BSE,PAP,DRE

7/27/2019 BSE,PAP,DRE

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http://www.nationalbreastcancer.org/breast-self-exam

Breast CancerFacts

WHAT IS BREAST CANCER?

Breast cancer is a disease in which malignant (cancer) cells form in the

tissues of the breast. The damaged cells can invade surrounding tissue, but

withearly detectionandtreatment, most people continue a normal life.

CAUSES OF BREAST CANCER: HOW DID THIS

HAPPEN?

When youre told that you have breast cancer, its natural to wonder what may

have caused the disease. But no one knows the exact causes of breast cancer.

Doctors seldom know why one woman develops breast cancer and anotherdoesnt, and most women who have breast cancer will never be able to

pinpoint an exact cause. What we do know is that breast cancer is always

caused by damage to a cell's DNA.

KNOWN RISK FACTORS

Women with certainrisk factorsare more likely than others to develop breast

cancer. A risk factor is something that may increase the chance of getting a

disease. Some risk factors (such as drinking alcohol) can be avoided. But most

risk factors (such as having a family history of breast cancer) cant be avoided.
http://www.nationalbreastcancer.org/breast-self-examhttp://www.nationalbreastcancer.org/early-detection-of-breast-cancerhttp://www.nationalbreastcancer.org/early-detection-of-breast-cancerhttp://www.nationalbreastcancer.org/early-detection-of-breast-cancerhttp://www.nationalbreastcancer.org/breast-cancer-treatmenthttp://www.nationalbreastcancer.org/breast-cancer-treatmenthttp://www.nationalbreastcancer.org/breast-cancer-treatmenthttp://www.nationalbreastcancer.org/breast-cancer-risk-factorshttp://www.nationalbreastcancer.org/breast-cancer-risk-factorshttp://www.nationalbreastcancer.org/breast-cancer-risk-factorshttp://www.nationalbreastcancer.org/breast-cancer-risk-factorshttp://www.nationalbreastcancer.org/breast-cancer-treatmenthttp://www.nationalbreastcancer.org/early-detection-of-breast-cancerhttp://www.nationalbreastcancer.org/breast-self-exam


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Having a risk factor does not mean that a woman will get breast cancer. Many

women who have risk factors never develop breast cancer.

Breast Self-Exam

ONCE A MONTHAdult women of all ages are encouraged to perform breast self-exams at least

once a month. Johns Hopkins Medical center states,

Forty percent of diagnosed breast cancers are detected by women who feel a lump,

so establishing a regular breast self-exam is very important.

While mammograms can help you to detect cancer before you can feel a lump,

breast self-exams help you to be familiar with how your breasts look and feel

so you can alert your healthcare professional if there are anychanges.

BSE
http://www.nationalbreastcancer.org/breast-cancer-symptoms-and-signshttp://www.nationalbreastcancer.org/breast-cancer-symptoms-and-signshttp://www.nationalbreastcancer.org/breast-cancer-symptoms-and-signshttp://www.nationalbreastcancer.org/breast-cancer-symptoms-and-signs


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And guess what Ive got for you here today? Its my three super simple

easy steps to performing a monthly breast self exam.

1. Get naked and give those babies a good look over in the

mirror. Put your arms at your side and inspect and then above your

head and inspect. What are you looking for? Good question. Youre

looking for changes in the contour (the outline of the breast), swelling,

dimpling of the skin, or changes in the nipples. Finally, push your

palms against hips and flex your chest muscles. Look for any

dimpling or puckering in either breast.
http://www.wendy-nielsen.com/wp-content/uploads/2012/10/breast-self-exam-three-steps.jpg


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2. Time to jump in the shower and lather up! Seriously. Your slick

hands move more easily over your breasts. So, use the pads of your

fingers and move around your entire breast in a circular pattern

moving from the outside to the center. Check the entire breast and

armpit area for any lumps, thickening, or knots.

3. Lay back and relax. Yes, your breasts will probably fall into your

armpits but what can you do, right? Throw a pillow under one

shoulder and put that arm behind your head. Using your opposite

hand, move the pads of your fingers around your breast gently insmall circular motions covering the entire breast area and armpit.

Switch sides. Youre looking for lumps, thickening, or knots. And

dont forget to squeeze your nipples as you are looking for any

unusual discharge or lumps.

5 STEPS IN BSE

Source: www.cancer.org


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1. Begin by looking at your breasts in the mirror with yourshoulders straight and your arms on your hips.

Here's what you should look for:

Breasts that are their usual size, shape, and color.

Breasts that are evenly shaped without visible distortion or swelling.

If you see any of the following changes, bring them to your doctor'sattention:

Dimpling, puckering, or bulging of the skin.


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A nipple that has changed position or become inverted (pushed

inward instead of sticking out).

Redness, soreness, rash, or swelling.

2. and 3. Raise your arms and look for the same changes.

While you're at the mirror, gently squeeze each nipple between your finger

and thumb and check for nipple discharge (this could be a milky or yellow

fluid or blood).


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4. Feel your breasts while lying down, using your right hand to feel

your left breast and then your left hand to feel your right breast.

Use a firm, smooth touch with the first few fingers of your hand,keeping the fingers flat and together.

Cover the entire breast from top to bottom, side to sidefrom your

collarbone to the top of your abdomen, and from your armpit to your

cleavage.


