Breast examination is a physical examination of the breast, and screening of breast diseases, early detection, early diagnosis and early treatment, is very important in the treatment of breast disease prevention. Mainly through the visual inspection and palpation to check the shape of the breast, the surface of the breast skin, the condition of the nipple areola, breast lumps, nipple discharge, etc. Finally, do not forget the regional lymph node examination and systemic examination. Breast examination should first observe the development of the mammary gland. Whether the breasts on both sides are symmetrical, whether the nipples on both sides are similar, whether the nipples at the same level, whether there is a retraction depression; whether the nipple areola is erosive, how the color of the breast skin is, whether there is edema and orange peel-like changes, whether there is redness or the like Inflammatory, showing whether the superficial veins in the breast area are angry.Basic Information
Specialist classification: growth and development check classification: ultrasound
Applicable gender: whether men and women apply fasting: not fastingReminder: Requirements for inspection: Checking for relaxation, checking may cause physical and psychological burdens, should be actively faced, and actively cooperate with the inspection. Normal value
No abnormal lumps were found in the examination.Clinical significance
1. Breast medical examination
Mainly through the visual inspection and palpation to check the shape of the breast, the surface of the breast skin, the condition of the nipple areola, breast lumps, nipple discharge, etc. Finally, do not forget the regional lymph node examination and systemic examination.
(1) The shape of the breast needs to check whether the appearance, size and position of the breast are symmetrical.
(2) The condition of the skin surface of the breast needs to check the color of the skin of the breast and have no edema, rash, ulceration, superficial vein engorgement, skin wrinkles and orange peel-like changes.
(3) The nipple areola should be checked for abnormality, elevation, retraction, depression, erosion and desquamation of the nipple; whether the color of the areola is abnormal, or whether there is an eczema-like change.
(4) Breast lumps need to check the location, shape, size, number, texture, surface smoothness, mobility and tenderness of the breast lumps. It is mainly checked by palpation. In general, masses with multiple bilateral pains associated with periodic breast pain are more likely to be benign lesions; and unilateral single-shot painless masses may have malignant lesions.
(5) The nipple discharge situation needs to check whether the nipple has overflow, and check whether it is self-discharge or extrusion, unilateral or bilateral, and the characteristics of the discharge.
(6) Regional lymph node condition and systemic condition Because breast cancer is often prone to lymph node metastasis in the armpit and supraclavicular region, the physical examination of the breast should routinely check the size, texture and activity of the lymph nodes in the above region.
2. Breast cancer screening
(1) mammography x-ray photography
Early breast cancer with clinically undetectable mass can be observed due to mammography.
B-ultrasound is also one of the commonly used examination methods for breast diseases, and can be used in combination with mammography. The method has the characteristics of being non-toxic, harmless and simple, and can identify breast diseases such as benign, malignant, cystic, solid and hyperplastic. However, ultrasound examinations sometimes have false positives, and it is difficult to diagnose a mass less than 1 cm.
(3) Breast tube examination
If the patient has a nipple discharge (flowing water), a breast ductoscopy can be used and most patients can be diagnosed. The method has a high diagnosis rate and little pain, but before the examination, hepatitis B surface antigen (hbsag) should be examined, and HIV (hiv) should be tested if necessary to prevent cross-infection.
(4) Pathological examination
Pathological examination is an essential basis for clinical diagnosis of breast cancer. It is mainly used for mammography and b-ultrasound suspicious people. Pathological examinations include both cytopathological examinations and histopathological examinations. Cytopathological examination has less damage, less pain, faster speed and convenience. Histopathological examination can not only be qualitative, but also determine the type of tumor before surgery, providing a reference for treatment. A new generation of tissue puncturing equipment can even suck (cut) away from early cancerous foci and avoid surgery.
People who need to be examined: people whose breasts can reach a mass, middle-aged and elderly women.Precautions
Forbidden before examination: Pay attention to the particularity of the history of breast disease, and various diseases may have an impact on the examination.
Requirements for inspection: Checking for relaxation, checking may cause physical and psychological burdens, should be actively faced, and actively cooperate with the inspection. The examination needs to expose the breasts, so the upper body should wear clothes that are easy to take off. For patients with newly diagnosed breast diseases, if they are not satisfied with the physical examination, they can cooperate with the patients and check again at the best physical examination time, such as on the 10th day of the menstrual cycle to avoid physiological changes in the breast during the menstrual cycle. The interference caused. The examination should be adequately illuminated to avoid neglecting signs caused by minor lesions.Inspection process
1, the correct breast examination when touching the palms should be flat and four fingers together, with the most sensitive index finger, middle finger, ring finger end fingertips in order to gently lick the outer upper and lower parts of the breast, the inner and lower, the inner upper area is the middle of the breast Nipple and areola area. Do not grasp the breast tissue with your fingers during the examination, otherwise the grasped breast tissue will be mistaken for a lump.
2, from the sitting position, any nipple inversion skin depression structure shape is a clue to deep breast cancer. If the patient clapped his hands on his head to contract the chest muscles, the above signs will appear. When the woman is in a sitting position, it is easy to check the upper and lower clavicle lymph nodes. Finally, you need to sit and palpate, and touch the area under the nipple with your fingers.
3, take the supine position, for a wider area of palpation. A pillow is placed under the breast on the same side, and the hand on the same side is lifted over the head so that the breast is evenly spread on the chest wall, so that the finger can easily reach the deep part. The palpation of the middle finger of the middle finger of the index finger is used instead of the fingertip for palpation. The way of palpation should be rotated from the nipple to the lateral direction. It is especially important to check the breast that extends to the armpit.
4, breast examination should first observe the development of the breast. Whether the breasts on both sides are symmetrical, whether the nipples on both sides are similar, whether the nipples at the same level, whether there is a retraction depression; whether the nipple areola is erosive, how the color of the breast skin is, whether there is edema and orange peel-like changes, whether there is redness or the like Inflammatory, showing whether the superficial veins in the breast area are angry.Not suitable for the crowd
Inappropriate people: lactating women.Adverse reactions and risks
No related complications and hazards.