2-7.
BREAST EXAMINATION
Although breast cancer is a leading cause of cancer death in American women,
breast cancer is a disease that can also occur in men. Unfortunately, the causes of
breast cancer are not known, so it is not clear how this disease can be prevented.
Breast cancer can often be treated successfully if it is detected early, before the cancer
spreads.
a. The Male Breast. Although carcinoma of the male breast occurs infrequently
(about one percent of all male cancer), it does occur. Men should, therefore, be
examined for breast cancer regularly. Males are also afflicted with mastitis
(inflammation of the breast) and gynecomastia (excessive development of the male
breast).
b. The Female Breast. The best time for female breast examination is five to
seven days after the menstrual cycle. At this time, the breasts are less likely to be
swollen and are easier to examine.
c. Method of Examination. After you have taken the patient's history, have the
patient disrobe to the waist and drape her. Inspect the breasts for symmetry,
appearance, nipple retraction, and skin appearance and texture. Notice whether the
skin dimples. Next, palpate the breasts. Using the palm of the hand, palpate all areas
of breast tissue systematically. Note the elasticity of the nipple and areola (pigmented
area around the nipple of the breast). Observe the breasts for the following:
consistency, elasticity, absence or presence of tenderness, and masses.
d. Breast Self-Examination. Every woman's breasts are different. That is why
it is so important to teach each woman how to examine her own breasts. Over ninety
percent of all breast cancers are first discovered by women themselves. Women should
know to look for changes such as these in their breasts: new wrinkling or dimpling of
the skin; retraction of the nipple; puckering of the breast on one side; or a red scaling
rash or sore on the nipple. Have any of these checked by a physician.
2-8.
CLOSING
Your ability to perform a thorough physical assessment of the integumentary
system can provide an excellent diagnostic tool for identifying potentially serious or
disabling problems. The condition of a patient's skin often is an indication of other
physical problems. Use this tool for the complete assessment of your patient.
MD0575
2-10