Which of the following is NOT considered a normal physical examination finding in an elderly woman?

The presence of puckering of the skin over breast tissue is an observation that raises concern for underlying pathology, such as breast cancer or other breast disorders, rather than a typical age-related change. In elderly women, alterations in breast tissue can occur due to hormonal changes, but puckering or dimpling of the skin indicates a deviation from what is generally expected in a normal physical examination.

On the other hand, reduced saliva production, decreased deep tendon reflexes, and corneal arcus are all findings commonly associated with aging. Reduced saliva production can lead to dry mouth, which is a frequent complaint among older adults. Decreased deep tendon reflexes may occur as a natural consequence of changes in the nervous system with age. Corneal arcus, characterized by a grey or white arc around the cornea, is often associated with aging and does not typically indicate a disease process in elderly individuals.

Therefore, recognizing the distinction between normal age-related changes and potential indicators of underlying health issues is crucial in the assessment of elderly patients. In this context, the puckering of skin over breast tissue stands out as an abnormal finding that warrants further investigation.