breast

• The Breast


  The primary function of female breasts is to produce milk in order to nourish an infant, a process called lactation. The breasts, which are composed primarily of fatty tissue, also contain milk producing glands called lobules. Lobules are connected to the nipple by a network of tubes called milk ducts.
• The Breast Quadrants


  • No additional details provided
• The Axillary Lymph Nodes


  They drain lymph vessels from the lateral quadrants of the breast, the superficial lymph vessels from thin walls of the chest and the abdomen above the level of the navel, and the vessels from the upper limb.
• The Nursing Health History - History of Present Health Concern

  • Lumps or swelling in breast
  • Lumps or swelling in the underarms
  • Redness, warmth or dimpling of breast
  • Change in firmness or size of breast
  • Pain in breast (COLDSPA – Character, Onset, Location, Duration, Severity, Pattern, Associated Factors)
  • Discharge from nipples
• The Nursing Health History - Personal Health History

  • Prior breast disease
  • Menarche and Menopausal Period
  • Child Birth
  • Menstrual Cycle
• The Nursing Health History - Family History

  • Breast cancer in the family
• The Nursing Health History - Lifestyle and Health Practices

  • Taking of hormones, contraceptives or antipsychotic agents
  • Exposure to radiation
  • Typical daily diet
  • Alcohol consumption
  • Caffeine Consumption
  • Engagement in regular exercise; type of brassier
  • Perceptions on the importance of breast in relation to positive feeling and physical appearance or fears regarding breast disease
  • Breast examination
• Physical Assessment - General Routine Screening

  • Inspect the size and symmetry
  • Inspect superficial venous pattern
  • Inspect the areolas and nipples
  • Inspect the breast for retraction or dimpling
  • Palpate texture and elasticity
  • Palpate for tenderness and temperature
  • Ask the client to demonstrate BSE
• Physical Assessment - Focus Specialty Assessment

  • Palpate the nipples for discharge
  • Palpate the breast for masses
  • Palpate mastectomy or lumpectomy site
  • Inspect and palpate the axillae
• Physical Assessment: Breast - Normal Findings


  • Breast can be a variety of sizes and are somewhat round and pendulous; symmetrical and no signs of dimpling or retraction, no masses or tumors
• Physical Assessment: Breast - Abnormal Findings

  • A recent increase in size of one breast may indicate inflammation or an abnormal growth
  • Dimpling and retractions are usually cause by malignant tumor
  • Malignant masses or tumors are most often found in the outer quadrant of the breast; hard, immobile and fixed, irregular
• Physical Assessment: Breast - Normal Findings

  • Color varies depending on the client's skin tone, texture is smooth with no edema
• Physical Assessment: Breast - Abnormal Findings

  • Redness is associated with breast inflammation.
  • Edema is caused by blocked lymphatic drainage
• Physical Assessment: Breast - Normal Findings


  • Veins radiate either horizontally and toward the axillae (transverse) or vertically with a lateral flare (longitudinal). Veins are prominent during pregnancy
• Physical Assessment: Breast - Abnormal Findings

  • A prominent venous pattern may occur as increased circulation due to malignancy.
  • Asymmetric venous pattern may be due to malignancy
• Physical Assessment: Breast - Normal Findings


  • Areolas vary from dark pink to dark brown, depending on the client's skin tone. They are round and may vary in size. Small montgomery tubercles are present.
  • Nipples are bilaterally in size and in the same location each breast. Nipples are usually everted, but maybe inverted or flat
• Physical Assessment: Breast - Abnormal Findings


  • Peau d orange skin associated with carcinoma may be first seen in the areola
  • Red scaly, crusty areas may appear in Paget's Disease
• Physical Assessment: Breast - Normal Findings

  • A generalized increased in nodularity and tenderness maybe a normal finding associated with menstrual cycle or hormonal medications. Breast should be a normal body temperature
• Physical Assessment: Breast - Abnormal Findings

  • Painful, tender breast may be an indicative of fibrocystic breast especially before menstruation
  • Pain may also occur with a malignant tumour
  • Heat in the breast of women who have not just given birth or who are not lactating indicates inflammation
• Physical Assessment: Male Breast

  1. Inspect the nipple and areola for nodules, swelling, or ulceration.

  2. Palpate the areola and breast tissue for nodules. If the breast appears enlarged, distinguish between the soft fatty enlargement of obesity and the firm disc of glandular enlargement GYNECOMASTIA
• Physical Assessment: The Axillae - Normal Findings


  • No rash and infection
  • No palpable nodes or one to two small (less than 1 cm) discreet, non-tender, movable nodes in the central area
• Physical Assessment: The Axillae - Abnormal Findings

  • Redness and inflammation may be seen with infection in the sweat gland.
  • Dark velvety pigmentation of the axilla may indicate underlying malignancy
  • Enlarged (greater than 1 cm) lymph nodes may indicate infection of the hand or arm.
  • Large nodes that are hard and fixed to the skin may indicate an underlying malignancy