Download breast conditions

BREAST CONDITIONS
ARE THESE BREASTS NORMAL?
WARNING SIGNS
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LUMP - firm, discrete, no change with menses
NIPPLE D/C - SPONTANEOUS, unilateral, persistent,
clear, bloody, amber, from one duct , guiac +
DIMPLING/RETRACTION OF SKIN
SKIN EDEMA/ERYTHEMA - not assoc. with fever, NO
CHANGE WITH ANTIBIOTIC, usually painless.
ULCERATED,SCALY NIPPLE/AREOLA - non-healing
after course of cortisone-often bleeds if you try to
remove it.
Dimpling/retraction
Peau de orange /
Inflammatory Breast Ca
MYSTERY SYMPTOMS
EXPLAINED
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LUMPS AND BUMPS:
NORMAL FIBROCYSTIC
CHANGE FEELS LIKE
LUMPY SQUISHY
COTTAGE CHEESE
SEE YOUR DOCTOR IF
A LUMP IS FIRM, has
IRREGULAR
EDGES,DOESN’T
MOVE
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PAINFUL-TENDER BREASTS-USUALLY
DUE TO MONTHLY HORMONE
CHANGES. RARELY SERIOUS
ESPECIALLY IN ABSENCE OF A LUMP.
Decrease caffeine
TREATMENT:
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BREAST PAIN –Evening Primrose Oil
500mg po take 2-3 per day
Anti-inflammatories
CYSTS OR SWELLING – FIBROCYSTIC
Vitamin E 400 IU/day
Vitamin B6 100 mg/day
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PAIN IS RARELY A PRESENTING
SYMPTOM FOR CANCER OF THE
BREAST!
CANCER OF THE BREAST RARELY HAS
PAIN
SEE YOUR PROVIDER IF THERE IS
REDNESS, FEVER, SEVERE PAIN as
this is sign of infection !
CHEST WALL PAIN
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Chest Wall Pain is commonly present
and commonly mistaken for breast pain.
Treatment : Anti-inflammatory like
Ibuprofen 600 mg 3 x / day for 1-2 wks
Warm moist compress 4 x/day
LEAKY NIPPLES
•NORMAL WHEN BREASTS ARE STIMULATED OR
SQUEEZED/SUCKED
•NORMAL COLORS : GREEN, GREY, WHITE, multi-colored
•CAN BE THE SIDE EFFECT OF MEDICATIONS: HORMONES,
ANTIDEPRESSANTS, ETC. CHECK WITH YOUR DOCTOR OR PHARMACIST
•COMES OUT OF SEVERAL DUCTS
•ABNORMAL: BLOODY, CLEAR, AMBER ; FROM ONE DUCT,
SPONTANEOUS, PERSISTENT (GUIAC +)
•BILATERAL MILKY D/C > 2 YRS POST BREASTFEEDING - check :
TSH, PROLACTIN - meds that cause this*
•Most common cause of unilateral nipple d/c IS NOT CANCER
Meds assoc. with milky nipple
discharge or galactorrhea
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*Estrogens, digitalis, marijuana, heroin,
dopamine receptor blockers,
phenothiazines, haloperidol,
metoclopramide, isoniazid, CNS
dopamine depleters, triacyclic
antidepressants,reserpine, methyldopa,
cimetidine, benzodiazepines. These
increase prolactin levels which triggers
the discharge (see gynecomastia too)
Nipple Discharge cont’d.
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Duct Ectasia
Permanantly distended
ducts that collect fluid,
cheesy material. Drains
from nipple & may
result in chronic
inflammatory reaction
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Papilloma : a
benign tumor with
slight potential for
malignant
degeneration. Fluid
seen from a single
duct usually bloody,
clear, amber. Guiac
positive
BREAST CANCER IS THE LEAST
COMMON CAUSE OF NIPPLE
DISCHARGE !
BREAST EXAMINATION MADE
EASY…………
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VISUALLY EXAMINE THE BREASTS
WITH HANDS ABOVE HEAD ,PRESS
PALMS TOGETHER, HANDS ON HIPS,
PRESS
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PADS OF 3 FINGERS
OVERLAPPING
CIRCLES, WORKING
IN ROWS LIKE
MOWING THE LAWN
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3 DIME SIZE CIRCLES
IN ONE PLACE
USING LIGHT, MEDIUM, DEEP
PRESSURE
COVER FROM COLLAR BONE TO
BREAST BONE TO BRA LINE TO
MID-AXILLARY LINE-LIKE THE
SIDE SEAM OF A SHIRT
EXAMINE SUPRACLAVICULAR AND AXILLARY NODES
GOOD CLINICAL EXAM
INVERTED NIPPLES
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USUALLY FROM LAX ERECTILE TISSUE
ABNORMAL : SUDDENLY ONE NIPPLE
PULLS IN - will NOT evert
Inverted Nipples
Benign Lumps
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FIBROADENOMA common b9 tumor
often teens to 30yo.
May be found later
on mammo.
Painless, rubbery
smooth round
mobile
Benign: CYSTS
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Cysts are fluid filled
lumps that may or
may not be tender.
If palpable >= to
1cm can be
aspirated if not
resolving with end
of menses.
Vit. E 400 IU/d, B6
100mg/d