Breast lumps physical examination

Breast lumps Microchapters
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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]

Physical Examination

Physical examination of patients should perform both in sitting position and supine position to examine breast abnormalities

Appearance of the patient

• Patients with breast lumps usually appear well

Vital signs

• Patients with breast lumps usually have normal vital signs

Skin

• Patients' breast skin may develop with dimpling, redness and peaud'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 4 quadrant parts of both breast while patients are in sitting position and supine position
• 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 pain
  • 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 in favor of:
  • fibroadenoma
• 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 in 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

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