Breast and draining lymph nodes

In this case of breast and drainage lymph nodes, a proper breast examination is needed. The normal breast examination time for women should be every six months or a year. No matter how young a woman is, as long as she has reached puberty, she needs to have a breast examination, because breast examination can clearly determine the early symptoms of breast disease, so as to avoid worsening of the disease in the later stage.

A breast physical examination mainly uses visual inspection and palpation to check the breast morphology, the condition of the breast skin surface, the condition of the nipple and areola, breast lumps, nipple discharge, etc. Finally, don't forget the regional lymph node examination and systemic examination.

(1) Breast morphology: Check whether the appearance, size and position of the breasts are symmetrical.

(2) Condition of the breast skin surface: Check the color of the breast skin and the presence of edema, rash, ulceration, engorged superficial veins, skin wrinkles, and orange peel-like changes.

(3) Condition of the nipple and areola: Check whether the nipple is deformed, elevated, retracted, sunken, eroded or desquamated; check whether the areola has abnormal color or eczema-like changes.

(4) Breast lumps: The location, shape, size, number, texture, surface smoothness, mobility, and tenderness of the breast lumps need to be checked. The examination is mainly done by palpation. Generally speaking, multiple lumps on both sides accompanied by cyclical mastalgia are more likely to be benign lesions, while single unilateral painless lumps may be malignant lesions.

(5) Nipple discharge: Check whether there is any nipple discharge, and check in detail whether it is spontaneous discharge or after squeezing, whether it is unilateral or bilateral, and the nature of the discharge.

(6) Regional lymph node status and general condition: Since breast cancer is prone to metastasis to the axillary and supraclavicular lymph nodes, physical examination of the breast should routinely check the size, texture, and mobility of the lymph nodes in the above areas.

Inspection method: With the upper body completely naked, stand upright in front of a mirror, raise both hands and then put them down to compare and observe the breasts on both sides to see if they are symmetrical, if there are any changes in size, if there are any swelling, bulges or sunken areas, if there are any changes in skin color, if there are any ulcers, and if the breasts on both sides are on the same level. When checking, put your fingers together and touch the breast with the fingertips. Choose light, medium, or heavy strength for palpation. Remember not to pinch or grab the breast with your hands. Generally, use your left hand to check the right breast and your right hand to check the left breast. When checking the axillary lymph nodes, keep your hands at a flat angle. Do not lift or grab the axillary tissue or skin. If you find any abnormalities, you should seek medical attention in time.

The specific steps are as follows:

1. The correct way to examine and touch the breasts is to stretch out your palm flat with four fingers together, and use the most sensitive index finger, middle finger, and ring finger to gently touch the upper and outer lower, lower and inner upper areas of the breast in order, and finally the nipple and areola area in the middle of the breast. During the examination, do not pinch the breast tissue with your fingers, otherwise you will mistake the pinched breast tissue for a lump.

2. Starting from the sitting position, any inversion of the nipple, skin depression, or abnormal structure or shape are clues to cancer deep in the breast. The above signs will appear if the patient claps his hands above his head to contract his pectoral muscles. It is easier to examine the lymph nodes above and below the clavicle and under the arms when women are in a sitting position. Finally, palpation is performed while you are sitting, using your fingers together to feel the area under the nipple.

3. Lie on your back and palpate a wider area. Place a pillow under the ipsilateral breast and raise the ipsilateral hand above the head so that the breast is evenly spread on the chest wall, making it easier for the fingers to touch deeper areas. Use the palm surface of the index, middle and ring fingers rather than the fingertips for palpation. The palpation should be done in a circular motion from the nipple to the outside. It is especially important to examine the breast that extends into the armpit.

4. Breast examination should first observe the development of the breast. Whether the breasts are symmetrical in size, whether the nipples on both sides are similar, whether they are on the same level, whether the nipples are retracted and sunken; whether the nipples and areola are eroded, what is the color of the breast skin, whether there is edema and orange peel-like changes, whether there is redness and swelling and other inflammation, whether the superficial veins in the breast area are dilated, etc.