Breast lumps physical examination: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Breast lumps}} | {{Breast lumps}} | ||
{{CMG}} {{AE}} {{S.M}} | |||
{{CMG}} {{AE}} {{S.M}} | |||
== Overview== | == Overview== | ||
Physical examination of patients with [[breast lumps]] should perform both in sitting position and supine position to examine all 4 quadrants of breast. Careful physical examination may lead to diagnosis. Breast physical exam should include information about, number, size, location, shape, mobility, consistancy of masses, nipple discharge, and axillary [[lymph nodes]] | Physical examination of patients with [[breast lumps]] should perform both in sitting position and supine position to examine all 4 quadrants of breast. Careful physical examination may lead to diagnosis. Breast physical exam should include information about, number, size, location, shape, mobility, consistancy of masses, nipple discharge, and axillary [[lymph nodes]]. | ||
== Physical Examination == | == Physical Examination == | ||
Physical examination of patients should perform both in sitting position and supine position to examine breast abnormalities. <ref name="pmid25114845">{{cite journal| author=Shah R, Rosso K, Nathanson SD| title=Pathogenesis, prevention, diagnosis and treatment of breast cancer. | journal=World J Clin Oncol | year= 2014 | volume= 5 | issue= 3 | pages= 283-98 | pmid=25114845 | doi=10.5306/wjco.v5.i3.283 | pmc=4127601 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25114845 }} </ref> | Physical examination of patients should be perform both in sitting position and supine position to examine breast abnormalities.<ref name="pmid25114845">{{cite journal| author=Shah R, Rosso K, Nathanson SD| title=Pathogenesis, prevention, diagnosis and treatment of breast cancer. | journal=World J Clin Oncol | year= 2014 | volume= 5 | issue= 3 | pages= 283-98 | pmid=25114845 | doi=10.5306/wjco.v5.i3.283 | pmc=4127601 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25114845 }} </ref> | ||
=== Appearance of the patient === | |||
* Patients with [[breast lumps]] usually appear well. | |||
=== Vital signs === | |||
*Patients with [[breast lumps]] usually have normal [[Vital signs (medicine)|vital signs]]. | |||
=== Skin === | |||
*Patient's breast skin may develop with dimpling, redness, and peau d' Orange particularly in inflammatory [[breast cancer]]. | |||
=== HEENT === | |||
HEENT | |||
*HEENT examination of patient with breast lumps is usually normal. | *HEENT examination of patient with breast lumps is usually normal. | ||
Neck | |||
*[[Lymphadenopathy]] maybe present in [[Cervical|cervica]]<nowiki/>l and [[supraclavicular]] [[lymph nodes]] and determination of size, mobility and number are essential. | === Neck === | ||
Lungs | *[[Lymphadenopathy]] maybe present in [[Cervical|cervica]]<nowiki/>l and [[supraclavicular]] [[lymph nodes]] and determination of size, mobility, and number are essential. | ||
*Pulmonary examination of patients with [[breast lumps]] is usually normal. | |||
Heart | === Lungs === | ||
* Pulmonary examination of patients with [[breast lumps]] is usually normal. | |||
=== Heart === | |||
*Cardiovascular examination of patients with breast lumps is usually normal. | *Cardiovascular examination of patients with breast lumps is usually normal. | ||
*Breast examination must consider 4 | === Breast === | ||
*Breast examination must consider all 4 quadrants of both breast while patients are in sitting position and supine position.<ref name="pmid25114845" /><ref>Santen RJ. Benign Breast Disease in Women. [Updated 2018 May 25]. In: De Groot LJ, Chrousos G, Dungan K, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK278994/</ref> | |||
*General inspection of both breast for probable findings of nipple changes, asymmetric changes and notable masses. | *General inspection of both breast for probable findings of nipple changes, asymmetric changes and notable masses. | ||
*Size, location, shape, mobility, consistency and number of lesions should be mentioned. | *Size, location, shape, mobility, consistency, and number of lesions should be mentioned. | ||
*Axillary [[lymph nodes]] must be examined for [[adenopathy]] | *Axillary [[lymph nodes]] must be examined for [[adenopathy]]. | ||
*Examination of nipple discharge | *Examination of nipple discharge: | ||
**From one duct or multiple ducts | **From one duct or multiple ducts | ||
**Presence or absence of [[galactorrhea]] | **Presence or absence of [[galactorrhea]] | ||
**Presence or absence of blood | **Presence or absence of blood | ||
**Type of discharge such as being clear, viscous, watery or bloody | **Type of discharge such as being clear, viscous, watery or bloody | ||
*Determination of chest wall | *Determination of chest wall tenderness: | ||
**Examination of [[costochondral]] junction | **Examination of [[costochondral]] junction | ||
**Examination of lateral chest wall while the patient is lying down at 90 degrees on her side in order to move the breast away | **Examination of lateral chest wall while the patient is lying down at 90 degrees on her side in order to move the breast away | ||
**Comparison of pain from chest wall and breast tissue | **Comparison of pain from chest wall and breast tissue | ||
Discrete solitary breast lump: | '''Discrete solitary breast lump:''' | ||
