OB CH: 6-8
BREAST DISORDERS
Fibrocystic breast changes
This is a benign breast condition that commonly causes:
● breast tenderness or pain
● lumpiness
● cystic changes
● symptoms that may worsen before menstruation
Key things to remember
● Often painful
● Usually feels lumpy or rope-like
● Not the same as breast cancer
● Severe cases may be treated with tamoxifen or danazol
● Penicillin is not a treatment
Teaching
● decrease caffeine
● wear a supportive bra
● monitor for any new changes
● report anything suspicious
NCLEX tip
If the stem describes painful, cyclic, lumpy breasts, think fibrocystic changes, not cancer.
Benign vs malignant breast masses
Benign breast mass
Usually:
, ● more mobile
● well-defined
● no skin dimpling
● not fixed to chest wall
Malignant breast mass
Usually:
● hard
● irregular
● fixed
● may cause dimpling
● may cause nipple retraction
● often painless, especially early
Very high-yield clue
Nipple retraction is a classic sign of breast cancer.
Absence of dimpling leans more benign.
Easy memory
Cancer pulls and sticks
● pulls the nipple inward
● sticks to surrounding tissue
● causes dimpling
Duct ectasia
This can present with:
● nipple discharge
● redness below the areola
● swelling
● tortuous tubular swelling under the nipple area
NCLEX clue
If the stem talks about nipple discharge plus red/swollen tissue beneath the areola, think duct
ectasia.
, Clinical breast exam
The nurse should:
1. inspect first
2. then palpate
Why this matters
You always look before you touch so you can notice:
● symmetry
● skin changes
● retraction
● dimpling
● contour abnormalities
Important technique
For breast palpation or self-exam:
● use the finger pads of the 3 middle fingers
● include the axillary area
NCLEX trap
A patient saying “I don’t need to check under my arm if my breast feels fine” is wrong.
Axillary nodes matter.
Breast self-awareness
Current teaching emphasizes breast awareness:
● know what is normal for your own breasts
● report changes promptly
This is more important than doing a rigid ritual without understanding what you are feeling for.
BREAST DISORDERS
Fibrocystic breast changes
This is a benign breast condition that commonly causes:
● breast tenderness or pain
● lumpiness
● cystic changes
● symptoms that may worsen before menstruation
Key things to remember
● Often painful
● Usually feels lumpy or rope-like
● Not the same as breast cancer
● Severe cases may be treated with tamoxifen or danazol
● Penicillin is not a treatment
Teaching
● decrease caffeine
● wear a supportive bra
● monitor for any new changes
● report anything suspicious
NCLEX tip
If the stem describes painful, cyclic, lumpy breasts, think fibrocystic changes, not cancer.
Benign vs malignant breast masses
Benign breast mass
Usually:
, ● more mobile
● well-defined
● no skin dimpling
● not fixed to chest wall
Malignant breast mass
Usually:
● hard
● irregular
● fixed
● may cause dimpling
● may cause nipple retraction
● often painless, especially early
Very high-yield clue
Nipple retraction is a classic sign of breast cancer.
Absence of dimpling leans more benign.
Easy memory
Cancer pulls and sticks
● pulls the nipple inward
● sticks to surrounding tissue
● causes dimpling
Duct ectasia
This can present with:
● nipple discharge
● redness below the areola
● swelling
● tortuous tubular swelling under the nipple area
NCLEX clue
If the stem talks about nipple discharge plus red/swollen tissue beneath the areola, think duct
ectasia.
, Clinical breast exam
The nurse should:
1. inspect first
2. then palpate
Why this matters
You always look before you touch so you can notice:
● symmetry
● skin changes
● retraction
● dimpling
● contour abnormalities
Important technique
For breast palpation or self-exam:
● use the finger pads of the 3 middle fingers
● include the axillary area
NCLEX trap
A patient saying “I don’t need to check under my arm if my breast feels fine” is wrong.
Axillary nodes matter.
Breast self-awareness
Current teaching emphasizes breast awareness:
● know what is normal for your own breasts
● report changes promptly
This is more important than doing a rigid ritual without understanding what you are feeling for.
