By Paul D. Chan MD, Susan M. Johnson MD
Gynecology and Obstetrics summarizes prognosis and administration of universal issues that ensue in ladies. this article experiences licensed remedy guidance for either inpatients and outpatients. 149 pages.
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Additional info for Gynecology and Obstetrics, 2004 Edition
Breast Masses A. The normal glandular tissue of the breast is nodular. Nodularity is a physiologic process and is not an indication of breast pathology. Dominant masses may be discrete or poorly defined, but they differ in character from the surrounding breast tissue. The differential diagnosis of a dominant breast mass includes macrocyst (clinically evident cyst), fibroadenoma, prominent areas of fibrocystic change, fat necrosis and cancer. B. Cystic Breast Masses 1. Cysts are a common cause of dominant breast masses in premenopausal women more than 40 years of age, but they are an infrequent cause of such masses in younger women.
About 8% of biop sies performed for nipple discharge demonstrate cancer. The duration, bilaterality or unilaterality of the discharge, and the presence of blood should be determined. A history of oral contraceptives, hor mone preparations, phenothiazines, nipple or breast stimulation or lactation should be sought. Dis charges that flow spontaneously are more likely to be pathologic than discharges that must be manually expressed. 2. Unilateral, pink colored, bloody or non-milky dis charge, or discharges associated with a mass are the discharges of most concern.
Physical examination A. The breasts should be inspected for asymmetry, deformity, skin retraction, erythema, peau d'orange (indicating breast edema), and nipple retraction, discoloration, or inversion. B. Palpation 1. The breasts should be palpated while the patient is sitting and then supine with the ipsilateral arm extended. The entire breast should be palpated systematically. 2. The mass should be evaluated for size, shape, tex ture, tenderness, fixation to skin or chest wall. The location of the mass should be documented with a diagram in the patient’s chart.