Introduction, explanation, consent
- Date of Birth
- Same gender as the patient, for reassurance and reasons of liability
Ask about pain
Exposure - chest to waist
- Hands on thighs:
- Hands on waist
- Arms crossed above head
- Hands on knees, leaning forwards to examine the pendulous breasts
- Crouched down, at breast level
- Changes in shape and contour of the breast
- Skin changes(Peau d'orange)
- Nipple changes (Inverted, Paget's disease, Excoriation)
- Radiotherapy marks
- Ask the patient to raise the arm on the side of the breast being examined
Imagine the breast as a clock, with the nipple at the centre of the hands.
- Move in a spiral, moving inwards with each turn
- Palpate inwards at each "hour" on the clock
- If any artefacts are found, they may be given a more focussed palpation.
- Supraclavicular nodes
- Neck lymph nodes.
- Summary of all the categories above