1
, -Colostrum (4thmonth) thick yellow protein rich
Cultural Considerations
-African-American girls begin puberty 1-1.5 years earlier than Caucasian
-Menses: African-American girls 8.87 years compared to 10 years for Caucasian
-Puberty began before 8 years highest in Hispanics
Breast Exam: Inspection
-Skin: color, texture, temperature, appearance, dimpling, nipple retraction
-One breast usually bigger than the other
-Supernumerary Nipples: normal variant
Supernumerary Nipples
-Normal variant along tract of mammary ridge
-3rd Nipple
Abnormalities
Peaucl’orange: porous, orange looking, big sign of breast cancer
Gynecomastia: enlargement of breasts (male) usually due to testosterone decrease from cirrhosis,
testicular tumor, DM, pituitary tumor, alcoholism, obesity
Risk Factors for Breast CA
-50 years or older
-BRCA 1 and 2 genes
-First degree relative
-Menstruation less than 12 yr
, -Menopause greater than 55 yr
-Never breast feed
-Nulliparity (never having a child) or first child greater than 30
Breast Abnormalities
Fibrocystic: (benign)
-20-35 “water balloons” that change size/shape with monthly hormones, can be painful
-Wear supportive bra
-Decrease caffeine, low fat diet, decrease smoking
Fibroadenoma (benign)
-Very common “lump” found in younger women 18-25, rapid growing “lump” firm,
smooth, painless, moveable-frequent biopsies
Mammary Duct Ectasia (benign)
-Ducts get wide and full of old cells, dried colostrum-pain, hard lump, with pasty colored
discharge, often nipple retraction
Mastitis
-Infection often after/while breastfeeding, hard, hot, red, lump, pain, fever
Cancer
-Pucker, pull, skin change, discharge
-Can be contained or spreading
Intraductal Papilloma
-Starts in duct and moves outward
-Blood tinged discharge
Paget’s
-Skin changes with scaling, redness, pain, nipple changes, from inside to out, length of
breast, malignant
Female Reproductive System
External Genitalia
-Mons Pubis: adipose tissue covering the symphysis (hair in mature female), protects
reproductive structures
-Clitoris: small, elongated mound of erectile tissue
-Labia: dual set of lip-like structures on either side
-Labia Majora: cover external genitalia
-Labia Minora: overlie the vaginal and urethral openings
Skene’s Gland: paraurethal gland
-Located posterior to urethral orifice
-Has higher pH value to decrease bacteria, cleans urethra
, -Colostrum (4thmonth) thick yellow protein rich
Cultural Considerations
-African-American girls begin puberty 1-1.5 years earlier than Caucasian
-Menses: African-American girls 8.87 years compared to 10 years for Caucasian
-Puberty began before 8 years highest in Hispanics
Breast Exam: Inspection
-Skin: color, texture, temperature, appearance, dimpling, nipple retraction
-One breast usually bigger than the other
-Supernumerary Nipples: normal variant
Supernumerary Nipples
-Normal variant along tract of mammary ridge
-3rd Nipple
Abnormalities
Peaucl’orange: porous, orange looking, big sign of breast cancer
Gynecomastia: enlargement of breasts (male) usually due to testosterone decrease from cirrhosis,
testicular tumor, DM, pituitary tumor, alcoholism, obesity
Risk Factors for Breast CA
-50 years or older
-BRCA 1 and 2 genes
-First degree relative
-Menstruation less than 12 yr
, -Menopause greater than 55 yr
-Never breast feed
-Nulliparity (never having a child) or first child greater than 30
Breast Abnormalities
Fibrocystic: (benign)
-20-35 “water balloons” that change size/shape with monthly hormones, can be painful
-Wear supportive bra
-Decrease caffeine, low fat diet, decrease smoking
Fibroadenoma (benign)
-Very common “lump” found in younger women 18-25, rapid growing “lump” firm,
smooth, painless, moveable-frequent biopsies
Mammary Duct Ectasia (benign)
-Ducts get wide and full of old cells, dried colostrum-pain, hard lump, with pasty colored
discharge, often nipple retraction
Mastitis
-Infection often after/while breastfeeding, hard, hot, red, lump, pain, fever
Cancer
-Pucker, pull, skin change, discharge
-Can be contained or spreading
Intraductal Papilloma
-Starts in duct and moves outward
-Blood tinged discharge
Paget’s
-Skin changes with scaling, redness, pain, nipple changes, from inside to out, length of
breast, malignant
Female Reproductive System
External Genitalia
-Mons Pubis: adipose tissue covering the symphysis (hair in mature female), protects
reproductive structures
-Clitoris: small, elongated mound of erectile tissue
-Labia: dual set of lip-like structures on either side
-Labia Majora: cover external genitalia
-Labia Minora: overlie the vaginal and urethral openings
Skene’s Gland: paraurethal gland
-Located posterior to urethral orifice
-Has higher pH value to decrease bacteria, cleans urethra
