Whether the size is symmetrical, whether the position is normal, and whether there is sagging. Generally, the breasts of adult women are hemispherical, protruding from the 2nd-3rd ribs to the 6th-7th ribs on both sides of the chest, with symmetrical size and shape. If one breast is swollen, pay attention to whether it is breast inflammation, milk deposition, abscess, etc. If a certain part of the breast bulges, most of them are breast lumps and boils in the superficial part of the breast. The morphological changes of breast are the most obvious, so we should always pay attention to observation so as to find the lesions as soon as possible and get treatment in time. First, in a bright room, take off your coat and observe your breasts. Carefully observe with a mirror whether there is any color change on the surface of the breast, whether there is any orange peel-like change on the skin, whether the breasts on both sides are symmetrical in size and whether the position is normal. There are mainly three kinds of breast skin changes: skin color changes, edema and the relationship between skin and mass (including adhesion, retraction, depression and so on). ). Acute mastitis, if the skin color is not red, is often milk stagnation mastitis or catarrhal mastitis caused by mammary duct obstruction; If the skin is red and hot, it is mostly caused by Staphylococcus aureus infection; Plasma cell mastitis skin is red but not fresh, inflammatory breast cancer skin can also be congested and red, but its color is often a special violet. Breast skin edema, that is, degeneration of orange skin or pig skin, is one of the signs of breast cancer skin lesions. Plasma cell mastitis can also cause skin edema, so it is often misdiagnosed as breast cancer. Raise your arms and look at both sides of your breasts in the mirror. If there is a lump in the breast under the skin change, the skin adheres to the lump and the skin shrinks and sags, we should pay attention to and consider the possibility of breast cancer. In short, it is also an effective method to observe and identify various breast diseases through skin changes.
Many breast diseases are complicated with no breast's skin changes, but acute and chronic inflammation of the breast, subcutaneous fat bleeding after breast trauma and inflammatory breast cancer have breast skin changes. Lean forward slightly, carefully observe whether there are fine wrinkles in the breast skin, whether the nipple is invaginated or has a tendency to invaginate, whether the outer edge of the breast has changed, and so on.
touch
Raise your left hand to the back of your head, check the left breast with your right hand, and press the breast with your fingertips to feel if there is a lump. Do a circumferential examination clockwise from the nipple and press outward gradually, about three or four times, until all breasts are examined. Check the right breast in the same way.
Attention should be paid to the following points when palpating the breast:
(1) Location of the tumor: According to statistics, 60% of breast cancer occurred in the external superior septum, areola 12%, internal superior septum 12%, external inferior septum 10% and internal inferior septum 6%. Lateral superior subarea is a common site of breast cancer. In addition, some patients have very small breast lumps, which may be missed by general examination methods. In this case, if you check it again according to the patient's own habitual posture and the exact position displayed, you may find something, so pay attention to this feature when touching.
(2) The size of the mass: measure the diameter and radius of the mass. The specific date and exact size of the tumor should be recorded, which is helpful to understand the nature and growth rate of the tumor. It is worth noting that some patients' tumors are located deep outside the breast, and the tumors are relatively small. Only 1 can't get the correct conclusion in the exam. After reading, you can touch your breasts with your fingertips. At this point, lie flat, relax and put your left hand behind your head. Put your left hand on the back of your head, check your left breast and armpit with your right hand, and then touch the top of armpit and clavicle to see if there is a lump. If there is, it depends on whether it is swollen lymph nodes.
(3) Tumor activity: The activity of breast tumor is a very important basis for judging the nature of tumor. Benign tumors have high fluidity; Malignant tumor is not only unclear, but also relatively fixed. If the patient's hands are akimbo, the tumor activity on the breast is limited, indicating that the tumor has attached to the pectoralis major muscle. If the tumor is fixed, it means that the tumor has involved the pectoralis major.
(4) Hardness of tumor: Touching the hardness of tumor is helpful to judge the nature of tumor. Breast cancer is generally hard, abscesses and cystic lesions have a sense of elasticity or fluctuation.
(5) Number of lumps: How many lumps should we pay attention to during palpation? Single shot or multiple shots? Unilateral breast or bilateral breast? Generally speaking, breast physiological cystic hyperplasia and breast fibroadenoma can often be multiple or bilateral; However, breast cancer is only in one breast, especially in the upper lateral region, and there are few patients with cancer in both breasts. lie down
Lie flat, put a pillow under your right shoulder, bend your right hand under your head, and repeat the "touch" method to check your right chest. Put your right hand on the back of your head, and touch the right breast with your left finger and palm. Be careful not to pinch the breast by hand, so as not to mistake the normal breast tissue for a breast lump. Gently press, touch and slide with the palm of your hand in the following order: upper inner side → upper outer side → lower outer side → lower inner side → middle part → armpit. turn around
In addition to the breast, check whether there is lymphadenopathy under the armpit, and finally press the nipple with your thumb and forefinger to pay attention to whether there is abnormal secretion. Gently press the areola with your thumb and forefinger, and then gently rub the nipple to see if there is abnormal secretion. Through breast self-examination, we often find some subtle changes, such as small lumps, swelling, scars, red spots and so on. Some are normal phenomena. Once you find breast changes, such as obvious skin vessels, wrinkles, nipple discharge and even bloody secretions, you should see a doctor as soon as possible. How often should I check my breasts? Gynecologists believe that it is better to check at least once every quarter (3 months), and it is better to do self-examination once a month. The best time for breast examination is within 7- 10 days after menstruation.