BREASTS AND LYMPHATIC

SYSTEM
Michaella Belarmino| Ethan Fortin| Radhia Julaili | Jillian Maravilla| Zahir Nain| Ericka Napao| Karla Yu
Group 2
 HISTORY OF PRESENT HEALTH
CONCERN

QUESTION RATIONALE/QUESTIONS

1. Do you have any lump or mass? Any thickening in or
near the breast or under your arm that persists through the
menstrual cycle?
2. Do you have any abnormalities in the skin of your
breasts? Is the nipple red, dimpled, puckered, scaly, or
inflamed?
Most lumps are not cancerous and there are numerous
reasons why breast lumps develop. Breast lumps may
develop in both males and females, but they are much
more common in females.
Causes of dermatitis such as eczema and sunburn can
cause changes in the breast. Skin changes in the breast
include puckering, rash, dimpling, redness, scaling,
thickening of the skin or the formation of pimples.
 HISTORY OF PRESENT HEALTH
CONCERN
QUESTION
3. Has your breast change its shape, size or are there any
discoloration that you had observed?
4. Do you have any nipple discharge? Do you feel any
pain or tenderness? Did you observe change in location of
one nipple points? Inversion or eversion of nipples?
RATIONALE/QUESTIONS
Cancer can result in many changes to your skin, not only
discoloration. The presence of cancerous cells in the
breast can manifest in the form of skin discoloration.
Breast asymmetry is very common and affects more than
half of all women.
A number of noncancerous conditions can cause nipple
discharge. Nipple discharge that contains pus may
indicate an infection in your breast also also known as
mastitis. The most common reason women experience
abnormal nipple discharge is Intraductal papilloma.
 PERSONAL HEALTH HISTORY
QUESTION
1. Have you had any past diagnoses of illnesses in your
breast and/or Lymphatic system?
2. Was medical consultation/help sought upon suspicion?
RATIONALE/QUESTIONS
Asking this question can help the nurse formulate a
nursing care plan with the knowledge of how long the
patient is diagnosed with the cancer. Patients who may
have been diagnosed recently might be in the early stages
of cancer where in operation may be possible.
There may already have been a proper diagnosis of the
patient's disease by a physician, and medications have
been provided in that instance. Taking note of the
consultation's in-between periods, on the other hand, may
indicate that the condition has already been treated or that
the existing condition has been aggravated due to the
patient's negligence.
 PERSONAL HEALTH HISTORY

QUESTION RATIONALE/QUESTIONS

3. Are you currently taking prescription drugs? If so, what
are these? Have you had any adverse effects when taking
some medications?
It is important to take note of the drugs that the patient
specifies as it helps the nurse to identify the exact nature
of the allergic reaction and can clearly show its direct
clinical implications. Furthermore, it is also important to
ask this question in order for the nurse to be aware of why
the patient is experiencing some symptoms and side
effects as a result of using the drug.
 FAMILY HISTORY

QUESTION RATIONALE/QUESTIONS

1. Do you have any history of cancer in your family? If
yes, can you specify what kind of cancer?
A mutated gene can be passed by parents to offspring. An
individual with a multiple family history of cancer has an
increased risk to inherit the same condition, as well as the
specificity of the type of cancer. Cancers like breast
cancer have a high genetic contribution.
 LIFESTYLE AND HEALTH PRACTICES
QUESTION
1. How often do you work out on a daily basis? What type
of exercise do you engage in? Do you engage in any
hobbies?
2. Do you have a balanced diet?
RATIONALE/QUESTIONS
Exercising has numerous advantages, including the ability
to prevent or lessen discomfort in the body and the ability
to promote long-term health. Regular exercise may help
women with breast cancer live longer lives. Outside
hobbies are enjoyable things to partake in, especially
when done with family.
A nutritious and healthy diet is necessary for optimal
health and nutrition. It guards against heart disease,
diabetes, and cancer, among other chronic non-
communicable diseases.
 LIFESTYLE AND HEALTH PRACTICES

QUESTION RATIONALE/QUESTIONS

3. How many hours of sleep do you get on a regular basis? Sleeping is a means to rest the body after a long day and
reclaim the energy we've expended. Sleep is required for
us to complete our daily responsibilities and improve our
physical well-being.
 TOOLS NEEDED FOR PHYSICAL
ASSESSMENT

Mammogram Metric Ruler Small Pillow

Gloves
INSPECTION

ASSESSMENT NORMAL ABNORMAL

Inspect the breasts for size, • Breast conical, symmetrical, or
symmetry, and shape in various slightly asymmetrical
positions: • Skin color lighter than in
exposed areas; no lesions,
redness, or edema; texture even.
• No dimpling or retraction
Inspect the nipples for size, shape, • Nipples everted, pointing in
color, position, direction, discharge, same direction, no discharge or
or lesions. lesions
• Change in breast size
• Edema and peau d’orange
(orange skin appearance)
• Erythema: Infection, abscess,
Presence of dimpling/puckering
• Lesions/asymmetrical increased
venous pattern
• Flattened or inverted nipples
• Presence of spontaneous
discharge
INSPECTION

