OBSERVATION OF WOMEN’S BREASTS

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OBSERVATION OF WOMEN’S BREASTS

Chapter contents

INTRODUCTION

The routine observation in clinical practice does not normally include a woman’s breasts, but is carried out when a patient reports specific breast problems such as tenderness, pain or lumps.

The symptoms and signs related to the breast are discussed in Part 5, Chapter 88.

CHANNELS INFLUENCING THE BREASTS

The channels coursing through the breasts are illustrated in Figure 12.1.

Fig. 12.1 Channels coursing through the breast

As we can see, the main channels influencing the breast are the Liver, Stomach and Penetrating Vessel: in addition, the Muscle channels of the Heart, Pericardium and Gall-Bladder also flow through the breast. In the internal anatomy of the breast, the various structures are influenced by the following channels or tissues:

• glandular lobes: Stomach channel

• milk ducts: Stomach channel and Penetrating Vessel

• nipple: Liver channel

• areola: Penetrating Vessel

• adipose tissue in breast: fat tissue (Gao)

• connective tissue compartments: Membranes (Huang)

• blood vessels in the breast: Penetrating Vessel.

Box 12.1 summarizes the channels influencing the breasts.

BOX 12.1 CHANNELS INFLUENCING THE BREASTS

• Penetrating Vessel

• Heart Muscle channel

• Pericardium Muscle channel

• Gall-Bladder Muscle channel

BREAST SIZE

Small breasts

Symptoms and Signs, Chapter 88

By ‘small breasts’ here is not meant breasts that are constitutionally small but that have become small. If the breasts become smaller, it indicates Qi and Blood deficiency or Yin deficiency. The sagging of the breasts may indicate Stomach deficiency or dryness of the Blood.

Breast distension

Interrogation, Chapter 46; Symptoms and Signs, Chapter 88

Breast distension is both a subjective sensation and an objective sign. The patient is uncomfortably aware of the distension of the breasts, and this distension is visible. It is very common in premenstrual syndrome. By far the most usual cause of this sign is Liver-Qi stagnation. It should be remembered that Qi stagnation can occur also in the Lungs and Lung-Qi stagnation may also cause breast distension. A slight breast distension may also occur with a Spleen and Kidney deficiency.

Swollen breasts

Symptoms and Signs, Chapter 88

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