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
Montgomerys glands

Structures
Nipple
Coopers 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
Montgomerys glands:
Sebaceous gland
Nipple:
Nursing and sexual stimulation
Coopers 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:
Prevention
SelfCancer
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 oclock in RUQ
No palpable nodes