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superior lateral cornoer of breast tissue that projects up and laterally into the axilla |
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site of most breast tumors |
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-located just below center of breast -round, rough, protuberant |
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-1-2cm radius -surrounds the nipple -small, elevated Montgomery's glands -has smooth muscle fibers that causes nipple erection |
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sebaceous glands secrete a protective lipid material during lactation |
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-suspensory ligaments that support breast tissue -contracted in cancer and forms pits and dimples |
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contains lobes that store milk |
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-layers of subQ and retromammary fat -surrounds the lobes (glandular tissue) |
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>75% of lymph drains into ipsilateral axillary nodes |
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high up in middle of axilla |
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along the lateral edge of pectoralis major muscle |
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subscapular (posterior) node |
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along the lateral edge of the scapula |
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along the humerus inside upper arm |
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-extra nipple along mammary ridge (embryonic "milk line" -normal variation, benign -located on thorax or abdomen |
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-precursor to milk -thick, yellow fluid -same amount of protein as milk, but no fat -rich in antibodies -form and leaks at 4 months pregnant -expressed first few days after delivery |
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lactation (milk formation) |
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-milk -whitish color -calcium caseinate and emulsified milk -begins 1-3 days postpartum |
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-when male breast tissue temporarily enlargers -feels like smooth, firm, movable disk -adolescents usually unilateral -aging male due to testosterone deficiency (bilateral) -alcohol abuse, smoking weed, obesity |
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slightly asymmetrical is normal (left>right) |
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-"pig skin" "orange peel" look -edema exaggerates hair follicles caused by lymphatic obstruction |
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sign of skin retention when suspensory ligaments contract (in cancer) |
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-elevate arm maneuver -breasts asymmetrical -cancer causes fiberosis to fix breast to muscle |
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benign breast disease (BBD) aka: fibrocystic breast disease, "fibrocystic changes" |
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Definition
-50% of all women have a form of BBD -tender mobile, smooth water ballon masses -6 characterisitics: 1)swollen and tender, 2)mastalgia, 3)nodularity, 4)dominant lumps, 5)nipple discharge, 6)infection and inflammation |
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-nontender, fixed, solidarity unilateral, hard, dense -most common location: upper outer quadrant |
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lesions in the breast duct (single duct, unilateral) causes serous or serosanguenous discharge |
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clogged milk duct causes one section of breast to be tender, reddened |
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-caused by infection or stasis from plugged duct -red, swollen, tender, hot, hard area -associated with flu like symptoms -treat with rest, heat, antibiotics, frequent nursing |
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-complication if mastitis not treated -pus accumulates in one area -treat with antibiotics and I&D |
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-normal: none except when breast feeding -serosanguenous (pink): intraductal papilloma (benign) -blood: cancer (malignant) -clear |
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-central axillary nodes -pectoral -subscapular -lateral |
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1. preadolescent: only small, elevated nipple 2. breast bud stage: nipple develops, areola widens 3. nipple still flush with breast areola and breast enlarge 4. nipple and areola form secondary mound over breast 5. mature breast: only nipple protrudes; areola flush with breast contour |
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breast development and menarche |
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Definition
breast development (Tanner 1) --> 2 years later --> menarche(Tanner 3 or 4) at 12 y.o |
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breasts feel full, tight, heavy, sore (3-4 days before period) breast has smallest volume (4th-7th day of period |
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-feels like rope, stringy -mechanism: decrease estrogen, decrease glandular tissue, increase fibrous connective tissue -appearance: decrease fat decreases breast size, droopy, saggy, flat, flabby |
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begins at 40 every 1-2 years 50 every year 74 earliest age to discontinue |
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maneuvers to screen for retraction |
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1. arms over head 2. push hands on hips 3. push hands together 4. lean forward (large breasts) |
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-supine with arm over the head -palpation pattern: vertical stripe, concentric circle, spokes on a wheel |
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breasts feel like...(nullparous, after pregnancy, premenstrual) |
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-nullparous: firm, smooth, elastic -after pregnancy: softer, looser -prementrual: engorged (increased estrogen) |
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supine with arm over the head |
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mass in the breast (characteristics) |
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Definition
1. location (1 o'clock, 1cm from nipple) 2. size (w x h x l) 3. shape (oval, round, indistinct) 4. consistency (soft, hard) 5. movable (movable, fixed) 6. distinctness (1 or more) 7. nipple (retracted?) 8. note skin over lump 9. tenderness 10. lymphadenopathy |
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