ASSESSMENT NORMAL ABNORMAL

Inspect the axillae for color and • Skin intact. No presence of • Rashes/redness/unusual
lesions rashes or lesions. pigmentation
• Dark pigmentation/velvety skin
texture of axilla
PALPATION

ASSESSMENT NORMAL ABNORMAL

1. Palpate the axillary, No tenderness, masses, or nodules Tenderness, masses, or nodules

subclavicular, and • Palpable nodes: Infection or
supraclavicular lymph nodes metastatic disease.
while the client sits with the • Enlarged lymph nodes caused
arms abducted and supported by infection are usually tender;
on the nurse’s forearm. Use the those caused by malignancy are
flat surfaces of all fingertips to nontender.
palpate the four areas of the
axilla:
PALPATION

ASSESSMENT NORMAL ABNORMAL

2. Palpate the breast for masses,
tenderness, and any discharge
from the nipples. Palpation of
the breast is generally
performed while the client is
supine. Palpate the areolae and
the nipples for masses.
Compress each nipple to
determine the presence of any
discharge.
No tenderness, masses, nodules, or
nipple discharge
Tenderness, masses, nodules, or
nipple discharge
• Loss of elasticity may indicate
underlying malignancy.
• Bloody, purulent discharge:
Infection
• Serous, serosanguineous, or
bloody drainage: Intraductal
papilloma.
• Thick, gray drainage, fixation of
nipple: Ductal ectasia.
ABNORMALITIES
UPON INSPECTION

PEAU D’ORANGE
-“orange peel” or “orange
skin.”

• thick and pitted

 ABNORMALITIES
UPON INSPECTION

DIMPLING
ABNORMALITIES
UPON INSPECTION

PAGET’S DISEASE OF THE NIPPLE - is a rare condition associated

with breast cancer.
• Red, Scaly rash on the skin of the nipple and
areola
• Area is often sore and inflamed.
• It can be itchy or cause a burning sensation.
The nipple can sometimes be ulcerated
ABNORMALITIES
UPON INSPECTION

Retracted Breast Tissue – • Inverted Nipple

Risk factor for developing
breast cancer. Indicates
malignancy.

Retracted Nipple – A • Retracted Nipple

nipple that turns
inward instead of
outward; referred to as
an inverted nipple.
 ABNORMALITIES
UPON INSPECTION

MASTITIS
• Breast Swelling
• Thickening of breast tissue,
or a breast lump
• Skin - redness, often in a
wedge-shaped pattern
• Breast tenderness or warmth
to the touch
ABNORMALITIES
UPON PALPATION

CANCEROUS TUMORS - Breast cancer originates in your breast

tissue. It occurs when breast cells mutate and grow out of control,
creating a mass of tissue (tumor).
• Swelling of the breast
• Skin irritation or dimpling
• Breast pain
• Nipple pain or nipple turning inward
• Redness, scaliness, or thickening of the
nipple or breast skin
• A lump in the underarm area
ABNORMALITIES
UPON PALPATION
 ABNORMALITIES
UPON PALPATION

• Inflammatory Breast Cancer - People

with inflammatory breast cancer
usually notice redness, swelling, pitting
and dimpling of their breast skin.
ABNORMALITIES
UPON PALPATION

Fibroadenoma - Fibroadenomas are common, benign (non-cancerous)

breast tumors made up of both glandular tissue and stromal (connective)
tissue.
• Round with distinct, smooth
borders
• Easily moved
• Firm or rubbery
• Painless
ABNORMALITIES
UPON PALPATION

BENIGN BREAST DISEASE

• Breast cysts - Up to a quarter of breast lumps are fluid-

filled cysts. Breast cysts can be tender and lumpy, but they
don’t make you more prone to cancer.
ABNORMALITIES
UPON PALPATION

• Smooth, easily moved lump

• Breast tenderness in the area of the
breast lump
• An increase in breast lump size and
breast tenderness just before your
period
• A decrease in breast lump size and
resolution of other symptoms after
your period
References

• https://my.clevelandclinic.org/health/diseases/3986-breast-cancer

• https://my.clevelandclinic.org/health/articles/6270-benign-breast-disease

• https://www.cancer.org/cancer/breast-cancer/non-cancerous-breast-conditions/fibr
oadenomas-of-the-breast.html#:~:text=Fibroadenomas%20are%20common%2C
%20benign%20(non,a%20woman%20goes%20through%20menopause
.

• Dillon, P. Nursing Health Assessment: A Critical Thinking, Case Studies

Approach. Edition 2.