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Assessment of the Breasts and Axillae
Health History
- Breast Pain and Tenderness
- Breast Lump and Thickening
- Nipple Changes
- Breast Skin Characteristics
- Axilla Characteristics
- Past Medical History
- Breast self-examination
Special Considerations
- Males
- Infants
- Children
- Adolescents
- Older Adults
- Pregnant Women
- Lactating Women
General Approach
- Provide optimal privacy
- Environment should be warm and relaxing
- Provide good lighting
- Teach self breast examination
Inspection of the Breasts
- Position
- Size and symmetry
- Contour (masses, dimpling, and flattening)
- Skin Characteristics (color, thickening, peau d’orange, edema, venous pattern)
- Nipples and Areola (size, shape, symmetry, color, lesions, discharge)
- Supernumerary Nipples
- Axillae (rashes, lesions, masses)
Position Changes
- Arms extended overhead
- Hands pressed against hips
- Pressing hands together
- Leaning forward from waist
Palpation
- Position
- General Technique
- Concentric Circles
- Wedge method
- Vertical Strip method
- Mama-Care
- Back-and-forth technique
- Nipple palpation
- Male Examination
Assessment of Masses/Lumps
- Location
- Size
- Shape
- Consistency
- Tenderness
- Mobility
- Delimitation of borders
- Retraction signs
Special Consideration
- Infants
- Children
- Adolescents
- Older Adults
- Pregnant Women
- Lactating Women
- Clients with a Mastectomy
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