 WAYS TO EXAM HUMAN BREAST

 How Should A Breast Self-Exam Be Performed?

1) In the Shower
- Using the pads of your fingers, move around your entire breast in a circular pattern moving from
the outside to the center, checking the entire breast and armpit area. Check both breasts each month
feeling for any lump, thickening, or hardened knot. Notice any changes and get lumps evaluated by
your healthcare provider.
2) In Front of a Mirror
- Visually inspect your breasts with your arms at your sides. Next, raise your arms high overhead.
- Look for any changes in the contour, any swelling, or dimpling of the skin, or changes in the
nipples. Next, rest your palms on your hips and press firmly to flex your chest muscles. ---Left and
right breasts will not exactly match—few women's breasts do, so look for any dimpling, puckering,
or changes, particularly on one side.
3) Lying Down
-When lying down, the breast tissue spreads out evenly along the chest wall. Place a pillow under
your right shoulder and your right arm behind your head.
- Using your left hand, move the pads of your fingers around your right breast gently in small
circular motions covering the entire breast area and the armpit.
-Use light, medium, and firm pressure. Squeeze the nipple; check for discharge and lumps. Repeat
these steps for your left breast.
Mammography
• For women aged 40–49 years, we recommend not routinely screening with mammography. (Weak
recommendation; moderate-quality evidence.)
• For women aged 50–69 years, we recommend routinely screening with mammography every two to
three years.
(Weak recommendation; moderate-quality evidence.)
• For women aged 70–74 years, we recommend routinely screening with mammography every two to
three years.
(Weak recommendation; low-quality evidence.)
Magnetic Resonance Imaging
• We recommend not routinely screening with MRI scans. (Weak recommendation; no evidence.)
Clinical Breast Examination
• We recommend not routinely performing clinical breast examinations alone or in conjunction with
mammography to screen for breast cancer. (Weak recommendation; low-quality evidence.)
Breast Self-Examination
• We recommend not advising women to routinely practise breast self-examination. (Weak
recommendation; moderate-quality evidence.)

 WHAT ARE THE NORMAL AND ABNORMAL FNDINGS ON TESTICULAR EXAM?

The testicular self-examination(TSE) is an easy way for guys to check their own testicles to make sure
there aren't any unusual lumps or bumps — which can be the first sign of testicular cancer.

Although testicular cancer is rare in teenage guys, overall it is the most common cancer in males
between the ages of 15 and 35. It's important to try to do a TSE every month so you can become familiar
with the normal size and shape of your testicles, making it easier to tell if something feels different or
abnormal in the future.
 Here's what to do:
 It's best to do a TSE during or right after a hot shower or bath. The scrotum (skin that covers the
testicles) is most relaxed then, which makes it easier to examine the testicles.
 Examine one testicle at a time. Use both hands to gently roll each testicle (with slight pressure)
between your fingers. Place your thumbs over the top of your testicle, with the index and middle
fingers of each hand behind the testicle, and then roll it between your fingers.
 You should be able to feel the epididymis (the sperm-carrying tube), which feels soft, rope-like, and
slightly tender to pressure, and is located at the top of the back part of each testicle. This is a normal
lump.
 Remember that one testicle (usually the right one) is slightly larger than the other for most guys —
this is also normal.
 When examining each testicle, feel for any lumps or bumps along the front or sides. Lumps may be
as small as a piece of rice or a pea.
 If you notice any swelling, lumps, or changes in the size or color of a testicle, or if you have any pain
or achy areas in your groin, let your doctor know right away.

Lumps or swelling may not be cancer, but they should be checked by your doctor as soon as possible.
Testicular cancer is almost always curable if it is caught and treated early.

ABNORMAL FINDINGS
Lumps or swelling on testes
Change in size or weight Bulge or swelling in the scrotum
Other signs:Dull abdominal or back pain Dull abdominal or back pain

 WHAT ARE THE SIGN AND SYMPTOMS OF PELVIC INFLAMATORY DISEASE?

 PID refers to any acute, subacute, recurrent, or chronic infection of the oviducts and ovaries, with
adjacent tissue involvement. It includes inflammation of the cervix (cervicitis), uterus (endometritis),
fallopian tubes (salpingitis), and ovaries (oophoritis), which can extend to the connective tissue lying
between the broad ligaments (parametritis).
Pathophysiology
Various conditions, procedures, or instruments can alter or destroy the cervical mucus, which usually
serves as a protective barrier. As a result, bacteria enter the uterine cavity, causing inflammation of
various structures.

