Breast Self Examination.pptx

Breast Self Examination and management

1. Breast self examination

2. Overvie w : Introduction Purposes Timing Guidelines Procedure

3. Cont d … Results Precautions M e r i t Disadvantages Role of nurses Research article

4. Introduction A breast self examination is a technique which allows an individual to examine his/her breast tissue for any physical or visual changes. It is often used as an early detection method for breast cancer. Both men and women should perform a BSE at least once each month beginning at age 20.

5. Cont d .. A breast self-exam is a way anyone can check own breasts for any changes such as lumps or thickenings that could be symptomatic of breast cancer. This process includes looking and feeling each breast, and reporting anything unusual to the doctor.

6. Cont d .. When breast cancer is detected in its early stages, chances of surviving the disease are greatly improved. In fact, women who perform regular breast self exam find 90% of all breast masses.

7. Definit i on A procedure in which women examine her breasts and their accessory structure for evidence of change that could indicate a benign or malignant process.

8. Purposes To find any changes that may occur. To detect breast lumps. To improve quality of life. To cost benefit.

9. T iming of BSE Beginning at the age of 20years or after onset of menarche. The BSE is usually performed within 7-10 days after the first day of the menstrual cycle, when the breasts are smallest and cyclic nodularity is least apparent.

10. Cont d … If her periods arenot regular, a BSE should be done on the same day every month. BSE should be regularly performed by every woman such as pregnant, breast feeding and menopausal woman, or have breast implants.

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17. Guidelines for Breast self Examination The national comprehensive cancer network screening guidelines suggest that women between 25 and 40 years old who are asymptomatic and have no special risk factors for breast cancer undergo a clinical breast exam every 1 to 3 years.

18. Contd…. Women older than age 50, women with increased risk factors for breast cancer, history of breast cancer, and/or symptomatic patients are recommended to receive more frequently clinical breast exams.

19. Step 1 a. Begin by looking at breasts in the mirror with shoulders straight and arms on the hips. without vis i ble Look for: Breasts: size, shape and color B r e a sts : e v en l y shaped distortion or swelling.

20. Cont d … Dimpling, puckering or bulging of the skin, A nipple that has changes position or become inverted (pushed inward instead of sticking out) Redness, soreness, rash or swelling If any changes, consult doctor.

21. Cont d .. Step 2: Place the hand at the back of the head. Lo o k for an y c h anges i n s ize, shape, positi o n or any changes to the skin of the breasts. Check for any skin puckering, dimpling, sores or discoloration.

22. Cont d … Inspect nipples and look for any sores, peeling or change in the direction of the nipples and other unusual changes.

23. Cont d … Step 3: Next, place hands on hips and press down firmly to tighten the chest muscles beneath the breast. Turn from side to side so, inspection of outer part of breast can be done.

24. Cont d … Step 4: Bend forward toward the mirror. Roll shoulders and elbows forward to tighten the chest muscles. Breasts will fall forward.

25. Cont d … Look for any changes in the shape or contour of breast. Step 1 to St e p 4 in v olves in s pe c t i on of breast.

26. Co n td.. Step 5: Palpation of the breast. Pal p ate the breas t s with pads of t he f i ngers t o feel for lumps or soreness. Several com m on patte r ns, which are de s i gned to ensure complete coverage. The ve r tical str i p patte r n i nvo l ves m ov i ng t h e fingers up and down over breast.

27. Cont d … The pie-wedge pattern starts at the nipple and moves outward. The circular pattern involves moving the fingers in concentric circles from the nipple outward.

28. Cont d .. Step 6: Palpation of nipple Check nipples for discharge (fluid). Place thumb and forefinger on the tissue surrounding the nipple and put outward toward the end of the nipple. Look for any discharge. Repeat on other breasts.

29. Cont d … Step 7: Palpation of breast while lying down. Lie down and place a small pillow or folded towel under right shoulder. Put right hand behind head. Place l eft hand o n t he u p p e r po r t i on o f right breast with finger together.

30. Cont d .. Do the circular motions. When the circle is complete, move in one inch toward the nipple and complete another circle. Continue in this pattern until felt the entire breast. Make sure to feel the upper outer areas that extend into armpits.

