breast assesement

7/25/2019 Breast Assesement

1/18

Assessment of BreastDr. Muhamad Taufiqy Setyabudi, SpOG

RSUD Tugurejo FK U!MUS Semara"g


2/18

Anatomy of the breast

Composed of :

Mu#$%e#

&igame"t# G%a"du%ar ti##ue

Fatty ti##ue &ymphati$ ti##ue


3/18

Assessing: Subjective Data

'i#tory of (rea#t Di#ea#e)Surgery &ump# or thi$*e"i"g Di#$harge)Ra#h S+e%%i"g)Trauma

ai" Doe# pt. perform S(-Se%f (rea#t -/am0

mo"th%y1

Date of %a#t $%i"i$a% brea#t e/am 2(-0 Date of %a#t mammogram3/i%%ary te"der"e##, %ump# #+e%%i"g, ra#h


4/18

3##e##i"g (rea#t 2a"$er Ri#*

-/ami"er mu#t a#* fo$u#ed que#tio"# regardi"g

ri#* fa$tor#4

Fami%y hi#tory4 5#t degree re%ati6e#-#troge" e/po#ure4 3ge o"#et of me"#e# ) 3ge

me"opau#e

Ob#tetri$

hi#tory ) U#e of 'RTer#o"a% habit#4 3%$oho% ) Dietary Fat ) -/er$i#e

-6er te#ted for ge"e mutatio"4 (R235) (R237

3ge4 O6er 89 :; ri#*


5/18

Assessing:Objective Data

Inspection< patie"t #itti"g, di#robedto +ai#t

ote #ymmetry, #i=e a"d #hape

S*i" "orma%%y #mooth >e6e" i" $o%or. Ob#er6e the a/i%%ary a"d #upra

$%a6i$u%ar area# for a"y bu%gi"g,

di#$o%oratio" or edema

ipp%e#< #ymmetri$a%1 F%at1 !"6erted1

Di#$harge1 (%eedi"g1


6/18

Screen for Retraction

?hi%e patie"t i# #itti"g

3#* patie"t to4

&ift arm# #%o+%y abo6e head. (othbrea#t #hou%d mo6e up #ymmetri$a%%y

u#h ha"d# i"to hip.

u#h pa%m# together &ea" for+ard.


7/18

Inspect and Papate A!iae

?hi%e patie"t i# #itti"g, %ift a"d #upport thearm #o patie"t@# mu#$%e# are re%a/ed

U#e the right ha"d to pa%pate %eft a/i%%ae

Rea$h fi"ger# high i"to a/i%%ae Mo6e fi"ger# firm%y do+" i" four

dire$tio"#4

Do+" the $he#t +a%%, a%o"g the a"terior a"d

po#terior border# of a/i%%ae a"d arou"d the

i""er a#pe$t of the arm

Mo6e arm through ROM to ha6e a$$e## to

area#.


8/18

Breast Papation

Supi"e po#itio" +ith #ma%% pad)pi%%o+u"der #ide to be pa%pated

3rm rai#ed o6er head

U#e pad# of fi"ger# a"d ma*e ge"t%erotary mo6eme"t o" brea#t

U#e a patter" of $o"$e"tri$ $ir$%e# or

%atera%%y, %i*e #po*e# of +hee%.

a%pate a%% area# of brea#t, $%o$*+i#e

fa#hio"


9/18

Bimanua Breast Papation

For pe"du%ou# brea#t#

atie"t #itti"g, %ea"i"g for+ard

Support i"ferior part of brea#t +itho"e ha"d.

U#e other ha"d to pa%pate brea#t

ti##ue agai"#t #upporti"g ha"d.


10/18

"!amination of #ippes

erformed after brea#t pa%patio".

a%pate "ipp%e, "oti"g a"y i"duratio"#or ma##.

U#e thumb a"d forefi"ger to app%y

ge"t%e pre##ure to "ote a"ydi#$harge.


11/18

ASS"SS$"#% of Breast &umps

&o$atio"< u#e brea#t a# $%o$* fa$e tode#$ribe di#ta"$e from "ipp%e i"

$e"timeter# u#e diagram to %o$ate0.

Si=e< i" $e"timeter# Shape

2o"#i#te"$y

Mo6ab%e

Te"der"e##


12/18

2ompari#o" of (rea#t &ump#

Benign Breast Disease

Mu%tip%e or #i"g%e

Rubbery te/ture

Mobi%e ) #%ippery

Regu%ar border#

Te"der"e## $y$%i$0

o retra$tio" May i"$rea#e)de$rea#e

i" #i=e rapid%y

Cancer

U"i%atera%

Firm te/ture

Fi/ed firm%y

!rregu%ar border

U#ua%%y pai"%e##

U#ua%%y +)retra$tio" Gro+# $o"#ta"t%y


13/18

%eaching SB"

3##i#t patie"t to e#tab%i#h a #$hedu%e

Regu%ar mo"th%y e/am#

Majority of +ome" "e6er get brea#t$a"$er, majority of %ump# are be"ig"

-ar%y dete$tio" i# importa"t.

!" "o"


14/18

Sef Breast "!am

Tea$hi"g po#itio"#4 5. Sta"di"g i" fro"t of mirror

7. !" the #ho+er #oap a"d +ater

a##i#t pa%patio" B. Supi"e

Keep tea$hi"g #imp%e

Demo"#trate to patie"t a"d u#e retur"

demo"#tratio"


15/18

%he $ae Breast

-/ami"atio" $a" be abbre6iated but"ot omitted.

!"#pe$t the $he#t +a%% "oti"g #*i"

#urfa$e a"d a"y %ump# or #+e%%i"g. a%pate "ipp%e area for %ump# or

e"%argeme"t.

orma% ma%e brea#t ha# a f%at di#$ ofu"de6e%oped brea#t ti##ue be"eaththe "ipp%e. Shou%d be e6e" +ith "o

"odu%e#.


16/18

Documentation: 'emae

S< De"ie# brea#t pai", %ump,di#$harge, ra#h, #+e%%i"g, trauma.De"ie# pa#t hi#tory of brea#t di#ea#e

or #urgery. State# perform# mo"th%ybrea#t e/am#.

O< !"#pe$tio"4 (rea#t# #ymmetri$.

S*i" #mooth +ith e6e" $o%or. odimp%i"g or retra$tio" e%i$ited. o"ipp%e di#$harge. o %e#io"#.


17/18

Documentation: 'emae

A< 'ea%thy brea#t# bi%atera%%y +ith "o

S)S of ab"orma%itie#

P< Rei"for$e (S- patie"t perform#

(S- mo"th%y0, fo%%o+ up +ith MD for

2(- > mammogram


18/18

Summary

3##e##i"g the brea#t i"$%ude#4

Ta*e i"to a$$ou"t de6e%opme"ta%

%e6e% Rememberi"g to a##e## both fema%e#

a"d ma%e#

!"#pe$ti"g > pa%pati"gbrea#t#,"ipp%e#, %ymph "ode# a"da/i%%ary

Tea$hi"g (S-

breast assesement

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