BREAST SELF

EXAMINATION
SYLVIA LOPEZ MAN RN
, ,
 THE SCIENCE OF
CANCER PREVENTION
CONTINUES TO
ESCALATE AND MOVE
RAPIDLY FORWARD
.
HOW TO DETECT BREAST CANCER :

Yearly Mammography for women older than 40

years old
Yearly Clinical Breast Exam for women older than
40 y/o and every 3 years at the age of 20 y/o
Breast Self Exam every month for women 20 y/o
and above
MRI and Breast Ultrasound for clients with Risk
 BSE IN MEN
BSE training and education starting at
the age of 35 y/o
Clinical Breast examination every 6-12
months starting at the age of 35y/o
Consider baseline mammogram at the
age of 40 y/o, annual mammogram if
gynecomastia or glandular breast
density on the baseline study
BREAST SELF EXAM
A valuable tool by which women
learn the appearance and feel of
their own breast
Performed 5- days after menstrual
period( premenopausal)
Menopausal - select the same date
each month for BSE
 2 PARTS OF BSE
INSPECTION PALPATION
INSPECTION
Stand in front of the
mirror inspect for:
Skin changes
Redness
Visible Bumps
Nipple crusting
Symmetry
INSPECTION
Raise arms up and
inspect
Breast should rise
evenly
Watch for dimpling
and retraction
INSPECTION
INSPECTION
PALPATION
Performed with the pads
of the fingers
Tips too sensitive
Palm too insensitive
PALPATION
Raise the arm
Feel with the opposite
hand
Pay special attention
on the upper outer
quadrant (Lymph
nodes)
PALPATION
Raise the arm
Move fingers in small
circles about the size of
,

a dime
Feel for thickenings the
size of a marble
PALPATION
Assess for nipple discharge
Strip the ducts towards the nipple .

Normally one or two drops of clear

, ,

milky or green tinged secretions

- .

Should not be bloody or in large

quantity squirting out or staining
,

the inside of a bra

Peau d orange
 Testicular
Self-Exam
is performed to detect testicular

cancer early . It is recommended to be

done once a month and is ideally for

men over the age of 14

 TESTICULAR SELF EXAM
Best performed during or
after a bath or shower
Skin of the scrotum is
relaxed
Stand in front of the mirror
and look for swelling
TESTICULAR SELF EXAM
Hold the penis out of the way and
check one testicle at a time
Feel for any hard lumps or smooth
rounded bumps
Assess for changes in size shape
,

or consistency of the testicles

.
TESTICULAR SELF EXAM
Gather equipment clean gloves
( )

Introduce yourself and verify client s identity

’

Explain the procedure why it is necessary and how he

,

can cooperate
Perform hand hygiene and wear gloves
Provide privacy Request the presence of another person
.

if needed.

Cover the pelvic are with a sheet

Inspect the scrotum for appearance general size and
,

symmetry
Ask the client to hold the penis out of the way
TESTICULAR SELF EXAM
Cup testicles
Its normal that one is lower
than the other
Firm but not hard
 TESTICULAR SELF EXAM
Check one testicle at a time
Hold the testicle between the
thumb and fingers
Gently roll the testicle
between your index and
thumb
Feel for any lumps bumps or
,

painful areas
Don t squeeze too hard
’
 TESTICULAR SELF EXAM
At the back you’ll feel
the epididymis
Feel up the
spermatic cord
Document findings
Other signs to look out
for :

Any enlargement of a testicle

A significant loss of size in one of
the testicles
A feeling of heaviness in the
scrotum
Other signs to look out
for :
A dull ache in the lower abdomen or
in the goin
A sudden collection of fluid in the
scrotum
Pain or discomfort in a testicle or in
the scrotum
Tumor
Markers
Tumor Markers
Protein products that may be
excreted by cancer cells or in
response to the presence of cancer
and other conditions
May be used in determining the
prognosis of specific CA detects
,

occurrence and effectiveness of

treatment
Prostate Specific Antigen
Can be elevated in prostate CA or
BPH(Benign Prostatic Hyperplasia)
Usually accompanied by DRE
S100
Found in Melanoma cells
Measured in the tissue samples
Elevated with Metastatic Melanoma
THYROGLOBULIN ( 3 - 40 NG / ML )
IS A PROTEIN MADE BY
THE THYROID GLAND
ELEVATED IN MANY
THYROID DISEASES
INCLUDING CANCER
 CA 15 - 3 AND CA 27 - 29
Specific for Breast Cancer
Commonly used to monitor the
recurrence in women in Breast
Cancer
CA 27-29 test (< 38 u/ml) is more
sentitive than CA 15-3 (30 u /ml)
 CARCINOEMBRYONIC ANTIGEN ( CEA )
AND CA 19 - 9
Commonly elevated
in advanced colon
cancer
CA- 125
Advanced epithelial
ovarian cancer
HUMAN CHORIONIC
GONADOTROPIN
often elevated in Germ Cell
Ovarian Tumor or
Nonseminoma Testicular
Cancer
Alpha-fetoprotein
AFP CAN ALSO BE
ELEVATED IN CHRONIC
HEPATITIS ( LIVER CANCER
 BETA 2 MICROGLOBULIN
B2M IS ELEVATED FOR MULTIPLE
MYELOMA CHRONIC LYMPHOCYTIC
,

LEUKEMIA AND SOME LYMPHOMAS

CAN ALSO DETECT KIDNEY DAMAGE
HER - 2 / NEU - HUMAN EPIDERMAL GROWTH
FACTOR RECEPTOR 2
ELEVATED IN 1 / 3 OF CLIENTS
WITH BREAST CANCER
HELPS GUIDE TREATMENT
AND DETERMINE PROGNOSIS
Chromogranin A= cGA
cGa produced by neuro endocrine tumors
-

Carcinoid neuroblastoma Small Cell Lung

, ,

Cancer
Carcinoid tumors are rare slow growing
, -

cancers that usually start in the lining of

the digestive tract or in the lungs
Thank You