Breast disorders are a widespread occurrence and can range from minor issues to severe malignant conditions. As always, if your patient presents with symptoms of breast disorders, you should start off by conducting a thorough Nursing Assessment. This will allow you to evaluate the patient’s situation from all perspectives.
Let’s start…
1. History
Knowing the patient’s medical, surgical and psychosocial history is the first step to start shaping the nursing diagnosis. As the nurse, you should ask your patient about the following:
Medical conditions
Previous surgeries (type and year)
Gynaecologic and Obstetric history
Fertility treatments
Medications (current and past)
Family history of medical conditions or cancer
Social habits (drinking, smoking or drugs)
Psychosocial state (occupation, living conditions)
2. Assessing the Symptoms of Breast Disorders
After having a clear picture of your patient’s situation, you can now move on to evaluate the patient’s symptoms. Start by asking your patient to describe what she has and if she can feel any ‘bulges’ (aka. masses).
Next ask her if she has experienced any pain, swelling, redness, or change in colour over her breasts. And lastly, ask the patient if she has seen any nipple discharge or inversion. (please keep in mind that the patient may be a male too ?)
3. Inspection for Breast Disorders
Now that you have an idea of what to expect, you can move on to conduct an inspection of your patient’s breast. Start by asking the patient if she feels comfortable to have the inspection done, or if she would like someone else to be in the room.
Having established a safe space, examine the following in comparison with both breasts:
Size
Symmetry
Colour
Venous pattern
Thickening
Oedema
Erythema
Nipple inversion, discharge or crust
Rashes
Ulcerations
Repeat the same inspection with the patient’s hand raised above the head and with the patient’s hands on her waist. Lastly, inspect the axillary and clavicular regions for any swelling, lesions or enlarged lymph nodes.
4. Palpation
The last step of the Nursing Assessment is to palpate the breasts. This allows you to identify any masses or tenderness of the breasts. Ask your patient to sit upright or lay down with a pillow under her shoulders.
Put your second, third and fourth finger together, and gently press on the breast with the ‘flat’ part of your fingertips. Move clockwise from the outer part towards the nipple to make sure that you cover all the breast areas. The same method is applied to palpate the clavicular and axillary regions.
5. Diagnostic Tests for Breast Disorders
Great! That is the full Nursing Assessment for patients presenting with Breast Disorders. The next step is to liaise with the medical team and help your patient attend any further diagnostic tests.
Usually, the medical team starts off by ordering Imaging tests such as a Mammogram, Ultrasound or MRI. If these tests indicate an abnormality, your patient will most likely get an appoint for a biopsy.
Did you find this article helpful? Make sure to read the whole study series on Breast Disorders, Breast Cancer and Mastectomy
Do you feel like giving up? Watch my YouTube Video about how I almost quit Nursing School