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Breast Examination

From Mediwikis

Introduction, explanation, consent

  • Name
  • Date of Birth

Chaperone

  • Same gender as the patient, for reassurance and reasons of liability

Wash Hands

Ask about pain

Exposure - chest to waist

Inspection

Patient positions

  • Hands on thighs:
  • Hands on waist
  • Arms crossed above head
  • Hands on knees, leaning forwards to examine the pendulous breasts

Your view

  • Front
  • Side
  • Crouched down, at breast level

Abnormalities

  • Asymmetry
  • Changes in shape and contour of the breast
  • Skin changes(Peau d'orange)
  • Nipple changes (Inverted, Paget's disease, Excoriation)
  • Lumps
  • Discharge
  • Scars
  • Radiotherapy marks

Palpation

Breasts

  • Ask the patient to raise the arm on the side of the breast being examined
2 Methods

Imagine the breast as a clock, with the nipple at the centre of the hands.

  1. Move in a spiral, moving inwards with each turn
  2. Palpate inwards at each "hour" on the clock
  • If any artefacts are found, they may be given a more focussed palpation.

Lymph Nodes

  • APICAL
    • Anterior
    • Posterior
    • Infraclavicular
    • Central
    • Axial
    • Lateral
  • Supraclavicular nodes
  • Neck lymph nodes.

Lump Description

Summary

  • Name
  • Age
  • Summary of all the categories above

Thank the patient

Wash hands