The nurse is performing a breast examination and is palpating into the tail of Spence. The nurse understands that this is necessary for which of the following reasons?
1. It does not contain any lymph nodes.
2. It can show the difference between fibrocystic disease and fibroadenomas.
3. Breast cancer occurs more frequently in this area.
4. Peau d'orange may occur in this area of the breast.
3
Rationale 1: The area of the tail of Spence is in the upper outer quadrant of the breast into the axillary region, which does contain lymph nodes; therefore, this statement is not accurate.
Rationale 2: It would be difficult to detect the difference between fibrocystic disease, breast cancer, and fibroadenomas by palpation alone—correlating physical symptoms with physical findings during exam and possibly a biopsy would make the definitive diagnoses.
Rationale 3: Breast cancer does occur more frequently in this area. The incidence of breast cancers is highest in the upper outer quadrant, including the axillary tail of Spence.
Rationale 4: Peau d'orange and Paget's disease are changes in the breast skin and nipple area associated with forms of cancer; therefore, palpation in the tail of Spence area would not be a detection method for these abnormalities.
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