Three types of PID

Pelvic inflammatory disease (PID) can be classified in three ways, each with its own signs and
symptoms and diagnostic findings.
OTHERS:

• profuse, purulent vaginal discharge

• low-grade fever and malaise (especially if N. gonorrhoeae is the cause)
• lower abdominal pain
• extreme pain on movement of the cervix or palpation of the adnexa.

 BREAST CANCER
 It is the second most common cancer in women and the second most common cause of cancer-
related deaths in women. It is breast cancer, a malignant growth of abnormal cells within the breasts.
The American Cancer Society estimates that in the U.S., for the year 2014, close to 300,000 new
cases of varying types of breast cancer will be diagnosed and around 40,000 women will die from
breast cancer. Men can also get breast cancer, but it is about 100 times more common in women.
Pathophysiology
Breast cancer is more commonly found in the left breast than the right. It’s also more common in the
upper outer quadrant.
Growth rates vary. Theoretically, slow-growing breast cancer may take up to 8 years to become palpable
at 1 cm in size.
Signs and symptoms of breast cancer include:
• painless lump or mass in the breast
• changes in breast symmetry or size
• changes in breast skin, such as dimpling (called peau d’orange), edema, or ulcers
• changes in nipples; for instance, itching, burning, erosion, retraction, or discharge
• skin temperature changes (a warm, hot, or pink area).

If you detect any of these changes, suspect cancer in a nonlactating woman past childbearing age until
proven otherwise. Investigate spontaneous discharge of any kind in a non–breast-feeding, nonlactating
woman.
Signs and symptoms of metastasis
Metastatic disease may cause shoulder, hip, or pelvic pain; cough; anorexia; persistent dizziness; or
enlarged axillary or supraclavicular lymph nodes.
• Generally, lesions are nontender, fixed, and hard with irregular borders; most occur in the upper outer
quadrant.
• Some women have no symptoms and no palpable lump but have an abnormal mammogram.
• Advanced signs may include skin dimpling, nipple retraction, or skin ulceration.

 CERVICAL CANCER
 The third most common cancer of the female reproductive system (after uterine and ovarian cancer),
cervical cancer may be preinvasive or invasive. With early detection and proper treatment, the
preinvasive form has a high cure rate.
 Cancer of the cervix is predominantly squamous cell cancerand also includes adenocarcinomas.
Pathophysiology
 Preinvasive cervical cancer ranges from minimal cervical dysplasia, in which the lower third of the
epithelium contains abnormal cells, to carcinoma in situ, which involves the full thickness of
epithelium.
What to look for
 Preinvasive cervical cancer is asymptomatic. Abnormal vaginal bleeding, persistent vaginal
discharge, and postcoital pain and bleeding may signal early invasive disease.
 Advanced disease may cause pelvic pain or vaginal leakage of urine and feces from a fistula, along
with anorexia, weight loss, and fatigue.
 Cervical cancer is most often asymptomatic. When discharge, irregular bleeding, or pain or bleeding
after sexual intercourse occurs, the disease may be advanced.
 Vaginal discharge gradually increases in amount, becomes watery, and finally is dark and foul
smelling because of necrosis and infection of the tumor.
 Bleeding occurs at irregular intervals between periods or after menopause, may be slight (enough to
spot undergarments), and is usually noted after mild trauma (intercourse, douching, or defecation).
As disease continues, bleeding may persist and increase.
 Leg pain, dysuria, rectal bleeding, and edema of the extremities signal advanced disease.
 Nerve involvement, producing excruciating pain in the back and legs, occurs as cancer advances and
tissues outside the cervix are invaded, including the fundus and lymph glands anterior to the sacrum.
• Extreme emaciation and anemia, often with fever due to secondary infection and abscesses in the
ulcerating mass, and fistula formation may occur in the final stage.

