ASSESSING THE
BREASTS
NUR211
Kathleen Hancock
Assessing the
Breasts
 Obtain a breast history.
 Perform a breast physical
assessment.
 Document breast assessment
findings.
Differentiate between normal and
abnormal findings.
Breast
Composition
3 types of tissue:
*Glandular
*Fibrous
*Adipose
Structures
 Lobes and lobules
 Lactiferous ducts and sinuses
 Areola
 Montgomery’s glands
Structures
 Nipple
 Cooper’s ligament
 Pectoralis major and serratus
anterior muscles
Functions
What are the functions of…
Lobes & lobules:
Contain alveoli cells that produce
milk
Lactiferous ducts & sinuses:
Carry and store milk
Areola:
Dark tissue surrounding nipple
(Continued)
Functions
What are the functions of…
Montgomery’s glands:
Sebaceous gland
Nipple:
Nursing and sexual stimulation
Cooper’s Ligament:
Ligament attached to chest wall
muscles that supports breasts
(Continued)
Functions
What are the functions of…
Pectoralis major & serratus anterior
muscles:
Breast overlies these muscles
Lymph nodes:
Drain breast, chest, and arms
Breast Health:
Cancer Prevention
Self Breast Exam (SBE)
Every month
Mammogram
After age 40 every year
More frequent if personal or family history
Breast Exam by nurse or doctor every year
Developmental
Variations
What developmental breast variations
might be seen with:
Children
Pregnant clients
Older adults
History
What can the history tell you about
the breast?
Biographical data
Current health status
Past health history
Family history
Review of systems
Psychosocial history
Symptoms
What symptoms signal a problem with
the breasts?
 Breast lump or mass
 Pain or tenderness
 Nipple discharge
Physical Assessment
Anatomical
landmarks:
quadrants of the
breast, include
Tail of Spence
(Continued)
Inspection
Breasts: size, shape, symmetry, color,
lesions, venous pattern, dimpling, or
retraction
Nipple and areola: nipple position and
direction; discharge
Axillae: color, lesions, rashes
Physical Exam Inspection
Position: sitting, hands on hips, hands
over head, leaning forward
Tools: small pillow or towel, ruler,
gloves, slide, and culture slide.
Sitting, arms at
sides
Arms overhead
Arms pressing on
hips
Leaning forward
Palpation
Lymph nodes: axillary, clavicular
while sitting
Breasts: consistency, masses,
tenderness in supine position
Nipple: elasticity, masses, tenderness,
discharge
Supraclavicular
Nodes
Infraclavicular
Nodes
Axillary Nodes
Palpation –Vertical
Strip Method
Preferred
 Approach: supine
with pillow or
towel under
shoulder
Pattern (vertical,
wedge, or circular)
light, medium, and
deep
Supine with shoulder
support –Use pads of
fingers of dominant hand
Strip Method of
Palpation
Cover all of breast
Use 3 middle finger pads, not tips
Use sliding motion
Overlapping dime size circles
3 pressure levels: light, medium, deep
Include nipple and areola
Large Breasts
Bimanual palpation to adequately
examine all areas
Often have an inframammary ridge
Male Breast
Inspection
Palpation
Lymph nodes while sitting
Breast while sitting or if large while
lying down
Male Breast
Enlargement:
Gynecomastia
Characteristics
of Masses
Note:
 Location
 Size
 Mobility
 Temperature
 Shape/Borders
 Tenderness
 Consistency
 Redness
Example: Pertinent
Physical Findings
 Right breast larger than left
 No dimpling, retraction
 Small, pea size (0.5cm), movable,
rubbery, smooth-edged lesion in
right breast at 2 o’clock in RUQ
 No palpable nodes