Faculty of Nursing-IUG Chapter (9) Assessment of the breast Faculty of Nursing-IUG

Assessment of the breast The breasts, or mammary glands, are highly specialized glands, which extend laterally from edges of the sternum to the anterior axillary fold. They are located between the third and seventh ribs on the anterior chest wall. Each breast is divided into 15 to 20 irregularly shaped lobes separated by fibro elastic and adipose tissues. The areola is a roughened, segmented, circular formation, which surround the nipple. Subjective data Tenderness, pain, swelling, or change in size of breasts. Change in position of nipple or nipple discharge. Presence of cysts, lumps, and lesions. History of prior breast surgery

Female breast: Inspection: Best done in sitting position with arms relaxed at sides Carefully observe the breasts for symmetry. The normal breasts may be slightly different in size. If necessary, reassure the patient that any difference in size is normal. Inspect Areola and nipples for position, pigmentation, inversion, discharge, crusting & masses. Examine the breast tissue for size, shape, color, and contour Assess level of breasts, notes any retractions or dimpling of the skin. Ask client to elevate her hands over her head, repeat the observation. Ask client to press her hands to her hips and repeat observation. Inspect the axilla for: rashes, signs of infection and unusual pigmentation

Palpation: Best done in recumbent position: Raise the arm of client on the side of the breast being palpated above client’s head. Palpate the breast from less painful or less diseased area (Use on palpation palmer aspects of the fingers in a rotating motion, compressing the breast tissue against the chest wall, this is done quadrant by until the entire breast has been palpated. Note skin texture, moisture, temperature, or masses. Gently squeeze the nipple and note any expressible discharge. "Normally not present in non lactating women". Repeat examination on the opposite breast & compare findings. If mass is palpated, its location, size, shape, consistency, mobility and associated tenderness are reported Remember the breast may feel slightly more fibrotic or be somewhat tender just prior to or during the menses.

Male Breast: Examination of male breast can be brief and should never be omitted. Observe nipple & areola for ulceration, nodules, swelling or discharge Instruct the patient to raise both arms, exposing the skin of the axilla. Carefully inspect the axilla for: rashes, signs of infection and unusual pigmentation Palpate the areola for nodules or tenderness