Methods of mammary gland research

by Abbas Jahangir · July 6, 2024

Regular preventive mammary examinations are essential to detect breast cancer in its earliest and most treatable stages.

What are the main methods of breast examination?

Medical history

Taking a detailed history is extremely important in any disease of the mammary gland. It should be specified how puberty went, how many pregnancies, births, breastfeedings, abortions the patient had, whether the menstrual cycle is normal or if there are some peculiarities, whether she or her blood relatives have tumors, whether there is discharge from the breast, etc.

View

The examination of the mammary gland is carried out in frontal, profile, upright and supine position. The shape, size, position of the gland, its symmetry, the appearance of the nipples, the condition of the skin and the pigmented part are examined. An examination is made when lifting and moving the hands, the condition of the superficial vascular network is also examined.

Palpation

By palpation, both mammary glands are thoroughly examined, not missing any part of the gland. The condition of the skin, its mobility, unevenness, the presence or absence of pathological seals is examined. The regional lymph nodes are also examined by palpation.

Palpation of the mammary gland can reveal:

areola thickening
indentation of the skin around the areola
“orange peel” symptom, which is looked for by cupping the skin with both fingers
thickening, nodulation or lobulation of the gland.

Various changes can occur in the female breast, such as atrophy, necrosis, fibrosis, etc.

Breast self-examination by palpation

Very often, women discover breast diseases quite by accident. Since prevention is very important, every woman should know the method of breast self-examination by palpation.

Breast self-examination by palpation is carried out in the following way:

the woman lies down with a pillow under her left shoulder and puts her left hand behind her head. Thus, the breast is stretched more evenly on the chest.
the left breast is felt with the right hand and lumps are looked for
the entire breast is explored, with the fingers moving in smaller and smaller circles until the nipple is reached
the movements are performed by moving the fingers at small distances and with strong pressure
palpation is performed with the fingers together and with their flat part, not with the tips.

The right mammary gland is examined by placing a pillow under the right shoulder and the right hand behind the head. The right breast is felt with the left hand.

Self-examination by palpation continues, starting from the armpit, the fingers with slow movements make a large circle around the outside of the breast.

Special methods for examining the mammary gland

Special methods of breast examination include:

Non-contrast mammography

Non-contrast mammography has high sensitivity and is used as the main screening method in women over 40-45 years of age. It is made in two projections – front and profile.

The main objectives of the mammographic examination are:

detection of tumors that cannot be palpated
distinguishing between benign and malignant processes
specifying the localization and distribution of the process
evaluate the dynamics of changes after conservative treatment.

In different diseases, the images are different, for example:

in mastopathy, diffusely distributed small clearings are visible throughout the gland
in fibroadenoma – bright outlines
in carcinoma – a shadow with radial adhesions towards the periphery.

Other special methods of breast examination are:

ultrasound examination
aspiration biopsywith subsequent cytological examination. In case of doubt in the cytological result, an extended sector excision is performed with subsequent biopsy and examination of sexchromatin – Barr bodies.
galactography – the contrast agent is introduced through the main opening of the milk ducts in the area of the nipple. This study allows to determine the size and location of the tumor, especially papillomas of the milk ducts.
lymphography – lymphatic metastases are detected under the pectoral muscles, in the axilla, in the subclavian and supraclavicular spaces and around the sternum.
Breast MRI – used for prophylactic purposes in women with a family history of breast cancer and for diagnostic purposes to establish the exact location of the tumor and assess the need for a biopsy.