19-7 Physical Exam Breast and Axilla

Question 1

what 7 things are used to describe the changes in a breast lump or mass

Answer 1

• location
• size
• shape
• consistency
• mobility
• borders
• retraction

Question 2

how to describe the location of a breast lump

Answer 2

clock position and distance from nipple

Question 3

how to describe the size of a breast mass or lump

Answer 3

in centimeters: length, width, thickness

Question 4

how to describe the shape of a breast lump

Answer 4

• round
• discoid
• lobular
• stellate
• regular or irregular

Question 5

how to describe the consistency of a breast mass or lump

Answer 5

• firm
• soft
• hard

Question 6

how to describe the mobility of a lump or breast mass

Answer 6

• movable (in what direction)
• fixed

Question 7

how to describe the borders of a breast mass or lump

Answer 7

• discrete
• poorly defined

Question 8

how to describe retraction in breast mass or lump

Answer 8

• presence or absence of dimpling
• altered contour
• nipple discharge
• tender lymph nodes
• medication taken

Question 9

what are nonmodifiable factors for breast cancer

Answer 9

• age
• gender risk factors
• personal history of breast cancer
• FMH of breast cancer
• previous breast biopsy
• race
• previous breast radiation
• early menarche
• late menopause
• breast density
• DES therapy

Question 10

what are modifiable risk factors for breast cancer

Answer 10

• nullparity (late childbirth)
• hormone therapy
• alcohol
• obesity and high fat diets
• lack of physical activity

Question 11

how many lobes are in each breast

Answer 11

15 to 20

Question 12

how many lobules are in each lobe

Answer 12

20 to 40

Question 13

what are the milk producing cells called

Answer 13

acini cells

Question 14

what duct drains milk from each lobe onto the surface of the nipple

Answer 14

lactiferous ducts

Question 15

what muscles forms the floor of the breast

Answer 15

• pectoralis major
• pectoralis minor
• serratus anterior
• latissimus dorsi
• subscapularis
• external oblique
• rectus abdominis

Question 16

where in the breast is the greatest amount of glandular tissue

Answer 16

upper outer quadrant (tail of spence)

Question 17

what equipment is needed to conduct a breast exam

Answer 17

• small pillow or folded towel
• ruler
• flashlight with transilluminator

Question 18

Benign fluid-filled cyst formation caused by ductal enlargement

Answer 18

Fibrocystic changes

Question 19

Benign tumors composed of stromal and epithelial elements that represents a hyperplastic or proliferative process in a single terminal ductal unit

Answer 19

Fibroadenoma

Question 20

what condition accounts for the majority of breast tumors in young women

Answer 20

fibroadenoma

Question 21

a firm, irregular mass, often appearing as an area of discoloration

Answer 21

fat necrosis

Question 22

benign 2 to 3 cm tumors of the subareolar duct that occurs singly or multiples

Answer 22

Intraductal papillomas and papillomatosis

Question 23

what is a common cause of bloody nipple discharge

Answer 23

Intraductal papillomas and papillomatosis

Question 24

what mnemonic is used when assessing the nipples and areolar

Answer 24

5 D’s
- discharge
- discoloration
- deviation
- dermatologic changes
- depression

Question 25

what ethnicity is more likely to have supernumerary nipples

Answer 25

black women

Question 26

where are supernumerary nipples commonly located in black women

Answer 26

along the embryonic mammary ridge

Question 27

which breast disorder is associated with the menstrual cycle and are usually multiple and bilateral fluid filled lesions

Answer 27

fibrocystic changes

Question 28

what are some physical exam findings with breast cancer

Answer 28

- mass or thickening in the breast - marked asymmetry - prominent unilateral veins - discoloration - peau d' orange - ulceration - dimpling - puckering - retraction of skin - nipple inversion or deviation

Question 29

a red scaling, crusty patch that forms on the nipple, areolar, and surrounding skin

Answer 29

paget disease

Question 30

what are lesions that appear eczematous and usually unilateral

Answer 30

pagent disease

Question 31

a smooth, firm, mobile, tender, disk of breast tissue located behind the areolar in males

Answer 31

gynecomastia

Question 32

what is the cause of gynecomastia

Answer 32

- hormone imbalance - liver failure - antihypertensive meds - testicular, pituitary, or hormone secreting tumors

Question 33

inflammation of the sebaceous glands in the areolar

Answer 33

retention cysts

Question 34

lactation not associated with childbearing

Answer 34

galactorrhea

Question 35

what causes galactorrhea

Answer 35

- pituitary tumors - cushing's syndrome - hypoglycemia - drugs (antidepressants, estrogen, phenothiazine, tricyclics)

Question 36

inflammation and infection of the breast tissue

Answer 36

mastitis

Question 37

who is more likely to get mastitis

Answer 37

lactating women

Question 38

what is the most common causative agent of mastitis

Answer 38

staph infection

Question 39

what is the likely diagnosis of a woman who is currently breast feeding and complains of sudden onset of swelling, tenderness, erythema, and heat around her breast

Answer 39

mastitis

Question 40

what population of women are more likely to have mammary duct ectasia

Answer 40

menopausal women

Question 41

what breast conditioned is characterized as blocked subareolar duct with desquamating secretory epithelium, necrotic debris, and chronic inflammatory cells

Answer 41

mammary duct ectasia