Breast and Axillae

Also called the Mammary Gland in women. Lie in the Anterior Portion.

BREAST

Differences in Areola Pigmentation

The pigment of the nipple and areola varies among different races, getting darker as skin tone darkens.

Whites Asians Blacks

 In men and women, the lymphatic system is the most common route for the spread of breast cancer cells.

Breast Changes through Lifespan

BREAST & AXILLAE

Inspect skin changes, symmetry, contours, and retraction in four views:
Arms at side Arms over head Arms pressed against hips Leaning Forward

Arms at side
Note for:
Appearance of skin
Color Skin thickening Unusual prominent pores

Size and symmetry Contour of the breasts Characteristic of the nipples

Mastitis & Breast Engorgement

ORANGE PEEL
Usually a late sign of breast cancer, peau dorange (orange peel skin) is the edematous thickening and pitting of breast skin. This sign can also occur with breast or axillary lymph node infection or Graves disease. Its striking orange peel appearance stems from lymphatic edema around deepened hair follicles.

Peau dorange

Arms over head

Maneuver helps to bring out dimpling or retractions that may otherwise be invisible by contracting the pectoralis muscles. Dimpling or retraction of breasts in these positions suggests underlying cancer

Dimpling

Breast dimplingthe puckering or retraction of skin on the breast results from abnormal attachment of the skin to underlying tissue.

Hands pressed against Hip

Contour
Note for: masses, dimpling, or flattening

Leaning Forward
This position may reveal an asymmetry of the breast or nipple not otherwise visible. May also reveal retractions of the nipple and areola

Characteristics of the nipple

Breast Size & Asymmetry

Asymmetry may occur normally in some adult women, with the left breast usually larger than the right

Gynecomastia

Palpation of Breasts

Palpation of Breasts

Identifying Location of Breast Lesions

Documenting a Breast Lump

If you palpate a lump, record these characteristics: size in centimeters shape round, discoid, regular, or irregular consistency soft, firm, or hard Mobility degree of tenderness location, using the quadrant or clock method.

Other Breast Abnormalities

Examining the Axillae

Inspection With the patient sitting or standing, inspect the skin of the axillae for rashes, infections, or unusual pigmentation.

Palpating Axilla
Ask the patient to relax her arm on the side youre examining. Support her elbow with one of your hands.

Palpating Axilla
Cup the fingers of your other hand, and reach high into the apex of the axilla. Place your fingers directly behind the pectoral muscles, pointing toward the midclavicle.