ray of the breast.
Mammograms are commonly used to screen for breast
cancer. If an abnormality is detected on a screening
mammogram, your doctor may recommend a diagnostic
mammogram to further evaluate that abnormality.
• Breast ultrasound. Ultrasound uses sound waves to
produce images of structures deep within the body.
Ultrasound may be used to determine whether a new breast
lump is a solid mass or a fluid-filled cyst.

6. Cont…
• Removing a sample of breast cells for testing (biopsy). A
biopsy is the only definitive way to make a diagnosis of
breast cancer. During a biopsy, your doctor uses a
specialized needle device guided by X-ray or another
imaging test to extract a core of tissue from the suspicious
area. Often, a small metal marker is left at the site within
your breast so the area can be easily identified on future
imaging tests.
• Biopsy samples are sent to a laboratory for analysis where
experts determine whether the cells are cancerous. A biopsy
sample is also analyzed to determine the type of cells
involved in the breast cancer, the aggressiveness (grade) of
the cancer, and whether the cancer cells have hormone
receptors or other receptors that may influence your
treatment options.

7. Cont…
• Breast magnetic resonance imaging
(MRI). An MRI machine uses a magnet and
radio waves to create pictures of the interior of
your breast. Before a breast MRI, you receive
an injection of dye. Unlike other types of
imaging tests, an MRI doesn't use radiation to
create the images.

8. Tumor and malignancy of breast
Fibrocystic Breast
• Fibrocystic breasts are composed of tissue
that feels lumpy or ropelike in texture. Doctors
call this nodular or glandular breast tissue.

9. Definition
• It is a benign condition characterized by
fibrocystic changes in the breast tissue.
The changes consist of fibrous tissue,
hyperplasia of epithelial lining of
mammary duct, proliferation of ducts and
cysts formation.

10. Clinical manifestation
• Breast lumps or areas of thickening that tend to blend
into the surrounding breast tissue
• Generalized breast pain or tenderness or discomfort that
involves the upper outer part of the breast
• Breast nodules or lumpy tissue change in size with the
menstrual cycle
• Green or dark brown non bloody nipple discharge that
tends to leak without pressure or squeezing
• Breast changes that are similar in both breasts
• Monthly increase in breast pain or lumpiness from mid
cycle (ovulation) to just before your period and then
gets better once your period starts

11. Diagnosis
• Clinical breast exam
• Ultrasonography
• Needle aspiration of cyst
• Biopsy
• Mammography

12. Management
• General measures- wearing a support bra, low
salt diet, diuretics, restriction of tea, coffee,
coca cola, chocolate, analgesics to reduce
pain.
• Hormonal therapy- ant estrogen therapy.
• Surgical therapy- subcutaneous mastectomy-
rarely used.

13. 2. Breast cancer

22. Cont…
• Complete blood count
• Platelet count
• Calcium and phosphate level
• Biopsy
• CT scan
• Bone scan
• MRI

27. Radiation therapy

31. Acute mastitis and breast abscess

51. GYNECOMASTIA