*Firm and rubbery lump in women<30 years is | *Firm and rubbery lump in women <30 years is suggestive of: | ||
**[[Fibroadenoma]] | **[[Fibroadenoma]] | ||
*Firm and discrete lump in women aged 30-50 years is suggestive of: | *Firm and discrete lump in women aged 30-50 years is suggestive of: | ||
| Line 52: | Line 54: | ||
**[[Atypical]] ductal [[hyperplasia]] | **[[Atypical]] ductal [[hyperplasia]] | ||
**Atypical lobular [[hyperplasia]] | **Atypical lobular [[hyperplasia]] | ||
*Firm and discrete lump in women> 50 years is | *Firm and discrete lump in women > 50 years is suggestive of: | ||
**[[Cyst]] | **[[Cyst]] | ||
**Invasive cancer | **Invasive cancer | ||
**[[Ductal carcinoma in situ]] | **[[Ductal carcinoma in situ]] | ||
Abdomen | |||
=== Abdomen === | |||
*Abdomen examination of patients with breast lumps is usually normal. | *Abdomen examination of patients with breast lumps is usually normal. | ||
Back | |||
=== Back === | |||
*Back examination of patients with breast lumps is usually normal. | *Back examination of patients with breast lumps is usually normal. | ||
Genitourinary | |||
=== Genitourinary === | |||
*Genitourinary examination of patients with breast lumps is usually normal. | *Genitourinary examination of patients with breast lumps is usually normal. | ||
Neuromuscular | |||
=== Neuromuscular === | |||
*Neuromuscular examination of patients with breast lumps is usually normal. | *Neuromuscular examination of patients with breast lumps is usually normal. | ||
Extremities | |||
=== Extremities === | |||
*Extremities of patients with breast lumps is usually normal. | *Extremities of patients with breast lumps is usually normal. | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
{{WikiDoc Help Menu}} | {{WikiDoc Help Menu}} | ||
{{WikiDoc Sources}} | {{WikiDoc Sources}} | ||
[[Category:Up-To-Date]] | |||
[[Category:Oncology]] | [[Category:Oncology]] | ||
[[Category:Gynecology]] | [[Category:Gynecology]] | ||
[[Category:Surgery]] | [[Category:Surgery]] | ||
Latest revision as of 20:42, 29 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shadan Mehraban, M.D.[2]
Overview
Physical examination of patients with breast lumps should perform both in sitting position and supine position to examine all 4 quadrants of breast. Careful physical examination may lead to diagnosis. Breast physical exam should include information about, number, size, location, shape, mobility, consistancy of masses, nipple discharge, and axillary lymph nodes.
Physical Examination
Physical examination of patients should be perform both in sitting position and supine position to examine breast abnormalities.[1]
Appearance of the patient
- Patients with breast lumps usually appear well.
Vital signs
- Patients with breast lumps usually have normal vital signs.
Skin
- Patient's breast skin may develop with dimpling, redness, and peau d' Orange particularly in inflammatory breast cancer.
HEENT
- HEENT examination of patient with breast lumps is usually normal.
Neck
- Lymphadenopathy maybe present in cervical and supraclavicular lymph nodes and determination of size, mobility, and number are essential.
Lungs
- Pulmonary examination of patients with breast lumps is usually normal.
Heart
- Cardiovascular examination of patients with breast lumps is usually normal.
Breast
- Breast examination must consider all 4 quadrants of both breast while patients are in sitting position and supine position.[1][2]
- General inspection of both breast for probable findings of nipple changes, asymmetric changes and notable masses.
- Size, location, shape, mobility, consistency, and number of lesions should be mentioned.
- Axillary lymph nodes must be examined for adenopathy.
- Examination of nipple discharge:
- From one duct or multiple ducts
- Presence or absence of galactorrhea
- Presence or absence of blood
- Type of discharge such as being clear, viscous, watery or bloody
- Determination of chest wall tenderness:
- Examination of costochondral junction
- Examination of lateral chest wall while the patient is lying down at 90 degrees on her side in order to move the breast away
- Comparison of pain from chest wall and breast tissue
Discrete solitary breast lump:
- Firm and rubbery lump in women <30 years is suggestive of:
- Firm and discrete lump in women aged 30-50 years is suggestive of:
- Fibroadenoma
- Cyst
- Fibrocystic changes
- Usual ductal hyperplasia
- Atypical ductal hyperplasia
- Atypical lobular hyperplasia
- Firm and discrete lump in women > 50 years is suggestive of:
- Cyst
- Invasive cancer
- Ductal carcinoma in situ
Abdomen
- Abdomen examination of patients with breast lumps is usually normal.
Back
- Back examination of patients with breast lumps is usually normal.
Genitourinary
- Genitourinary examination of patients with breast lumps is usually normal.
Neuromuscular
- Neuromuscular examination of patients with breast lumps is usually normal.
Extremities
- Extremities of patients with breast lumps is usually normal.
References
- ↑ 1.0 1.1 Shah R, Rosso K, Nathanson SD (2014). "Pathogenesis, prevention, diagnosis and treatment of breast cancer". World J Clin Oncol. 5 (3): 283–98. doi:10.5306/wjco.v5.i3.283. PMC 4127601. PMID 25114845.
- ↑ Santen RJ. Benign Breast Disease in Women. [Updated 2018 May 25]. In: De Groot LJ, Chrousos G, Dungan K, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK278994/