Fundamentals of Nursing Q 228
Beginning in their 20s, women should be told about the benefits and limitations of breast self-exam (BSE). Which scientific rationale should the nurse remember when performing a breast examination on a female client?
A. One-half of all breast cancer deaths occurs in women ages 35 to 45.
B. The tail of Spence area must be included in the self-examination.
C. The position of choice for the breast examination is supine.
D. A pad should be placed under the opposite scapula of the breast being palpated.
Correct Answer: B. The tail of Spence area must be included in the self-examination.
The tail of Spence, an extension of the upper outer quadrant of breast tissue, can develop breast tumors. This area must also be included in breast self-examination. As the fingers traverse the breasts, they must remain in contact with the skin to avoid missing any tissue plane. Assessment of the inner half of the breasts requires changing to a supine position, removing the hand from the forehead, and placing the inactive arm at a right angle on the examination surface.
Option A: One-half of all women who die of breast cancer are older than age 65. Breast cancer is the most prevalent malignancy among female populations and is responsible for the second-highest number of cancer-related deaths in American women. The need for early detection has manifested several screening initiatives intent on curtailing morbidity and mortality associated with the disease.
Option C: The correct position for breast self-examination is not limited to the supine position; the sitting position with hands at sides, above head, and on the hips is also recommended. A visual survey of the breast tissue requires an inspection from three angles, with arms at the side, arms raised above the head while bending forward, and hunched over with the hands placed on the hips. Each of these positions should be observed in a mirror from a direct view, right profile, and left profile.
Option D: A pad is placed under the ipsilateral (e.g., same side) scapula of the breast being palpated. The middle fingertip pad should be used to perform small circles with light, medium, and deep pressure investigating varying depths of breast tissue. To complete the examination of the breast’s outer half, up and down motions of palpation are performed medially from the axilla to the nipple and vertically from the clavicle to just below the bra line.