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5. Finally, feel your breasts while you are standing or sitting. Many

women find that the easiest way to feel their breasts is when their

skin is wet and slippery, so they like to do this step in the shower.Cover your entire breast, using the same hand movements described

in Step 4.


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Womens Health

http://womenshealth.gov/publications/our-publications/fact-sheet/pap-test.cfm

PAP SmearWhat is a Pap test?

The Pap test, also called a Pap smear, checks for changes in the cells of

your cervix. The cervix is the lower part of the uterus (womb) that opens intothevagina (birth canal). The Pap test can tell if you have an infection, abnormal

(unhealthy) cervical cells, or cervical cancer.

A Pap smear is a simple procedure in which cells are removed from the

lower end of the womb (cervix) during an internal examination of the vagina.

The cells are smeared onto aslide and sent to the laboratory, where trained

scientists examine the cells under a microscope

Why do I need a Pap test?

A Pap test can save your life. It can find the earliest signs ofcervical cancer. If

caught early, the chance of curing cervical cancer is very high. Pap tests also

can find infections and abnormal cervical cells that can turn into cancer cells.

Treatment can prevent most cases of cervical cancer from developing.

Getting regular Pap tests is the best thing you can do to prevent cervical

cancer. In fact, regular Pap tests have led to a major decline in the number of

cervical cancer cases and deaths.
http://womenshealth.gov/publications/our-publications/fact-sheet/pap-test.cfmhttp://womenshealth.gov/publications/our-publications/fact-sheet/pap-test.cfmhttp://womenshealth.gov/glossary/#cervixhttp://womenshealth.gov/glossary/#uterushttp://womenshealth.gov/glossary/#vaginahttp://womenshealth.gov/glossary/#cervical_cancerhttp://womenshealth.gov/glossary/#cervical_cancerhttp://womenshealth.gov/glossary/#cervical_cancerhttp://womenshealth.gov/glossary/#cervical_cancerhttp://womenshealth.gov/glossary/#vaginahttp://womenshealth.gov/glossary/#uterushttp://womenshealth.gov/glossary/#cervixhttp://womenshealth.gov/publications/our-publications/fact-sheet/pap-test.cfm


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Procedure:


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DREhttp://www.uhs.nhs.uk/media/suhtideal/doctors/medicalstudentresources/surgery/digitalre

ctalexamination.pdf

DIGITAL RECTAL EXAMINATION

Nick Purkis

DIGITAL RECTAL EXAMI NATION

An examination in which a doctor inserts a lubricated, gloved finger into the rectum to

feel for abnormalities.Rectal examination is inexpensive, relatively non--invasive, and non

morbid _ CancerNet

Common reasons to perform the DRE:

Prostate cancer screening

Urological symptoms

Colorectal cancer screening

Patient consent is imperative for all invasive procedures. Verbal consent only for DRE,

but do document in the notes that you gained consent from the appropriate person.

Common positions for the DRE

Left lateral position Modified lithotomy (patient on back, knees flexed) Standing, hips flexed with upper body on couch

Performing the DRE Most hospital patients will be lying on their beds They will need to bring their knees right up to their chest Glove both hands Gently separate the buttocks Inspect the perineum Palpate any abnormal areas, noting lumps or tenderness
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Performing the DRE

Ask the patient about any localized feelings of pain or tenderness. Generously lubricate the gloved index finger Inform the patient that you are going to insert your finger

With your right hand insert your index finger into the anus aiming for the Belly Button Perform a full 360 degree sweep assessing abnormalities

Examining the rectum

Examine the posterior and lateral walls of the rectum by rotating the finger at 180degrees

In order to palpate the entire rectum you need to turn away from the patient and pronateyour wrist

Sweep your finger around the anterior and anterolateral walls of the rectum Note the texture and elasticity of the rectal lining

DRE: Possible findings

Normal mucosa feels uniformly smooth and pliable to palpate Polypsmay be attached by stalk or base Masses or irregular shaped nodules Areas of unusual hardness Abscesses (perirectal sepsis) may be indicated by extreme tenderness Haemorrhoids (internal or external)DRE: Examining the prostate

For MALE patients:

Inform the patient that you are going to examine his prostate gland Sweep your finger over the prostate gland (anteriorly through the rectal wall) Identify the two lobes, and the longitudinal groove (median sulcus) Note the size, nodularity, consistency and tenderness of the prostate

DRE: Prostate exam: Possible findings

A.Normal prostate; About 2.5 cms across Prominent median sulcus Smooth, rubbery consistency Tenderness not usual, but patients should feel the need to urinate


B. Benign Prostatic hypertrophy (BPH) Enlargement of the gland is usually symmetrical Marked protrusion into the rectal lumen Smooth with no nodularity


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Median sulcus may be indistinguishable Consistency is rubbery, or slightly elastic


C. Prostate cancer Asymmetric shape Hard consistency Discrete nodule may be palpable Median sulcus often obscured

Concluding the examination

Inform the patient that you have finished Note the colour of any soiling on your glove Offer the patient a tissue Allow the patient to get dressed, sit down and prepare themselves for discussing results

Explain your findings to the patient Negotiate a follow up plan / tests /investigations Address the patients concerns Summary of issues Obtain consent Chaperone if possible communication.

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