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== 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 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  
Appearance of the patient  


* Patients with breast lumps usually appear well
* Patients with [[breast lumps]] usually appear well.
Vital signs
Vital signs
*Patients with breast lumps usually have normal vital signs
*Patients with [[breast lumps]] usually have normal [[Vital signs (medicine)|vital signs]].
Skin
Skin
*Patients' breast skin may develop with dimpling, redness and peaud'orange particularly in inflammatory breast cancer
*Patients' breast skin may develop with dimpling, redness and peaud'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
Neck
*[[Lymphadenopathy]] maybe present in [[Cervical|cervica]]<nowiki/>l and [[supraclavicular]] lymph nodes and determination of size, mobility and number are essential
*[[Lymphadenopathy]] maybe present in [[Cervical|cervica]]<nowiki/>l and [[supraclavicular]] [[lymph nodes]] and determination of size, mobility and number are essential.
Lungs
Lungs
*Pulmonary examination of patients with [[breast lumps]] is usually normal
*Pulmonary examination of patients with [[breast lumps]] is usually normal.
Heart
Heart
*Cardiovascular examination of patients with breast lumps is usually normal
*Cardiovascular examination of patients with breast lumps is usually normal.
Breast <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> <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>
Breast <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> <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>


*Breast examination must consider 4 quadrant parts of both breast while patients are in sitting position and supine position
*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  
*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
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**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 pain
*Determination of chest wall pain
**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 in favor of:
*Firm and rubbery lump in women<30 years is in favor of:
**[[Fibroadenoma]]
**[[Fibroadenoma]]
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**[[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==

Revision as of 17:55, 2 January 2019

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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. [1]


Appearance of the patient

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

Lungs

  • Pulmonary examination of patients with breast lumps is usually normal.

Heart

  • Cardiovascular examination of patients with breast lumps is usually normal.

Breast [1] [2]

  • 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:

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. ↑ 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.
  2. ↑ 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/


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