 PROSTATE CANCER
- Adenocarcinoma
- Diocese of elderly men (50-60)
- Prevalence greater in African-American men
-Usually the patient survives the cancer, but die of other causes
 Peripheral zone
 Pathophysiology
 Prostate cancer grows slowly. When primary lesions spread beyond the prostate, they invade the
prostatic capsule and spread along the ejaculatory ducts in the space between the seminal vesicles.
Clinical Manifestations
 Usually asymptomatic in early stage
 Nodule felt within the substance of the gland or extensive hardening in the posterior lobe
Signs and symptoms of prostate cancer appear only in advanced:
 disease stages and may include:
 difficult urination
 urinary dribbling
 urine retention
 unexplained cystitis (urinary bladder inflammation)
 hematuria (blood in the urine), a rare sign
 back or pelvic pain.
 DRE may reveal a hard nodule, which may be felt before other signs and symptoms develop.

 GONORRHEA: A sexually transmitted infection (STI) caused by a bacteria called Nesseria

gonorrheae or gonococcus (clap)
 HERPES: Genital herpes is a common sexually transmitted infection (STI) that can cause painful
sores on the genital area. There is no vaccine or cure, but antiviral medication can help ease the pain
associated with the sores and control recurrent episodes.
 SYPHILLIS: Syphilis is a sexually transmitted infection that can cause serious health problems if it is
not treated. Syphilis is divided into stages (primary, secondary, latent, and tertiary). There are different
signs and symptoms associated with each stage.
What are the signs and symptoms of syphilis?
Symptoms of syphilis in adults vary by stage:
Primary Stage
During the first (primary) stage of syphilis, you may notice a single sore or multiple sores. The sore is
the location where syphilis entered your body. Sores are usually (but not always) firm, round, and
painless. Because the sore is painless, it can easily go unnoticed. The sore usually lasts 3 to 6 weeks and
heals regardless of whether or not you receive treatment. Even after the sore goes away, you must still
receive treatment. This will stop your infection from moving to the secondary stage.
Secondary Stage
During the secondary stage, you may have skin rashes and/or mucous membrane lesions. Mucous
membrane lesions are sores in your mouth, vagina, or anus. This stage usually starts with a rash on one
or more areas of your body. The rash can show up when your primary sore is healing or several weeks
after the sore has healed. The rash can look like rough, red, or reddish brown spots on the palms of your
hands and/or the bottoms of your feet. The rash usually won’t itch and it is sometimes so faint that you
won’t notice it. Other symptoms you may have can include fever, swollen lymph glands, sore throat,
patchy hair loss, headaches, weight loss, muscle aches, and fatigue (feeling very tired). The symptoms
from this stage will go away whether or not you receive treatment. Without the right treatment, your
infection will move to the latent and possibly tertiary stages of syphilis.
Latent Stage
The latent stage of syphilis is a period of time when there are no visible signs or symptoms of syphilis. If
you do not receive treatment, you can continue to have syphilis in your body for years without any signs
or symptoms.
Tertiary Stage
Most people with untreated syphilis do not develop tertiary syphilis. However, when it does happen it
can affect many different organ systems. These include the heart and blood vessels, and the brain and
nervous system. Tertiary syphilis is very serious and would occur 10–30 years after your infection
began. In tertiary syphilis, the disease damages your internal organs and can result in death.

 CHLAMYDIA: is a common STD that can infect both men and women. It can cause serious,
permanent damage to a woman’s reproductive system. This can make it difficult or impossible for
her to get pregnant later on. Chlamydia can also cause a potentially fatal ectopic pregnancy
(pregnancy that occurs outside the womb).
 WARTS: Warts are benign (not cancerous) skin growths that appear when a virus infects the top layer
of the skin. Viruses that cause warts are called human papillomavirus (HPV).

Warts can grow anywhere on the skin. There are 6 clinically different types:

Common warts have a rather bumpy surface and appear most often on the hands and fingers (of
children, in particular).
Flat or plane warts are small, smooth warts appearing in clusters on the back of the hands, face, or
legs.
Plantar warts are those appearing on the soles of the feet.
Filiform warts form long, thin projections around the eyes, face, and neck.
Periungual warts (common in people who bite their nails) occur under and around the fingernails.
Genital (venereal) warts are those appearing on the genitalia.
Symptoms

Warts are generally easy to see or feel. People notice them as abnormal growths, bumps, or other odd
changes of the skin. More specifically, plantar and genital warts have very distinct symptoms and are
more serious types of warts:

Plantar warts sometimes resemble calluses. They are flat in appearance, deep-rooted in the skin, and
can cause pain when you walk. They may be yellow or brown and may also be dotted with tiny grey-
black nodules.

