Breast & Lymphatics Abnormal Findings Flashcards
shallow dimple is a sign of skin retraction. may be apparent at rest, with compression, or with lifting of the arms. areola distortion as nipple is pulled toward it.
dimpling also called a skin tether
produced by lymphatic obstruction. thickening of the skin and exaggerates the hair follicles producing a pig-skin or orange-peel look. condition usually suggests cancer - usually begins around and beneath areola
edema - peau d’orange
nipple looks flatter and broader. suggests cancer which causes fibrosis of the whole duct system and pulls in the nipple. may also occur with benign lesions such as ectasia of the ducts. do not confuse with normal longstanding nipple inversion, which has no broadening and is not fixed.
nipple retraction
asymmetry, distortion, or decreased mobility with the elevated arm maneuver. as cancer becomes invasive the fibrosis fixes the breast to the underlying pectoral muscles
fixation
an underlying cancer causes fibrosis in the mammary ducts, which pulls the nipple angle toward it.
deviation in nipple pointing
multiple tender masses. nodularity occurs bilaterally, regular, firm nodules that are mobile, well demarcated, and feel rubbery, like small water balloons. pain may be dull, heavy.
benign breast disease
solitary unilateral nontender mass. single focus in one area, although it may be interspersed with other nodules. solid, hard, dense, and fixed to underlying tissues or skin as cancer becomes invasive. borders are irregular and poorly delineated.
cancer
solitary and nontender benign mass. most common between 15 and 30 but can occur up to 55. solid, firm, rubbery, and elastic. roud, oval, or lobulated. freely movable, slippery, fingers slide easily through tissue. usually no axillary lymphodenopathy. grows quickly and constantly.
fibroadenoma
pastelike matter in subareolar ducts produces sticky, purulent discharge that may be white, grey, brown, green, or bloody. Caused by stagnation of cellular debris and secretions int he ducts, leading to obstruction, inflammation, and infection. occurs in women who have lactated usually occurs in perimenopausal period. itching, burning sensation, or pulling pain occurs around nipple.
mammary duct ectasia
serous or serosanguineous discharge which is spontaneous, unilateral, or from a single duct. lesion consists of tiny tumours, 2-3mm. often there is a palpable nodule in underlying duct. affect women age 40-60 years of age most are benign.
intraductal papilloma
bloody nipple discharge that is unilateral and from a single duct necessitates further investigation.
carcinoma
early lesion has unilateral, clear, yellow discharge and dry, scaling crusts, friable at nipple apec. spreads outward to areola with erythematous halo on areola and crusted, eczematous, retracted nipple.
paget’s disease - intraductal carcinoma
fairly common and serious condition. one milk duct is clogged, one section of breast is tender and may be redenned. no infection. it is important to keep breast as empty as possible and milk flowing. should nurse frequently on affected side first to ensure complete emptying and manually express any remaining milk. plug duct usually resolves in less than one day.
plugged duct
inflammatory mass before abscess formation. usually occurs in single quadrant. area is red, swollen, tender, very hot, and hard.
mastitis
rare complication of generalized infection if untreated. pocket of pus accumulate in one local area. nursing on affected breast must be discontinued temporarily, manually express milk and discard.
breast abscess