31. Cont d … After examination if find a lump See t h e he a l t h care pr o v i der i f discover any new changes.

32. Normal and abnormal results Many women find lumps or changes in their breasts, since some of these are normal changes that occur at various points in the menstrual cycles. Finding a change or lump in breast is not a reason to panic.

33. Cont d … Breasts often feel different in different places. A firm ridge along the bottom of each breast is normal, for instances. The l ook and fe e l o f breasts will c h ange as age increases.

34. When to contact A hard lump or knot near underarm. Changes in the way breasts look or feel, including thickening or prominent fullness that is different from the surrounding tissue. Dimples, puckers, bulges or ridges on the skin of breast.

35. Cont d … A re c ent c h a n ge i n a nipp l e t o b e c o me ouched in (inverted) instead of sticking out. Redness, warmth, swelling or pain. Itching, scales, sores or rashes. Bloody nipple discharge.

36. Precautions for BSE When examin i ng the breast, so m e general tips to keep in mind include: 1. Use the pads of fingers: Use of the pads, not the very tips of three middle fingers for exam. If any difficulty feeling with finger pads, use another part of hand that is more sensitive, such as palm or the backs of the fingers.

37. 2. Use different pressure levels: The goal is to feel different depths of breast by using different levels of pressure to feel all the breast tissue. Use light pressure to feel the tissue closet to the skin, medium pressure to feel a little deeper, and firm pressure to feel the tissue closet to the chest and ribs.

38. Cont d … B e sure t o use eac h pr e ssu r e l evel be f ore moving onto the next spot. If not sure how hard to press, talk with doctor or nurse.

39. 3. Take time: Donot rush. It may take se v er a l minutes t o c a reful l y examine breasts.

40. 4. Follow a pattern: Use a methodical tec h nique t o ensure the examination of entire breast. For instance, imagine the face of a clock over the breast. Be g i n n e ar coll a r bone and e x am i ne that section, moving finger toward nipple.

41. M e r i t Women can use BSE to assess their breasts. When they perform BSE properly and regularly, they can notice any changes in their breasts and seek further evaluation. Reduces the risk of breast cancer by early detection and treatment.

42. Cont d … Allows women to know the health of their breasts. Pr o vides e a ch wo m an knowledge o f what their own breast tissue feels like.

43. Cont d … Is a non invasive, simple procedure. Can detect breast cancer at an earlier stage than if a woman does not perform BSE. Awareness of breast anatomy.

44. B a r r i er s Fear and anxiety about what may be found during the exam. False-positive (False alarm) finding, which is a result that indicates that a condition is present (i.e. breast lump or possible cancer) when it is not (i.e. non-cancerous breast tissue)

45. Role of Nurse in BSE Assessing a patient’s compliance of performing self-breast examinations should entail not only if she merely does the examination, but when she is doing them and how she is doing them.

46. Cont d … As the primary nurse, if we are not educated on proper techniques of a self-breast examination, it is our responsibility to provide a resource to the patient that can properly demonstrate this.

47. Cont d .. Women should be educated on the proper way to do a self-breast examination. Women should be told about the ideal time of month to perform examination. This will allow women to know what is normal breast tissue and what is abnormal to aide in early detection of breast cancer.

48. References Book References Prasai S. Durga. Gynaecology Nursing. 2 nd Edition. Jamal,kathmandu: Medhavi Publication; 2018:105-110 Brunner and Suddarth’s. Textbook of Medical- Surgical Nursing. 13 th edition. New Delhi: Wolters Kluwer;2016:359-373 Sharma Sarojini. Oncology Nursing Manual. 4 th Edition. Bharatpur, Chitwan:BP Koirala Memorial Cancer Hospital, Dec 2014: 15-18

49. Net References Henderson J A , F erquson T . Breast Ex a mination T echn i q u es . A vailable from (https: //ww w. ncbi.nlm.nih.gov/books/NBK459179) Accessed Date: 30 th Edition, 2019 Myocli n i c . Breast Self ex a m i na t i on for breast awareness . A vailable from (https: //ww w. mayoclinic.org/tests.procedure/breastexa minationabout/pac.20393237) Accessed Date: 30 th Nov 2019 Breast 360. Breast Self Examination. Available from (https://Breast360.org/topics/2015/02/03/BreastSelfExa mination_bsel) Accessed Date : 30 th Nov 2019

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