Breast Assesement
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Transcript of Breast Assesement
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7/25/2019 Breast Assesement
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Assessment of BreastDr. Muhamad Taufiqy Setyabudi, SpOG
RSUD Tugurejo FK U!MUS Semara"g
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Anatomy of the breast
Composed of :
Mu#$%e#
&igame"t# G%a"du%ar ti##ue
Fatty ti##ue &ymphati$ ti##ue
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Assessing: Subjective Data
'i#tory of (rea#t Di#ea#e)Surgery &ump# or thi$*e"i"g Di#$harge)Ra#h S+e%%i"g)Trauma
ai" Doe# pt. perform S(-Se%f (rea#t -/am0
mo"th%y1
Date of %a#t $%i"i$a% brea#t e/am 2(-0 Date of %a#t mammogram3/i%%ary te"der"e##, %ump# #+e%%i"g, ra#h
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3##e##i"g (rea#t 2a"$er Ri#*
-/ami"er mu#t a#* fo$u#ed que#tio"# regardi"g
ri#* fa$tor#4
Fami%y hi#tory4 5#t degree re%ati6e#-#troge" e/po#ure4 3ge o"#et of me"#e# ) 3ge
me"opau#e
Ob#tetri$
hi#tory ) U#e of 'RTer#o"a% habit#4 3%$oho% ) Dietary Fat ) -/er$i#e
-6er te#ted for ge"e mutatio"4 (R235) (R237
3ge4 O6er 89 :; ri#*
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Assessing:Objective Data
Inspection< patie"t #itti"g, di#robedto +ai#t
ote #ymmetry, #i=e a"d #hape
S*i" "orma%%y #mooth >e6e" i" $o%or. Ob#er6e the a/i%%ary a"d #upra
$%a6i$u%ar area# for a"y bu%gi"g,
di#$o%oratio" or edema
ipp%e#< #ymmetri$a%1 F%at1 !"6erted1
Di#$harge1 (%eedi"g1
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Screen for Retraction
?hi%e patie"t i# #itti"g
3#* patie"t to4
&ift arm# #%o+%y abo6e head. (othbrea#t #hou%d mo6e up #ymmetri$a%%y
u#h ha"d# i"to hip.
u#h pa%m# together &ea" for+ard.
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Inspect and Papate A!iae
?hi%e patie"t i# #itti"g, %ift a"d #upport thearm #o patie"t@# mu#$%e# are re%a/ed
U#e the right ha"d to pa%pate %eft a/i%%ae
Rea$h fi"ger# high i"to a/i%%ae Mo6e fi"ger# firm%y do+" i" four
dire$tio"#4
Do+" the $he#t +a%%, a%o"g the a"terior a"d
po#terior border# of a/i%%ae a"d arou"d the
i""er a#pe$t of the arm
Mo6e arm through ROM to ha6e a$$e## to
area#.
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Breast Papation
Supi"e po#itio" +ith #ma%% pad)pi%%o+u"der #ide to be pa%pated
3rm rai#ed o6er head
U#e pad# of fi"ger# a"d ma*e ge"t%erotary mo6eme"t o" brea#t
U#e a patter" of $o"$e"tri$ $ir$%e# or
%atera%%y, %i*e #po*e# of +hee%.
a%pate a%% area# of brea#t, $%o$*+i#e
fa#hio"
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Bimanua Breast Papation
For pe"du%ou# brea#t#
atie"t #itti"g, %ea"i"g for+ard
Support i"ferior part of brea#t +itho"e ha"d.
U#e other ha"d to pa%pate brea#t
ti##ue agai"#t #upporti"g ha"d.
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"!amination of #ippes
erformed after brea#t pa%patio".
a%pate "ipp%e, "oti"g a"y i"duratio"#or ma##.
U#e thumb a"d forefi"ger to app%y
ge"t%e pre##ure to "ote a"ydi#$harge.
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ASS"SS$"#% of Breast &umps
&o$atio"< u#e brea#t a# $%o$* fa$e tode#$ribe di#ta"$e from "ipp%e i"
$e"timeter# u#e diagram to %o$ate0.
Si=e< i" $e"timeter# Shape
2o"#i#te"$y
Mo6ab%e
Te"der"e##
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2ompari#o" of (rea#t &ump#
Benign Breast Disease
Mu%tip%e or #i"g%e
Rubbery te/ture
Mobi%e ) #%ippery
Regu%ar border#
Te"der"e## $y$%i$0
o retra$tio" May i"$rea#e)de$rea#e
i" #i=e rapid%y
Cancer
U"i%atera%
Firm te/ture
Fi/ed firm%y
!rregu%ar border
U#ua%%y pai"%e##
U#ua%%y +)retra$tio" Gro+# $o"#ta"t%y
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%eaching SB"
3##i#t patie"t to e#tab%i#h a #$hedu%e
Regu%ar mo"th%y e/am#
Majority of +ome" "e6er get brea#t$a"$er, majority of %ump# are be"ig"
-ar%y dete$tio" i# importa"t.
!" "o"
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Sef Breast "!am
Tea$hi"g po#itio"#4 5. Sta"di"g i" fro"t of mirror
7. !" the #ho+er #oap a"d +ater
a##i#t pa%patio" B. Supi"e
Keep tea$hi"g #imp%e
Demo"#trate to patie"t a"d u#e retur"
demo"#tratio"
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%he $ae Breast
-/ami"atio" $a" be abbre6iated but"ot omitted.
!"#pe$t the $he#t +a%% "oti"g #*i"
#urfa$e a"d a"y %ump# or #+e%%i"g. a%pate "ipp%e area for %ump# or
e"%argeme"t.
orma% ma%e brea#t ha# a f%at di#$ ofu"de6e%oped brea#t ti##ue be"eaththe "ipp%e. Shou%d be e6e" +ith "o
"odu%e#.
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Documentation: 'emae
S< De"ie# brea#t pai", %ump,di#$harge, ra#h, #+e%%i"g, trauma.De"ie# pa#t hi#tory of brea#t di#ea#e
or #urgery. State# perform# mo"th%ybrea#t e/am#.
O< !"#pe$tio"4 (rea#t# #ymmetri$.
S*i" #mooth +ith e6e" $o%or. odimp%i"g or retra$tio" e%i$ited. o"ipp%e di#$harge. o %e#io"#.
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Documentation: 'emae
A< 'ea%thy brea#t# bi%atera%%y +ith "o
S)S of ab"orma%itie#
P< Rei"for$e (S- patie"t perform#
(S- mo"th%y0, fo%%o+ up +ith MD for
2(- > mammogram
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Summary
3##e##i"g the brea#t i"$%ude#4
Ta*e i"to a$$ou"t de6e%opme"ta%
%e6e% Rememberi"g to a##e## both fema%e#
a"d ma%e#
!"#pe$ti"g > pa%pati"gbrea#t#,"ipp%e#, %ymph "ode# a"da/i%%ary
Tea$hi"g (S-