Genital warts are often small and flat. They can be pink, white, or grey. They can also join together,
forming cauliflower-like growths. These warts are able to grow on both the external and internal
genitalia, including the anus, vagina, urethra, and cervix. Genital warts can also appear in the throat if
oral sexual contact occurs with an infected person.
 CANCER MASS

Benign tumours
Benign tumours are non-cancerous. They rarely cause serious problems or threaten life unless they occur
in a vital organ or grow very large and press on nearby tissues.
Benign tumours tend to grow slowly and stay in one place, not spreading into other parts of the body.
Once removed by surgery, benign tumours don’t usually come back (recur). Benign tumours usually
stay non-cancerous, except in very rare cases.
Precancerous conditions
Precancerous (premalignant) cells are abnormal cells that may develop into cancer if they aren’t treated.
Some cells develop mild changes that may disappear without any treatment. Other cells pass on genetic
changes and new cells gradually become more and more abnormal until they turn into cancer. It can take
a long time for this to happen.
Precancerous (or premalignant) changes can vary in their degree of abnormality.
 hyperplasia – an abnormal increase in the number of cells
o Some hyperplasias are precancerous, but most are not.
 atypia (atypical) – cells look slightly abnormal under a microscope
o Sometimes atypia refers to changes caused by healing and inflammation, rather than a
precancerous change, and the cells go back to normal once inflammation goes away or
the body heals.
 metaplasia – cells look normal under a microscope, but are not the type normally found in the
that tissue or area
o Metaplasias are usually not precancerous.
 dysplasia – cells develop abnormally, have an abnormal appearance and are not organized like
normal cells
o Dysplasia almost always refers to a precancerous condition.
People with precancerous conditions are usually checked regularly, so they can be treated quickly if cell
changes become more severe.
Malignant tumours
Malignant tumours are cancerous. Cancer can start in any one of the millions of cells in our bodies.
Cancer cells have a larger nucleusThe part of the cell that holds the chromosomes, which contain DNA
(genetic information) that looks different from a normal cell’s nucleus, and cancer cells behave, grow
and function quite differently from normal cells. Malignant tumours vary in size and shape. They grow
in an uncontrolled, abnormal way and can grow into (invade) nearby tissues, blood vessels or lymphatic
vessels. They can interfere with body functions and become life-threatening. Cancer cells can break off
and spread to distant locations in the body (metastasize). Cancer that spreads from its original location
(the primary tumour) to a new part of the body is called metastatic cancer. Malignant tumours can also
come back (recur) after they are removed.

BREAST TUMOR :A tumor is a mass of abnormal tissue. There are two types of breast cancer tumors:
those that are non-cancerous, or ‘benign’, and those that are cancerous, which are ‘malignant’.

Benign Tumors
When a tumor is diagnosed as benign, doctors will usually leave it alone rather than remove it. Even
though these tumors are not generally aggressive toward surrounding tissue, occasionally they may
continue to grow, pressing on organs and causing pain or other problems. In these situations, the tumor
is removed, allowing pain or complications to subside.
Malignant tumors
Malignant tumors are cancerous and aggressive because they invade and damage surrounding tissue.
When a tumor is suspected to be malignant, the doctor will perform a biopsy to determine the severity or
aggressiveness of the tumor.
Metastatic cancer
Metastatic cancer is when cancer cells of a malignant tumor spread to other parts of the body, usually
through the lymph system, and form a secondary tumor.
 AIDS (Acquired Immune Deficiency Syndrome): virus debilitates immune system by attacking
lymphocytes; A disease caused by the retrovirus human immunodeficiency virus, Characterized by
progressive destruction of cell-mediated immunity and changes to humeral immunity. AIDs
characterized by a large reduction in CD4 T cells and subsequent infections by opportunistic
pathogens. CD4 counts drop below 200 cells/mm3. The body becomes susceptible to opportunistic
infections. Survival in this stage is usually 1-3 years. Opportunistic infections occur: Respiratory, GI;
Neuro; Skin
What are the modes of transmission for HIV?
Sexual contact
Parenteral inoculation
Blood/Organ transplant
Transplacental
Intrapartum