2-7

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2-7. BREAST EXAMINATION

Although breast cancer is a leading cause of cancer death in American women, breast cancer is a disease that can also occur in men. Unfortunately, the causes of breast cancer are not known, so it is not clear how this disease can be prevented. Breast cancer can often be treated successfully if it is detected early, before the cancer spreads.

a. The Male Breast. Although carcinoma of the male breast occurs infrequently (about one percent of all male cancer), it does occur. Men should, therefore, be examined for breast cancer regularly. Males are also afflicted with mastitis (inflammation of the breast) and gynecomastia (excessive development of the male breast).

b. The Female Breast. The best time for female breast examination is five to seven days after the menstrual cycle. At this time, the breasts are less likely to be swollen and are easier to examine.

c. Method of Examination. After you have taken the patient's history, have the patient disrobe to the waist and drape her. Inspect the breasts for symmetry, appearance, nipple retraction, and skin appearance and texture. Notice whether the skin dimples. Next, palpate the breasts. Using the palm of the hand, palpate all areas of breast tissue systematically. Note the elasticity of the nipple and areola (pigmented area around the nipple of the breast). Observe the breasts for the following: consistency, elasticity, absence or presence of tenderness, and masses.

d. Breast Self-Examination. Every woman's breasts are different. That is why it is so important to teach each woman how to examine her own breasts. Over ninety percent of all breast cancers are first discovered by women themselves. Women should know to look for changes such as these in their breasts: new wrinkling or dimpling of the skin; retraction of the nipple; puckering of the breast on one side; or a red scaling rash or sore on the nipple. Have any of these checked by a physician.

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