5. The breast anatomy of males and
females is slightly different. Female
breasts have milk ducts and
glandular tissue that aid
breastfeeding. Male and female
breast nipples have many nerves
that enhance sexual arousal. All
genders can get breast cancer.
Women are more prone to benign
(noncancerous) breast disease.
Overview
The Anatomy of the Breast for Male and
Female
5
6. BREASTANATOMY&PHYSIOLOGY
Internal Anatomy
• Nipple
• Areola
• Montgomery glands
Add a footer 6
External Anatomy
• Composed of Three Tissues:
1. Grandular
• Functional part
• Allows for milk production
• Arranged in 15-20 lobes
around the breast
• Each lobe contains several
lobules which contains acini cells
2. Fibrous
• Provides support to glandular tissue through the Cooper ligaments
3. Fatty
• Provides most of the substance of the breast, determining the
size and shape of the breast
• Mammary Ducts
Organs of milk production in breast and modified sweat glands
7. 7
Aspect Male Breast Female Breast
Location Located over the pectoral muscles Located over the pectoral muscles
Size Generally smaller and less developed Typically larger and more developed
Composition Consists mainly of muscle and
connective tissue
Consists of glandular tissue, adipose
tissue, and connective tissue
Mammary Glands Fewer and less developed More numerous and well-developed
Duct System Less extensive, with fewer ducts More extensive, with multiple
branching ducts
Lobes and Lobules Fewer lobes and lobules More lobes and lobules
Hormonal influence Minimal hormonal influence, typically
low levels of estrogen and
progesterone
Influenced by hormonal changes,
particularly estrogen and
progesterone
Nipple and Areola Typically smaller and less prominent Typically larger and more prominent
Function Generally non-functional, no milk
production
Capable of milk production and
breastfeeding
Breast Cancer Can occur but is less common More common, with higher
incidence rates
8. AssessingBreast
Add a footer 8
How examination is conducted
Equipment:
• Centimeter Ruler
• Small Pillow
• Gloves
• Patient’s Gown
9. Add a footer 9
Inspect the breasts for size,
symmetry, and contour or shape
while the client is in a sitting position.
• Females: rounded shape; slightly
unequal in size, generally
symmetric
• Males: breasts even with the
chest wall, if obese, may be
similar in shape to female breasts
Recent change in breast size;
swellings; marked asymmetry
Inspect the skin of the breast for
localized discolorations or
hyperpigmentation, retraction or
dimpling, localized hypervascular
areas, swelling or edema
• Skin uniform in color (similar to
skin of abdomen if not tanned)
• Skin smooth and intact
• Diffuse symmetric horizontal or
vertical vascular pattern in light
skinned people
• Striae (stretch marks); moles and
nevi
• Localized discolorations or
hyperpigmentation
• Retraction or dimpling (result of
scar tissue or an invasive tumor)
• Unilateral, localized hypervascular
areas (associated with increased
blood flow)
• Swelling or edema appearing a
pig skin or orange peel due ta
exaggeration of the pores
PROCEDURE NORMAL FINDINGS ABNORMAL FINDINGS
INSPECTION OF BREAST
10. Add a footer 10
Emphasize any retraction by having the
client:
• Raise the arms above the head.
• Push the hands together, with
elbows flexed
• Press the hands down on the hips
No retractions Retractions noted
Inspect the areola area for size,
shape, symmetry, color, surface
characteristics, and any masses or
lesions.
• Round or oval and bilaterally the same
• Color varies widely, from light pink to
dark brown
• Irregular placement of sebaceous
glands on the surface of the areola
(Montgomery’s tubercles)
Any asymmetry, mass, or lesion
Inspect the nipples for size, shape,
position, color, discharge, and
lesions.
• Round, everted, and equal in size,
similar in color, soft and smooth, both
nipples point in same direction (out in
young women and men, downward in
older women)
• No discharge, except from pregnant
or breast-feeding females
• Inversion of one or both nipples that
is present from puberty
Any asymmetry, mass, or lesion
13. Add a footer 13
Peau d’ Orange
• French for “orange
peel skin” or, more
literally, “skin of an
orange”)
• describes anatomy
with the appearance
and dimpled texture of
an orange peel.
• Peau d’orange is
caused by cutaneous
lymphatic edema,
which causes swelling
Paget’s Disease
• Paget’s disease of the
nipple is a rare form of
breast cancer in which
cancer cells collect in or
around the nipple.
• The cancer usually
affects the ducts of the
nipple first (small milk-
carrying tubes), then
spreads to the nipple
surface and the areola
(the dark circle of skin
around the nipple)
14. Add a footer 14
PALPATION OF BREAST
PROCEDURE:
• While the client sits with the arms abducted and
supported on the nurse’s forearm, palpate the lymph
nodes using your fingertips. Palpate the:
• The edge of the greater pectoral muscle (musculus
pectoralis major) along the anterior axillary line
• The thoracic wall in the midaxillary area
• The upper part of the humerus
• The anterior edge of the latissimus dorsi muscle
a. along the posterior axillary line.
• Instruct patient to lie in a supine position (Variation:
Examination in both supine and sitting position is
recommended for clients who have history of breast
masses or those who have pendulous breasts)
• To enhance flattening of the breast, instruct the client
to abduct the arm and place her hand behind her
head. Then place a small pillow or rolled towel under
the client’s shoulder.
• While the client is in supine position, palpate the
breast for masses, tenderness and any discharge
from the nipples starting with the “normal” breast if
the client reports of a presence of a lump on the
other breast.
• Use the palmar surface of the middle three fingertips
(held together) and make a gentle rotary motion on
the breast. Choose one of three patterns for
palpation:
• Hands-of-the-clock or spokeson-a-wheel
• Concentric circles
• Vertical strips pattern
15. • Start at one point for palpation, and move
systematically to the end point to ensure that all breast
surfaces are assessed.
• Pay particular attention to the upper outer quadrant
area and the tail of Spence.
• Palpate the areolae and the nipples for masses.
Compress each nipple to determine the presence of any
discharge.
• If discharge is present, milk the breast along its radius
to identify the discharge-producing lobe. Assess any
discharge for amount, color, consistency, and odor.
Note also any tenderness on palpation.
Add a footer 15
NORMAL AND ABNORMAL FINDINGS
Normal: No tenderness, masses, nodules, or nipple
discharge
Abnormal: Tenderness, masses, nodules, or nipple
discharge
If mass is detected, record the
following data:
• Location
• Size
• Shape
• Consistency
• Mobility
• Skin over the
lump
• Nipple
• Tenderness
16. Gynecomastia
• Enlargement of the male breast gland
• May be due to hormonal imbalance or as a side
effect of some medication
• Pseudogynecomastia
Add a footer 16
• symptom of excess fat which deposits on the chest
• It can be common and temporary in boys going through
puberty
17. BreastCancer
• The most common invasive cancer in women
• The second main cause of cancer death in women, after lung
cancer.
• Symptoms include a lump or thickening of the breast, and
changes to the skin or the nipple.
• Risk factors can be genetic, but some lifestyle factors, such as
alcohol intake, make it more likely to happen.
• BRCA1 and BRCA2 genes are the most common cause of
hereditary breast cancer.
• In breast cancer care, three tumor markers – cancer antigen
15-3 (CA 15-3), cancer antigen 27.29 (CA 27.29), and
carcinoembryonic antigen (CEA)- have been used to help
monitor metastatic breast cancer (advanced disease).
Add a footer 17
