ANATOMY OVERVIEW

THE BREAST ARE PAIRED MAMMARY GLANDS THAT LIE OVER THE MUSCLES OF THE
ANTERIOR CHEST WALL, ANTERIOR PECTORALIS MAJOR AND SERRATUS
ANTERIOR MUSCLES.
THE MAMMARY GLANDS ARE BOTH PRESENT IN BOTH SEXES, BUT THEY NORMALLY
FUNCTION ONLY IN FEMALES.
THE BIOLOGICAL ROLE OF THE MAMMARY GLANDS IS TO PRODUCE MILK TO
NOURISH A NEWBORN BABY.
THE MALE AND FEMALE BREAST ARE SIMILAR UNTIL PUBERTY, WHEN FEMALE
BREAST TISSUE ENLARGES IN RESPONSE TO HORMONES, ESPECIALLY ESTROGENS.
 AREOLA IS THE PIGMENTED AREA OF THE
BREAST IT SURROUNDS THE PROTRUDING
NIPPLE.
NIPPLE CONTAINS THE TINY OPENING OF
THE LACTIFEROUS DUCTS.
LACTIFEROUS DUCTS PASSAGEWAY OF
THE MILK
EACH MAMMARY GLANDS CONSISTS OF
15 TO 25 LOBES WHICH RADIATES
AROUND THE NIPPLE.
WITHIN EACH LOBE ARE SMALLER
CHAMBER CALLED THE LOBULES WHICH
CONTAINS THE ALVEOLAR GLANDS THAT
PRODUCE MILK.
THE BREAST OF MEN
AND WOMEN NEED TO
BE INSPECTED AND
PALPATED.
 FOR ASSESSMENT OF THE BREAST,
THE BREAST IS DIVIDED INTO 4
QUADRANTS BY DRAWING
HORIZONTAL AND VERTICAL
IMAGINARY LINES THAT INTERSECT
AT THE NIPPLE.
IN FEMALES, THE LARGEST PORTION
OF THE GLANDULAR BREAST TISSUE
IS LOCATED AT THE UPPER OUTER
QUADRANT OF EACH BREAST.
THE MAJORITY OF THE BREAST
TUMORS ARE LOCATED IN THE UOBQ
INCLUDING THE TAIL OF THE SPENCE.
 ASSESSMENT OF THE BREAST
PLANNING
SHOULD NOT BE DELEGATED

ASSEMBLE EQUIPMENT:
CENTIMETER RULER
SMALL PILLOW
GLOVES AND SLIDE FOR SPECIMEN IF DISCHARGE IS PRESENT
 IMPLEMENTATION ( ASSESSMENT
TECHNIQUE)
1. INTRODUCE YOURSELF AND
VERIFY THE CLIENTS IDENTITY.
EXPLAIN TO THE CLIENT WHAT
YOU ARE GOING TO DO, WHY IT
IS NECESSARY, AND HOW SHE
CAN COOPERATE.
2. PERFORM HAND HYGIENE AND
OBSERVE OTHER APPROPRIATE
INFECTION CONTROL
PROCEDURES.
3. PROVIDE FOR CLIENT PRIVACY.
4. INQUIRE IF THE CLIENT HAS ANY HISTORY OF THE
FOLLOWING:
BREAST MASSES, AND WHAT WAS DONE ABOUT
THEM
ANY PAIN OR TENDERNESS IN THE BREASTS AND
RELATION TO THE WOMANS MENSTRUAL CYCLE
ANY DISCHARGE FROM THE NIPPLE
MEDICATION HISTORY
ESTROGEN REPLACEMENT THERAPY
MOTHER, SISTER, AUNT WITH BREAST CANCER
ALCOHOL CONSUMPTION
HIGH-FAT DIET
OBESITY
USE OF ORAL CONTRACEPTIVE
MENARCHE BEFORE AGE 12
MENOPAUSE AFTER AGE 55
PREGNANCY AFTER AGE 30
BREAST SELF-EXAMINATION; TECHNIQUE USED AND
WHEN PERFORMED IN RELATION TO THE MENSTRUAL
CYCLE
Inspection
Assessment Normal findings Deviation from normal
5. Observe breasts for
the following:
Size and Relatively equal with Recent change to
symmetry slight variation unequal size. Recent
increase in size of one
breast may indicate
inflammation or
Round and pendulous abnormal growth.
Shape Retraction or dimpling
maybe due to fibrosis
and may indicate a
Pink; striae with age and malignant tumor
Color pregnancy Redness, inflammation,
blue hue, increase
smooth venous engorgement
Skin surface Retraction, dimpling ,
enlarged pores, peau d
orange, edema, lumps,
lesions, rashes, ulcers
Inspection
Assessment Normal findings Deviation from normal
6. Observe areola and
nipple for the following;
Size Relatively the same, slight Large variation
variation
Color Inflamed
Pink to dark brown ( varies with
Shape skin and hair color Inversion, if it occurs after
Round, oval, everted maturation or changes with
movement. Recent retraction
of previously everted nipple
suggests malignancy

Discharge Foul, purulent, sanguineous

None; clear yellow 2 days after drainage. Any spontaneous
childbirth discharge needs to be
referred for further
Texture evaluation
Small Montgomery tubercles Lesions, rashes, ulcers,
present peau d orange is seen with
carcinoma. Red scaly, crusty
palpation
Assessment Normal findings Deviation from normal
7. Palpate breasts for the
following;
Temperature Warm Erythema: heat indicates
inflammation if client is not
lactating or has just given birth
Elasticity Elastic Lumpy

Tenderness Nontender; slightly tender Painful

before menses
Masses: note; Bilateral firm inflammatory Masses or nodules. Malignant
Size transverse ridge at base of tumors are most often found in
Shape breasts UOBQ & are usually unilateral
Mobility with irregular, poorly delineated
Consistency borders; hard nontender; and
Location fixed to underlying tissues.
according to Fibroadenomas are usually1-5
quadrant cm, round or oval, mobile, firm,
solid, elastic, nontender, &
single or multiple in 1 or both
breasts. Fibrocystic disease
Palpation
Assessment Normal findings Deviation from
normal
8. Palpate the nipple None; clear yellow 2 Unilateral serous,
gently for discharge days after childbirth serosanguineous, clear,
yellow, dark red. Discharge
maybe seen in endocrine
disorders and with some
medication, such as
antihypertensives,
antidepressants, and
estrogen. Discharge from
one breast may indicate
benign intraductal
papilloma, fibrocystic
disease, or breast cancer
Palpation
Assessment Normal findings Deviation from normal
9. Palpate the lymph nodes None palpable (<1 cm) Palpable lymph nodes (
in the following areas: >1 cm)
Supraclavicular
Subclavian
Intermediate
Brachial
Scapular
Mammary
Internal mammary

10. Document findings in the

client record using forms or
checklists supplemented by
narrative notes when
appropriate.