The diagnosis of breast touching point is to understand whether the breast mass and the nature of mass; regional lymph node enlargement. When palpation in patients with a doctor sat in the lateral, or Zhu Huanzhe supine, shoulder Xiadian a small pillow. Palpable breast check the inside of a half Zhu Huanzhe Arm Lift, lay hands on the outer half-time check beside Zhu Huanzhe sagging upper arm.
The method is based on the right hand under the breast on the inside and outside (including the tail), outside, the inside, the central (nipple and areola) progressive press gently lay hands on the breast. Jiyong finger Zhuanie breast, so as to avoid the normal glandular tissue that the breast lumps. Small, easily palpable mass in the central area that can hold up his left hand to the breast with his right hand lay hands on the investigation, relatively easy to find. Often a result of the lower part of breast lumps breast ptosis was concealed; can hold up the breast or arm is raised so that the patient supine and then proceed to lay hands on investigation. Deep palpable breast lumps unable to figure out if it can be will urge the patient bend forward and then lay hands on investigation of the upper body. Breast palpation, you must check palpable regional lymph nodes.
The order of the diagnosis of breast touching
(1) breast lumps: the former is derived from the breast lump chest, they should first pay attention identified. From the anterior chest wall of the mass (such as rib cartilage inflammation, rib tumor, chest wall tuberculosis, etc.) over the breast when the breast lump is not due to changes in the location of mobile. When the palpable breast lump to a specific attention should be given its size, location, number, texture, whether it has tenderness, appearance is neat, edge is clear, the surface is smooth, and the surrounding tissue such as skin, pectoralis major, serratus anterior muscle, etc. whether the adhesion and so on. Gentle Nianqi mass surface skin, the skin can be informed whether the mass availability of adhesion; if there is no inflammation of adhesion performance of the particular should be alert to the possibility of breast cancer. Check whether the palpable mass deep tissue adhesion, the first respectively in the horizontal direction and vertical direction of test mass activity, and then use pectoralis major contraction test: Zhu Huanzhe to forced limb akimbo in order to stress pectoralis major, and then for the same测试. Comparing the two tests, the surface of tumor activity in the pectoralis major, you can learn whether the pectoralis major fascia mass, pectoral muscle adhesion. Ammon under investigation outer quadrant breast lump as it might have exceeded the lower edge of pectoralis major, serratus anterior muscle contraction can be used test: Zhu Huanzhe limb force will push examiner shoulder to tense serratus anterior, comparison with the before.
(2) axillary lymph nodes: In addition to acute and chronic inflammation, in general, benign breast disease does not cause axillary lymph nodes. Inspection group of axillary lymph nodes, doctors faced with patients to check the right hand lay hands on patients Zuoye in order to check the left hand in patients with palpable right axillary. Zhu Huanzhe upper side of the first lift check, check by hand stretching from armpit to the highest place, that is, group of axillary lymph node pointed fingers palm side facing the patient chest wall, let the patient lay down their upper shelving in the examiner’s forearm, followed by palpable Cha axillary roof, anterior axillary, posterior axillary, medial latissimus dorsi muscle before. Whether the subclavian and supraclavicular enlarged lymph node. Cha Bi affected side, but also check the opposite side. Palpable to the enlarged lymph nodes must pay attention to its location, number, size, texture, tenderness and mobility degree.
