FACTS & HINTS
High-Yield Facts
Clinical Points
Examination of the Breast
Clinically the breast is divided into quadrants:
UI: upper inner
UO: upper outer (includes axillary tail)
LI: lower inner
LO: lower outer
The breast is palpated in a circular fashion, beginning with the nipple and moving outward. The palpation should extend into the axilla to
palpate the axillary tails.
After palpation of one breast, the other should be palpated in the same way.
Examine the skin of the breast for a change in texture or dimpling (peau d'orange sign) and the nipple for retraction, since these signs may
indicate an underlying pathology.Pathology of the Breast
Fibroadenoma: benign tumor, usually a solid and solitary mass that moves easily under the skin. Often painless although sometimes
tender on palpation. More common in young women but can occur at any age.
Intraductal carcinoma or breast cancer: the commonest type of malignancy in women but can also occur in men. Approximately 50% of
cancers develop in the upper quadrant of the breast; metastases from these cancers often spread to the axillary lymph nodes. This
malignancy presents as a palpable mass that is hard, immobile and sometimes painful. Additional signs can include bloody or watery
nipple discharge if the larger ducts are involved.
Gynecomastia: enlargement of the breasts in males because of aging, drug treatment, and changes in the metabolism of sex hormones by
the liver.