STRUCRURE AND FUNCTION

The breasts are paired mammary glands that lie over the muscles of the anterior chest wall, anterior to
the pectoralis major and serratus anterior muscles. Depending on their size and shape, the breasts
extend vertically from the second to the sixth rib and horizontally from the sternum to the mid-axillary
line.

The male and female breasts are similar until puberty, when female breast tissue enlarges in response to
the hormones estrogen and progesterone, which are released from the ovaries. The female breast is an
accessory reproductive organ with two functions: to produce and store milk that provides nourishment
for newborns and to aid in sexual stimulation. The male breasts have no functional capability.

For purposes of describing the location of assessment findings, the breasts are divided into four
quadrants by drawing horizontal and vertical imaginary lines that intersect at the nipple. The upper outer
quadrant, which extends into the axillary area, is referred to as the tail of spence. Most breast tumors
accur in this quadrant.

Lymph nodes are present in both male and female breasts. These structures drain lymph from the
breasts to filter out microorganisms and return water and protein to the blood.

SELF - ASSESSMENT: BREAST AWARENESS AND SELF-EXAMINATION

The five steps of a breast self-examination

Step 1: Look at your breasts in the mirror with your shoulders straight and your arms on your hips. Check
size, shape, and color. Notice if they are evenly shaped with no distortion or swelling.

Notify your doctor of you notice:

 Dimpling, puckering, or bulging of the skin

 A nipple that has changed position or an inverted nipple
 Redness, soreness, rash, or swelling

Step 2: Raise your arms and determine if you see the same changes.

Step 3: Look for any signs of fluid coming out of one or both nipples (e.g., watery, milky, yellow fluid, or
blood).

Step 4: Lie down with your right arm behind your head. Lying down spreads the breast tissue evenly over
the chest wall, making it easier to feel. Use the three middle finger pads and move them in a circular
motion covering the entire breast from top to bottom, side to side----from your collar bone to the top of
your abdomen, and from your armpit to your cleavege.

Follow a pattern to be sure that you cover the whole breast. You can begin at the nipple, moving in larger
and larger circles until you reach the outer edge of the breast.
Some women prefer to use an up-and-down approach by moving the fingers up and down vertically, in
rows, as if moving a lawn. Be sure to feel all the tissue from the front to the back of your breasts: for the
skin and tissue just beneath, use light pressure; use medium pressure for tissue in the middle of your
breasts; use firm pressure for the deep tissue in the back. When you have reached the deep tissue, you
should be able to feel down to your ribcage.

Step 5: Many women find it easier to do this in the shower when the skin is wet and slippery. Cover the
entire breast, using the same hand movements.